Response: Personality disorder is here to stay across the lifespan – a response to Commentaries on the May 2022 Debate

Abstract

Background: The classification of personality disorder is in a state of flux. Revision is necessary, overdue, and is provided by the new ICD-11 classification. Aims: To explain the advantages of the new classification system and why 'borderlne' is a redundant term. To summarise positive and negative views about its implications, especially in young people. Materials and Methods: Review of recent literature and developments. Results: Personality disturbance is ubiquitous and changes across the life span. The data are unequivocal. Discussion: As personality disturbance is so common in childhood and adolescence it should be recognised and acknowledged at this time even though it is very likely to change. Conclusions: The stigma surrounding personality disorder can be countered by science and courage.

The social domains organization of mentalizing processes in adolescents: a contribution to the conceptualization of personality function and dysfunction in young people

“…A firm understanding of what we mean by personality functioning would provide an invaluable starting point for examining impairing variations as candidates for personality dysfunction (Sharp, 2022; Sharp & Wall, 2021). Establishing this approach in adolescence will be particularly relevant because of the importance of differentiating normal and problematic functioning at a time of challenge and change (Hartley et al., 2022; Tyrer, 2022). In this paper we bring together a developmental hypothesis for personality functioning, the social domains hypothesis and current findings on social dysfunction and mentalization processes in borderline personality disorder (BPD; Sharp & Hernandez, 2021), to generate hypotheses for normal and variant patterns of personality functioning.…”

Commentary: Commentary on the Twitter comments evoked by the May 2022 debate on diagnosing personality disorders in adolescents

“…In the May 2022 issue of CAMH , we launched a debate about the value and utility of personality disorder (PD) diagnosis in adolescence (Cannon & Gould, 2022a; Chanen, 2022; Crease, 2022; Elvins & Kaess, 2022; Kingsley, 2022; Schmeck, 2022; Tyrer, 2022a). These articles also generated fervent Twitter discussion (https://twitter.com/HartleySamantha/status/1503706671327109127), which was followed by further commentaries and responses published in CAMH (Cannon & Gould, 2022b; Garralda, 2022; Harding, 2022; Hartley et al., 2022; Tyrer, 2022b). Some reactions to the initial article series illustrate that, after two decades of intensive research and clinical service delivery, diagnosing PD in adolescence remains controversial and emotionally charged among some mental health professionals and some people with lived experience.…”

“…This commentary focuses on some key points raised in the Twitter discussion initiated by @HartleySamantha, who invited people to collaborate on a collective response, which was later published in CAMH (Hartley et al., 2022), and responded to by Tyrer (2022b). Although Twitter commentary is neither peer‐reviewed, nor subject to the requirement of being evidence‐based, we have chosen to address selected, salient Twitter comments because we believe that they represent important social and/or cultural beliefs that are often presented in day‐to‐day practice but are rarely tested in the context of scientific evidence.…”

Response: Sometimes we wish Chris and Sam had died of cancer! – a response to Commentaries on the May 2022 Debate

“… 8 Academic/purist views . Tyrer (2022) argues with academic authority that BPD does not really fit amongst the other ‘personality disorders’. Fine!…”