Personality disorder in DSM-5: an oral history.
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.
Department of Psychology,Auburn University Montgomery,Montgomery,AL,USA.
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Zachar
Department of Psychology,University of Minnesota,Minneapolis, MN,USA.
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Krueger
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.
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Kendler
D039721:Diagnostic and Statistical Manual of Mental Disorders; D049674:History, 21st Century; D006801:Humans; D010554:Personality Disorders / Q000145:classification* / Q000266:history
DSM-5; history; personality disorder