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A new way of looking at personality disorders?

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A study published in the Journal Psychiatric Practice before the release of the DSM-V had suggested a potentially helpful new way of categorizing and thinking about personality disdorders. On the one hand, the authors suggest that we think of certain personality disorders as exhibiting specific 'core' dimensions. On the other hand, the research suggests thinking of "various maladaptive personality traits found in individual patients" that might not be essential to that personality disorder. This model was known as a "hybrid categorical-dimensional model." Among the goals the researchers proposed for the DSM-V were:

Reducing overlap among personality disorder diagnoses
Reducing heterogeneity among patients receiving the same diagnosis
Eliminating arbitrary diagnostic thresholds with little or no research basis
Addressing the widespread use of the vague "personality disorder not otherwise specified" diagnosis
Providing diagnostic thresholds that are related to level of impairment in a meaningful way(Wolters Kluwer Health, 2013)

While the model was endorsed by the DSM-V task force, the more traditional DSM-IV model of personality disorders was maintained. Psychologists were concerned, however:

A key concern was whether the new model would lead to discrepancies between DSM-IV and DSM-5 definitions of the same disorder -- especially for diagnoses such as borderline, antisocial, and schizotypal personality disorders for which a substantial body of research literature exists. "It is important to evaluate whether thresholds can be established that provide solid continuity between DSM-IV and proposed DSM-5 definitions," Drs Morey and Skodol write (Wolters Kluwer Health, 2013)

The study looked at 337 patients, however, who were diagnosed with both systems, and it was determined that the diagnostic categories of the classical DSM-IV model and the proposed model for the DSM-V exhibited a great deal of correspondence and consistency. "The two models agreed well for various subtypes, including borderline, avoidant, obsessive-compulsive, antisocial, narcissistic, and schizotypal personality disorders" (Wolters Kluwer Health, 2013).

Wolters Kluwer Health. (2013, May 10). Study supports alternative model for personality disorders in upcoming DSM-5. ScienceDaily. Retrieved June 17, 2014 from www.sciencedaily.com/releases/2013/05/130510124554.htm

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