Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T06:04:13.601Z Has data issue: false hasContentIssue false

5b - Classification of Complex Disorders Is a Challenge Solved by Simplicity: Commentary on Controversies in the Classification and Diagnosis of Personality Disorders

from Part II - Models

Published online by Cambridge University Press:  24 February 2020

By
Peter Tyrer
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
Get access

Summary

Because personality disorders are seen as highly complex there is a natural tendency to describe them in convoluted and multifaceted language. Novelists and playwrights have done this for hundreds of years; it is not the task of nosologists to repeat it. Instead we need a simpler classification of a very common disorder, as even if we lose some of the subtlety of the condition this is more than compensated by greater use and understanding. We also need to pay more attention to science rather than to clinical intuition in our terminology. Both the DSM-5 alternative model and the new ICD-11 classification have moved towards a dimensional system of classification that should help in selecting treatment and diluting the pervasive and unhelpful spread of the grossly heterogeneous condition, horderline. This has hindered progress and made us forget the many parts of personality disorder that are not in any way connected to the borderline spectrum and yet which are highly relevant pathologies.

Keywords

classificationborderline personality disorderutilityacceptabilityfive-factor model
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 115 - 117
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Clark, L. A. (2007). Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annual Review of Psychology, 58, 227–257.CrossRefGoogle Scholar
Department of Health. (2009). Borderline Personality Disorder: Recognition and Management. NICE Clinical Guideline [CG78]. London: Department of Health.Google Scholar
Herpertz, S. C., Huprich, S. K., Bohus, M., Chanen, A., Goodman, M., Mehlum, L., … Sharp, C. (2017). The challenge of transforming the diagnostic system of personality disorders. Journal of Personality Disorders, 31, 577–589.CrossRefGoogle ScholarPubMed
Hopwood, C. J., Kotov, R., Krueger, R. F., Watson, D., Widiger, T. A., Althoff, R. R. … Zimmermann, J. (2018). The time has come for dimensional personality disorder diagnosis. Personality and Mental Health, 12, 82–86.CrossRefGoogle ScholarPubMed
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42, 1879–1890.Google Scholar
Tyrer, P. (2018). Dimensions fit the data, but can the clinicians fit the dimensions? World Psychiatry, 7, 295–296.Google Scholar
Tyrer, P., Crawford, M., Mulder, R., Blashfield, R., Farnam, A., Fossati, A., … Reed, G. M. (2011). The rationale for the reclassification of personality disorder in the 11th revision of the International Classification of Diseases (ICD-11). Personality and Mental Health, 5, 246–259.CrossRefGoogle Scholar
Tyrer, P., Reed, G. M., & Crawford, M. J. (2015). Classification, assessment, prevalence and effect of personality disorder. Lancet, 385, 717–726.Google Scholar
Verheul, R., Bartak, A., & Widiger, T. (2007). Prevalence and construct validity of Personality Disorder Not Otherwise Specified (PDNOS). Journal of Personality Disorders, 21, 359–370.CrossRefGoogle ScholarPubMed
Widiger, T. A. (2007). Dimensional models of personality disorder. World Psychiatry, 6, 79–83.Google ScholarPubMed
Widiger, T. A., Livesley, W. J., & Clark, L. A. (2009). An integrative dimensional classification of personality disorder. Psychological Assessment, 21, 243–255.Google Scholar
World Health Organization. (2018). International Classification of Diseases (11th revision, ICD-11). Geneva: World Health Organization. www.who.int/classifications/icd/Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×