DSM-5 and the General Definition of Personality Disorder

Jerome C. Wakefield

    Research output: Contribution to journalArticle

    Abstract

    There is a fundamental change proposed for DSM-5 in the general definition of personality disorder, representing a new conceptualization that shapes how the DSM distinguishes personality pathology from other undesirable or negative personality features. The change is needed due to serious deficiencies in the current DSM-IV approach. Specifically, personality disorder is to be conceptualized as impairment in both self organization and interpersonal relating, caused by pathological (extreme) personality traits. This represents progress in that marked impairment in self organization and interpersonal relating are plausibly characteristic of personality disorder. However, the required level of impairment remains too low, and the kinds of impairment are not restricted to those which indicate disorder versus culturally undesirable features. Moreover, extreme traits are neither necessary nor sufficient for personality disorder because personality represents not the sum of traits but the holistic organization of traits and other meanings. The DSM-5's diagnostic focus on traits thus potentially opens the way to massive false positive diagnoses. An earlier proposal to reframe personality disorders using global similarity matching of the patient's condition to prototypical descriptions of specific personality disorders is argued to also lead toward less valid diagnoses.

    Original languageEnglish (US)
    Pages (from-to)168-183
    Number of pages16
    JournalClinical Social Work Journal
    Volume41
    Issue number2
    DOIs
    StatePublished - Jun 1 2013

    Fingerprint

    personality disorder
    Personality Disorders
    Personality
    personality
    self-organization
    personality traits
    pathology
    Diagnostic and Statistical Manual of Mental Disorders
    diagnostic
    Pathology
    organization

    Keywords

    • Classification
    • Diagnosis
    • DSM-5
    • Harmful dysfunction
    • Personality disorders

    ASJC Scopus subject areas

    • Health(social science)
    • Public Health, Environmental and Occupational Health

    Cite this

    DSM-5 and the General Definition of Personality Disorder. / Wakefield, Jerome C.

    In: Clinical Social Work Journal, Vol. 41, No. 2, 01.06.2013, p. 168-183.

    Research output: Contribution to journalArticle

    Wakefield, Jerome C. / DSM-5 and the General Definition of Personality Disorder. In: Clinical Social Work Journal. 2013 ; Vol. 41, No. 2. pp. 168-183.
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