Cited by 360Personality Disorders and PsychopathologyPersonality Traits and PsychologyMental Health and Psychiatry

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Personality Disorders in DSM-5

Skodol, Andrew E.·2012·Annual Review of Clinical Psychology

DOI 10.1146/annurev-clinpsy-032511-143131

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Abstract

A substantive revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) last occurred in 1994; therefore, the mental health field should anticipate significant changes to the classification of mental disorders in the fifth edition. Since DSM-5 Work Groups have recently proposed revisions for the major diagnostic classes of mental disorders, an article on the current status of the personality disorders (PDs) is timely. This article reviews scientific principles that have influenced the development of proposed changes for the assessment and diagnosis of personality psychopathology in DSM-5, presents the proposed model as of the summer of 2011, summarizes rationales for the changes, and discusses critiques of the model. Scientific principles were articulated for DSM-5 more than a decade ago; their application to the process has not been straightforward, however. Work Group members have labored to improve the DSM-5 approach to personality and PDs to make the classification more valid and more clinically useful. The current model continues to be a work in progress.

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Background
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Background
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Method
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Background
Validation of the DSM–5 Alternative Model Personality Disorder Diagnoses in Turkey, Part 1: LEAD Validity and Reliability of the Personality Functioning Ratings
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“Using the Personality Inventory for DSM‐5 (PID‐5; Krueger, Derringer, Markon,Watson, & Skodol, 2012) in a large sample of undergraduate students, Hopwood, Thomas, Markon, Wright, and Krueger (2012) found that only two of the four specified traits (Rigid Perfectionism and Perseveration) correlated moderately with Secti…”
BackgroundMethodInfluential
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“While intrapersonal functioning is concerned with aspects of identity and the aspect of self-regulation, interpersonal functioning addresses affective empathy, mind-reading, and also intimacy as central abilities for functioning well in interpersonal relations (24).”
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Why is the Diagnostic and Statistical Manual of Mental Disorders so hard to revise? Path-dependence and “lock-in” in classification
Cooper, R. (2015) · Studies in History and Philosophy of Science Part C Studies in History and Philosophy of Biological and Biomedical Sciences · doi:10.1016/j.shpsc.2015.03.001 · Cited by 13
“developed that replaced the prototypes with sets of diagnostic criteria, and reinserted one of the deleted personality disorder categories (Skodol, 2012).”
Method
Clinician and patient perspectives on the ontology of mental disorder: a qualitative study
Köhne, A. C. J., de Graauw, L. P., der Maas, R. L.-V., & van Os, J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1081925 · Cited by 14
The three-level model (3-LM) for observing patient transformations
Bernardi, R. (2018) · Routledge eBooks · doi:10.4324/9780429484032-1 · Cited by 12
Personality Pathology in Primary Care: Ongoing Needs for Detection and Intervention
Huprich, S. K. (2018) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-017-9525-8 · Cited by 13
Brazilian Version of the Level of Personality Functioning Scale-Brief Form 2.0: Evidence of Reliability and Validity
de Oliveira, S. E. S., Zimmermann, J., Krueger, R. F., & Hutsebaut, J. (2023) · Psicologia Teoria e Pesquisa · doi:10.1590/0102.3772e39nspe05.en · Cited by 13
Evolutionary Personality Psychology
Lewis, D. M. G., Al-Shawaf, L., & Buss, D. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.022 · Cited by 11
Comparing External Correlates ofDSM-5Section II and Section III Dimensional Trait Operationalizations of Borderline Personality Disorder
Anderson, J. L., Sellbom, M., Sansone, R. A., & Songer, D. A. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_189 · Cited by 11
Dimensional Clinical Personality Inventory 2: antecedents, development, and future improvements
Carvalho, L. D. F., & Pianowski, G. (2021) · Interação em Psicologia · doi:10.5380/riep.v25i3.67438 · Cited by 11
Psychological Predictors of Recidivism for Intimate Partner Violence Perpetrators: A Systematic Scoping Review
McDonagh, T., Travers, Á., Armour, C., Cunningham, T., & Hansen, M. (2024) · Trauma Violence & Abuse · doi:10.1177/15248380241284793 · Cited by 11
“At the same time, diagnostic classification systems have been shifting toward a more dimensional approach to personality disorders due to continuing problems with classification of personality disorders in general (Bach & First, 2018; McDonagh et al., 2021; Skodol, 2012; Tyrer et al., 2019).”
Construction and Validation of the Interpersonal Influence Tactics Circumplex (IIT-C) Scales
Bliton, C. F., & Pincus, A. L. (2019) · Assessment · doi:10.1177/1073191119864661 · Cited by 12
“The PID-5-BF (Krueger, Derringer, Markon, Watson, & Skodol, 2012) is a 25-item self-report measure of the pathological personality trait domains of negative affectivity, detachment, antagonism, psychoticism, and disinhibition found in the DSM-5 Alternative Model for Personality Disorders (Skodol, 2012).”
BackgroundInfluential
Relational Aggression and Narcissistic Traits: How Youth Personality Pathology Informs Aggressive Behavior
Reardon, K. W., Herzhoff, K., Smack, A. J., & Tackett, J. L. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_450 · Cited by 10
