scholarly journals Sociocultural Context and the DSM-5 Alternative Model of Personality Disorder: Comment on Widiger & Hines

2022 ◽  
Author(s):  
Craig Anthony Rodriguez-Seijas
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Sociocultural Context ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Psychological Stressors ◽  
And Gender ◽  
Theory Research

Widiger and Hines provide a brief overview of the development of the Alternative Model of Personality Disorder (AMPD) housed within Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). They highlight eight issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a ninth issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: 9) How is sociocultural context to be accommodated in AMPD—and more generally personality disorder—theory, research, and treatment? The historical intra-individual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and which hold potential to adversely affect sexual and gender minoritized populations, among others.

The DSM’s Reconnection to Psychoanalytic Theory through the Alternative Model for Personality Disorders

2019 ◽  
Vol 67 (6) ◽  
pp. 1023-1045 ◽  
Author(s):  
Adam P. Natoli
Keyword(s):  
Personality Disorders ◽  
Alternative Model ◽  
Psychoanalytic Theory ◽  
Diagnostic System ◽  
Personality Pathology ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Psychodynamic Diagnostic Manual ◽  
Current Systems

Often believed to have Kraepelinian origins, the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM-5) defines personality disorders using a categorical, hierarchical taxonomic system. This system possesses many long-standing problems for clinical practice, including a large assortment of symptom combinations that contribute to problematic heterogeneity and likely impair diagnostic validity. The DSM diagnostic system was at one time heavily influenced by psychoanalytic theory (Shorter 2005). A desire for greater theoretical neutrality then encouraged a shift away from psychoanalytic theory, resulting in the problematic atheoretical model of personality pathology introduced in DSM-III (1980) and still used today. The Alternative Model for Personality Disorders (AMPD), introduced in DSM-5 (2013), is an attempt to reconcile many of the categorical model’s issues and directly parallels primary themes that characterize psychoanalytic models of personality. After a review of the historical development of DSM, three current systems for diagnosing personality pathology—the DSM-5’s categorical model (2013), its AMPD (2013), and the Psychodynamic Diagnostic Manual (2nd ed.; Alliance of Psychoanalytic Organizations 2017) are compared. The comparison illustrates how the AMPD brings psychoanalytic theory back into the DSM system and acknowledges the implications of a more psychoanalytic DSM.

scholarly journals If an Entrepreneur Founded the DSM-5 Alternative Model of Personality Disorder: When Axis II Meets Disruptive Innovation

2022 ◽  
Author(s):  
Jennifer L Tackett ◽  
Kathleen Wade Reardon ◽  
Melissa Kaufman ◽  
Ryne A. Sherman
Keyword(s):  
Personality Disorder ◽  
Alternative Model ◽  
Developmental Process ◽  
Disruptive Innovation ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Paradigm Shifting

Personality disorder (PD) researchers proposed a highly innovative “paradigm-shifting” revamp for the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5; APA, 2013). Yet, ten years later, Widiger and Hines (this issue) summarize a developmental process plagued by disagreement and stagnation, with little evidence of the field having reaped the desired benefits of this diagnostic revolution. In this commentary, we draw on principles from entrepreneurial creation, operation, and success—positioning the personality disorder scientists in the role of “disruptive innovator”—and summarize key principles from the entrepreneurial process that may be relevant in understanding the challenges and failures of the personality disorder revolution to date.

ICD-11 and DSM-5 personality trait domains capture categorical personality disorders: Finding a common ground

2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Personality Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Domain Models

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.

