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Changes in regard to personality disorders in the coming DSM-5.

Significant changes are on the horizon with regard to personality disorders in the coming DSM-5. The authors of the source articles are members of the committee reviewing the personality disorders, so it is likely in fact that there will be significant changes made.

Discussion:

As time passes, new disorders arise, some change or we learn new things about them and we need to keep other professionals informed. There have been changes that have been proposed in the new DSM-V for personality disorders (PD).

There is a four-part conceptualization and assessment which focuses on pinpointing personality psychopathology with increasing degrees of specificity, replacing the general criteria for PD ( Skodol, et al., 2011a). This would be beneficial, seeing as there are varying degrees that can be quite broad. Some people may also be simply diagnosed as personality disorder not otherwise specified, which is the 3rd most prevalent with some of these diagnosis being made because there wasn't enough specifics to diagnose the client otherwise. There will be a 5-point scale to rate impairments towards a PD (Skodol, et al., 2011b).

Each of these new categories help as they all have degrees from different aspects that will specify more precisely what a person is dealing with, taking some of the guess work out. With out the specifics, a person may have characteristic symptoms of several PDs. This would allow someone with limited experience to still be able to see if there is a problem and how severe it is (Skodol, et al., 2011b). Severity is very useful as it is the most important predictor of dysfunction (Skodol, et al., 2011a). It would also be beneficial to not have excessive comorbidity, which is supposed to be improved with the addition of Specific PD types as well as trait-based types. This would be another modification because there was no marked temporal instability, no clear boundaries between normal and pathological personality, excessive within-diagnosis heterogeneity and poor convergent validity amongst other things previously mentioned (Skodol, et al., 2011a). The DSM-V will keep the diagnosis of PD but change its criteria to be better defined (Skodol, et al., 2011a).

Source:

Skodol, A. E., Bender, D. S., Oldham, J. M, Clark, L. A., Morey, L. C., Verheul, R., Silver, L. I. (2011). Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part I: Description and rationale. Personality Disorders: Theory, Research and Treatment, 2(1). 4-22.

Skodol, A. E., Bender, D. S., Oldham, J. M, Clark, L. A., Morey, L. C., Verheul, R., Silver, L. I. (2011). Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part II: Clinical application. Personality Disorders: Theory, Research and Treatment, 2(1). 23-40.

Solution Preview

Writing The Wrongs of DSM-5

Skodol et al (2011a) first article discusses the new four-part DSM-5 proposal for assessing and identifying total levels of personality functioning. The likert type rating have 5 personality types and 6 domains from which to satisfy the criteria for PD. Skodol et al(2011b) second article uses vignettes to demonstrate why the DSM-5 should be "given the green light" and the "thumbs up"-If Skodol and colleagues feel the new propositions will "take the guesswork out of the mix"? This is wrong. There should be no guessing in the first place-How much credibility can guesswork garner for clinicians in the field? Herein lies just one of many flaws. The proposed modifications are lacking in sound empirical evidence-PD and psychopathology is serious business. As such, there can be no "guessing" when we are dealing with diseases, condition and disorders of such magnitudes-there must be enough, solid, supporting evidence. This is what the proposed changes will do however: Just fewer "slots" in which to place individuals: Because, not having the right choices and insufficient evidence can only have us doing one thing; guessing.

Paring down the diagnostic criteria to the extent in the proposed changes seems hardly reasonable: As it is, many consider diagnosing to be "guesswork": As such, narrowing the list can only guarantee an easier, more accessible way for lackadaisical, irresponsible; diagnosis-happy clinicians to become lax in their work. Who is really concerned about the "in-betweens" on the diagnostic scale or on the spectrum of disorders? This is much too delineating-one or ...

Solution Summary

The solution discusses the changes in regard to personality disorders in the coming DSM-5.

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