Journal Article

The Challenge of Transforming the Diagnostic System of Personality Disorders

Newton-Howes, Giles, Goodman, Marianne, Moran, Paul, Huprich, Steven K., Chanen, Andrew, Mehlum, Lars, Sharp, Carla, Bohus, Martin, Herpertz, Sabine C., Scott, Lori

2017

Overview

While the DSM-5 alternative model of personality disorder (PD) diagnosis allows the field to systematically compare categorical and dimensional classifications, the ICD-11 proposal suggests a radical change by restricting the classification of PDs to one category, deleting all specific types, basing clinical service provision exclusively upon a severity dimension, and restricting trait domains to secondary qualifiers without defining cutoff points. This article reflects broad international agreement about the state of PD diagnosis. It is argued that diagnosis according to the ICD-11 proposal is based on broad, potentially stigmatizing descriptions of impaired functioning and ignores much of the impressive body of research and treatment guidelines that have advanced the care of adults and adolescents with borderline and other PDs. Before radically changing classification, which highly impacts the provision of health care, head-to-head field trials coupled with the views of patients as well as thorough debate among scientists are urgently needed.

• Publisher: Guilford Press
• Subject: Adolescents / Adult / Adult Development / Adults / Alternative approaches / Classification / Clinical medicine / Departments / Diagnostic and Statistical Manual of Mental Disorders / Disorders / Field trials / Health care / Health services / Humans / Medical diagnosis / Mental Disorders / Mental Health Programs / Modeling (Psychology) / Patient satisfaction / Patients / Personality / Personality Assessment / Personality Change / Personality disorders / Personality Disorders - diagnosis / Personality Problems / Personality Studies / Personality Traits / Psychiatry / Psychopathology / Psychotherapy / Quantitative psychology / Stigma