Report of the DSM-V Personality and Personality Disorders Work Group
November 2008
Andrew E. Skodol, M.D.
The Personality and Personality Disorders Work Group has initiated 17 literature reviews relevant to possible revisions in DSM-V. Overarching topics include a definition and diagnostic criteria for personality disorders, levels of severity of personality psychopathology, the clinical utility of an empirically-based model of personality traits, the conceptualization and assessment of functioning, a tripartite model of mental disorders, criteria for change in DSM-V, and gender and personality disorders. In addition, reviews are being conducted on the validity of each of the 10 DSM-IV personality disorder categories. Also under consideration are reviews on resiliency of personality, dimensional representations of personality disorder categories, and the impact of personality and personality disorders on the course of Axis I disorders.
The work group has examined alternative models of personality and personality disorder classification and assessment. Assessments of personality disorders, as well as non-diagnostic personality characteristics in all patients, are being examined. An improved method for noting such personality characteristics could have significant clinical utility (e.g., bulimia nervosa with clinically significant impulsivity or sensation seeking). Complementary dimensional and categorical assessment methods are being considered.
The next steps for the work group are to complete the literature reviews (target date: December 2008), perform secondary data re-analyses (target date: June 2009), and conduct field trials (target date: December 2009). These activities will refine a generic definition of personality disorder for patients with personality disorders at differing levels of severity; identify personality traits that most adequately describe and discriminate between revised personality disorders and have maximal clinical utility; and determine age, gender, and ethnic effects on generic personality disorder criteria, personality functioning, personality trait domains, and personality prototypes.