#DSM 5 PERSONALITY DISORDERS MANUAL#

Thus the DSM-5 trait model is based upon and informed by other well-known trait models of personality and personality pathology that can themselves be seen as consensual ( Widiger & Simonsen, 2005 Wright et al., in review), and which can provide a higher-order structure within which to fit a number of lower-order traits relevant to PD. A fifth dimension involving Psychoticism was added to capture РІР‚ВCluster AРІР‚в„ў features given that Openness to Experience has shown limited associations with PD (although, see Piedmont et al., 2009), rendering the higher order model very similar to the Personality Psychopathology-5 (PSY-5 Harkness & McNulty, 1994), which is itself undergirded by a substantial empirical literature supporting its validity for depicting variants of personality pathology, as well as connections to major domains of temperament ( Tellegen, 1985 Clark & Watson, 1999). The focus in the DSM-5 model was on maladaptive variants of these constructs, although additional scales were also created to accommodate personality disorders related to the typically more adaptive pole of a given trait (specifically, Histrionic PD and Extraversion, Obsessive-Compulsive PD and Conscientiousness). The traits for this measure were based on an extensive literature showing robust associations between four higher order factors of the Five Factor Model (FFM Samuel & Widiger, 2009 Widiger & Trull, 2007) and similar models ( Widiger & Simonsen, 2005 Watson, Clark, & Harkness 1994) with personality pathology: Introversion (similar to Detachment), Antagonism, Emotional Dysregulation (Negative Emotionality), and Impulsivity (Disinhibition) (see ). Lines in facets indicate corresponding higher order domains. PD = Personality Disorder, STPD = Schizotypal PD, ASPD = Antisocial PD, BPD = Borderline PD, NPD = Narcissistic PD, AVPD = Avoidant PD, OCPD = Obsessive-Compulsive PD. Traits that are proposed as criteria for each retained PD in the DSM-5 are in bold. These traits can also be used to augment the description of patients who meet criteria for another PD when they are not listed in Criterion B for that disorder.

Criterion B would be a list of elevated pathological traits from a hierarchical model composed of 5 higher order domains (Negative Affectivity, Detachment, Disinhibition, Antagonism, and Psychoticism) which in turn encompass 25 lower-order traits or facets (see Table 1). Criterion A would involve general deficits in self and interpersonal functioning and Criterion C-E would remain the same. As of this writing, all criteria and all features of criteria A and B would need to be met for a diagnosis, representing a shift from the polythetic criteria sets employed in DSM-IV.Р”Р„ patient with personality pathology who does not fit at least one of the six diagnostic categories would be classified using the PD-Trait Specified (PDTS) diagnosis. Criterion C involves stability across time and situations, Criterion D involves distinguishing culturally or developmentally normative personality features from clinical pathology, and Criterion E is a rule out for medical or substance-related causes of personality problems.

Criterion B is a constellation of pathological personality traits descriptive of the disorder. Criterion A involves impairments in self (i.e., identity and self-direction) and interpersonal (i.e., empathy and intimacy) functioning tailored to each PD. For patients with clinically significant personality pathology, 6 specific PDs (Antisocial, Avoidant, Borderline, Narcissistic, Obsessive-compulsive, and Schizotypal) would be assessed according to 5 criteria. A patientРІР‚в„ўs overall level of personality functioning would first be evaluated on a continuous dimension of severity of self and interpersonal dysfunction to determine whether a diagnosis of PD was merited. Unlike the DSM-IV, in which ten PDs were represented as distinct categories with polythetic criteria, in the most recent DSM-5 proposal ( ) PD would be diagnosed as follows.

#DSM 5 PERSONALITY DISORDERS MANUAL#

There will be a considerable transition in personality disorder (PD) description moving from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV American Psychiatric Association, 1994) to the DSM-5.

Dsm 5 personality disorders