Personality disorders and the DSM-5: Scientific and extra-scientific factors in the maintenance of the status quo

Abstract

The classification of mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) remains overwhelmingly categorical, despite substantial evidence that personality disorders (PDs), at least, are better conceptualised from a dimensional perspective. Why is this so? What would it have meant, on a clinical, professional and scientific level, if dimensions-derived from research on normal personality-had been applied to psychiatric disorders? In the following, we review the literature supporting the legitimacy of a dimensional model of PDs, and discuss various explanations for why such a model was ultimately rejected-including the possible fear that it would induce a 'scientific revolution' in psychiatry, leading to a fundamental paradigm shift in the field. Discussion of the fundamentals of psychiatric nosology is as relevant today as a hundred years ago (Kendell, 1975; Spitzer and Wilson, 1975; Zachar and Kendler, 2010). As explicitly acknowledged in the DSM-5, diagnosis should be guided by current knowledge and based on theoretical

Relationships between self-reported childhood traumatic experiences, attachment style, neuroticism and features of borderline personality disorders in patients with mood disorders

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Modern Scientific Views on the Clinic, Systematics, Diagnosis and Pathopersonalogy of Endogenous Psychosis With Episodic Course (Literature Riview)

“…Однією зі складних для вирішення проблем особистісних розладів є прояви агресії. П'ятифакторна модель оцінки розладів особистості, яка увійшла до DSM-V на думку O. Gøtzsche-Astrup та A.Moskowitz (2016) є проміжною, та набуде значних трансформацій в наступних класифікаціях [37].…”

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“…However, both in the American DSM‐5 and the upcoming 11th edition of WHO's International Classification of Diseases (ICD‐11), the conceptualizations of mental disorders incorporate a dimensional perspective in the diagnostic criteria . This change is partly due to several meta‐analyses that point to a large overlap between extreme scores on normal personality inventories and reaching the diagnostic thresholds for personality disorders .…”