Comorbidity of dsm-iii-r personality disorders in schizophrenic and unipolar mood disorders: a comparative study

1997 ◽  
Vol 12 (6) ◽  
pp. 316-318 ◽  
Author(s):  
P Oulis ◽  
L Lykouras ◽  
J Hatzimanolis ◽  
V Tomaras
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Comparative Study ◽  
Mood Disorder ◽  
Personality Disorders ◽  
Mood Disorders ◽  
Clinical Interview ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Patient Groups

SummaryWe investigated the overall prevalence and the differential comorbidity of Diagnostic and Statistical Manual (DSM)-III-R personality disorders in 166 remitted or recovered patients with schizophrenic (n = 102) or unipolar mood disorder (n = 64). Over 60% of both patient groups met the DSM-III-R criteria of at least one DSM-III-R personality disorder as assessed by means of the Structured Clinical Interview for DSM-III-R (SCID-II-R), receiving on average 3.1 personality diagnoses. Neither DSM-III-R categories of personality disorders, nor scores on its three clusters A, B and C, nor total score on SCID-II-R differed significantly across the two groups. In conclusion, DSM-III-R personality disorders, although highly prevalent in schizophrenic and unipolar mood disorders, lack any specificity with respect to these categories of mental disorders.

Pattern of Comorbidity Among Anxious and Odd Personality Disorders: The Case of Obsessive-Compulsive Personality Disorder

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 23-26 ◽  
Author(s):  
Alessandro Rossi ◽  
Maria Grazia Marinangeli ◽  
Giancarlo Butti ◽  
Artemis Kalyvoka ◽  
Concetta Petruzzi
Keyword(s):  
Personality Disorder ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Odds Ratios ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Cluster A ◽  
Obsessive Compulsive Personality Disorder

AbstractThe aim of this study was to examine the pattern of comorbidity among obsessive-compulsive personality disorder (OCPD) and other personality disorders (PDs) in a sample of 400 psychiatric inpatients. PDs were assessed using the Semistructured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Odds ratios (ORs) were calculated to determine significant comorbidity among OCPD and other axis II disorders. The most elevated odds ratios were found for the cooccurrence of OCPD with cluster A PDs (the “odd” PDs, or paranoid and schizoid PDs). These results are consistent with those of previous studies showing a higher cooccurrence of OCPD with cluster A than with cluster C (“anxious”) PDs. In light of these observations, issues associated with the nosologic status of OCPD within the Diagnostic and Statistical Manual of Mental Disorders clustering system remain unsettled.

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

2015 ◽  
Vol 46 (3) ◽  
pp. 647-655 ◽  
Author(s):  
L. C. Morey ◽  
K. T. Benson ◽  
A. E. Skodol
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Alternative Model ◽  
Work Group ◽  
Taxonomic Structure ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Criterion A ◽  
Dsm Iv

BackgroundThe DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system – antisocial, avoidant, borderline, narcissistic, obsessive–compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses.MethodData were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait–disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters.ResultsFindings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance.ConclusionsAlthough the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

Assessment of Co-occurring Psychiatric Disorders

2019 ◽  
pp. 143-160
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Concerned Significant Others

Co-occurring disorders (CODs) refers to the occurrence of both a substance use disorder (SUD) and a psychiatric disorder, such as mood disorder, anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, eating disorder, antisocial personality disorder, and borderline personality disorder. This chapter reviews the prevalence, patterns, and effects of CODs. Next, the relationships between psychiatric disorders and SUDs, challenges for practitioners, and types and causes of psychiatric disorders are discussed. The chapter continues with the process of conducting a comprehensive and thorough assessment using the format of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The authors also discuss the importance of conveying assessment findings to the client and/or family and concerned significant others, as well as getting the client to accept help.

The Current State of Personality Disorders Through the Lens of PDTRT

2019 ◽  
pp. 25-39
Author(s):  
Carl W. Lejuez ◽  
Alexis Matusiewicz ◽  
Nadia Bounoua ◽  
James Soldinger
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Research Trends ◽  
Current State ◽  
Time Period ◽  
History Of ◽  
Recent Trends ◽  
Theory Research

This chapter examines recent trends in personality disorder research as they appear in one of the top personality disorder journals—Personality Disorders: Theory, Research, and Treatment (PDTRT). The chapter provides an overview of the history of PDTRT, as well as describes the types of submissions and manuscripts published in the journal over the last 5 years. It also reports on research trends over that time period, noting increasing interest in the alternative model for personality disorders, the surfeit of research in borderline personality disorder and psychopathy, the increasing use of dimensional versus categorical approaches, the use of nonclinical samples, and the extension of personality disorder traits to younger populations.

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