The Hierarchical Structure and Predictive Validity of the Personality Inventory for DSM-5 in Chinese Nonclinical Adolescents
Zhang, W., Wang, M., Yu, M., & Wang, J. (2021) · Assessment · doi:10.1177/10731911211022835 · Cited by 10
In search of hidden threats: A scoping review on paranoid presentations in personality disorders
Fanti, E., Sarno, M. D., & Pierro, R. D. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2913 · Cited by 11
An Overview of theDSM-5: Changes, Controversy, and Implications for Psychiatric Nursing
Halter, M. J., Rolin-Kenny, D., & Dzurec, L. C. (2013) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20130226-02 · Cited by 10
All the Faces of Research on Borderline Personality Pathology: Drawing Future Trajectories through a Network and Cluster Analysis of the Literature
Benzi, I. M. A., Pierro, R. D., Carli, P. D., Cristea, I. A., & Cipresso, P. (2020) · Journal of Evidence-Based Psychotherapies · doi:10.24193/jebp.2020.2.9 · Cited by 10
Development of Personality across the Life Span
Atherton, O. E., Donnellan, M. B., & Robins, R. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.017 · Cited by 15
The interplay of Criterion A of the Alternative Model for Personality Disorders, mentalization and resilience during the COVID-19 pandemic
Maerz, J., Buchheim, A., Rabl, L., Riedl, D., Viviani, R., & Labek, K. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.928540 · Cited by 12
“Personality functioning is generally assessed within a dimensional model as the Criterion A of the alternative model of personality disorders (AMPD in DSM-5; Bender et al., 2011; Skodol, 2012; American Psychiatric Association, 2013) and as level of severity in the ICD-11 (Tyrer et al., 2011, 2015).”
Method
Theodore Millon's Contributions to Conceptualizing Personality Disorders
Pincus, A. L., & Krueger, R. F. (2015) · Journal of Personality Assessment · doi:10.1080/00223891.2015.1031376 · Cited by 10
“Although this distinction is also not unique to Millon’s thinking (e.g., Kernberg & Caligor, 2005; Pincus, 2005; Skodol, 2012), it is part of the deep structure of his model and further attests to its significance.”
Background
La classification de la paranoïa dans la psychiatrie américaine contemporaine : une revue de la littérature
Prudent, C., Évrard, R., & de Tychey, C. (2016) · L Évolution Psychiatrique · doi:10.1016/j.evopsy.2016.05.004 · Cited by 10
Personality Disorders Are Not as We Thought: Hierarchical Factor Structure at the Criterion Level
Muñoz-Champel, A., Gutiérrez, F., Peri, J. M., & Torrúbia, R. (2017) · Journal of Personality Assessment · doi:10.1080/00223891.2017.1278700 · Cited by 12
“…also called psychoticism or peculiarity (Guti errez et al., 2014; Harkness, Finn, McNulty, & Shields, 2012; Krueger, Derringer, Markon, Watson, & Skodol, 2012; Watson et al., 2008), whereas mistrust is a narrower construct that cuts across different factors in distinct taxonomies (Guti errez et…”
Background
Profiling Personality Traits with Games
Santos, C. P., Hutchinson, K., Khan, V.-J., & Markopoulos, P. (2019) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3230738 · Cited by 14
“Assessing personality traits of individuals is best known for its direct application in clinical research for diagnosing and treating personality disorders [62].”
Background
Co-Occurring Disorders and Treatment Complexity Within Personality Disorders
Fowler, J. C., & Oldham, J. M. (2013) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.11.2.123 · Cited by 9
Examination of DSM-5 Section III avoidant personality disorder in a community sample
Sellbom, M., Carmichael, K. L. C., & Liggett, J. (2017) · Personality and Mental Health · doi:10.1002/pmh.1388 · Cited by 9
Antisocial–psychopathic personality disorder
Crego, C., & Widiger, T. A. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811323-3.00004-3 · Cited by 9
The Arabic Version of the Personality Inventory for the DSM-5 (PID-5) in a Clinical Sample of United Arab Emirates (UAE) Nationals
Coelho, O., Pires, R., Ferreira, A. S., Gonçalves, B., Alkhoori, S. A., Sayed, M. A., El-Rasheed, A. H., Belhoul, S., AlJassmi, M. A., & Stocker, J. (2020) · American Journal of Health Behavior · doi:10.5993/ajhb.44.6.5 · Cited by 9
Changes in the anaclitic-introjective personality configurations following psychoanalytic psychotherapy with young adults
Werbart, A., Aldèn, S., & Diedrichs, A. (2017) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2017.239 · Cited by 9
Personality disorders: Current scientific status and ongoing controversies.
Lilienfeld, S. O., & Latzman, R. D. (2018) · American Psychological Association eBooks · doi:10.1037/0000064-023 · Cited by 8
Genetics of Personality
South, S. C., Reichborn‐Kjennerud, T., Eaton, N. R., & Krueger, R. F. (2012) · Wiley eBooks · doi:10.1002/9781118133880.hop205001 · Cited by 9

Authors: Skodol, A. E.
Affiliations: University of Arizona (US)
Corresponding author: Skodol, Andrew E.
Venue: Annual Review of Clinical Psychology
Publisher: Annual Reviews
Published: 2012-04-27
Volume: 8
Issue: 1
Pages: 317-344
ISSN: 1548-5943 (ISSN-L)
1548-5951
DOI: 10.1146/annurev-clinpsy-032511-143131
OpenAlex: W2124226322
Cited by: 360
References: 118
Citations by year: 2026: 7 · 2025: 19 · 2024: 14 · 2023: 19 · 2022: 14 · 2021: 18 · 2020: 63 · 2019: 25 · 2018: 28 · 2017: 18 · 2016: 17 · 2015: 33 · 2014: 27 · 2013: 38 · 2012: 12
FWCI: 5.12
Type: journal article
Language: en
Open access: closed
Locations: Annual Review of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: personality disorders, DSM-5, diagnostic classification, personality pathology, diagnostic criteria, classification validity, psychiatric diagnosis, personality disorder assessment
MeSH terms: Humans, Models, Psychological, Personality Disorders, Diagnostic and Statistical Manual of Mental Disorders

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