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Personality disorder in DSM-5: an oral history

Published online by Cambridge University Press:  20 October 2015

P. Zachar ,
R. F. Krueger  and
K. S. Kendler
P. Zachar
Affiliation:
Department of Psychology, Auburn University Montgomery, Montgomery, AL, USA
R. F. Krueger
Affiliation:
Department of Psychology, University of Minnesota, Minneapolis, MN, USA
K. S. Kendler*
Affiliation:
Department of Psychiatry and Department of Human and Molecular Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
*
*Address for correspondence: K. Kendler, MD, Department of Psychiatry and Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Box 980126, 800 E. Leigh Street, Room 1-123, Richmond, VA 23298-0126, USA. (Email: [email protected])
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Abstract

As the revision process leading to DSM-5 began, the domain of personality disorder embodied the highest aspirations for major change. After an initial prototype-based proposal failed to gain acceptance, the Personality and Personality Disorders Work Group (P&PDWG) developed a hybrid model containing categorical and dimensional components. A clash of perspectives both within the P&PDWG and between the P&PDWG and DSM-5 oversight committees led to the rejection of this proposal from the main body of DSM-5. Major issues included conflicting ways of conceptualizing validation, differences of opinion from personality disorder experts outside the P&PDWG, divergent concepts of the magnitude of evidence needed to support substantial changes, and the disagreements about clinical utility of the hybrid model. Despite these setbacks, the ‘Alternative DSM-5 Model of Personality Disorder’ is presented in Section III of the DSM-5. Further research should clarify its performance relative to the DSM-IV criteria reprinted in the main DSM-5 text.

Keywords

DSM-5historypersonality disorder
Type
Review Article
Information
Psychological Medicine , Volume 46 , Issue 1 , January 2016 , pp. 1 - 10
Copyright
Copyright © Cambridge University Press 2015 

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