Personality DisordersFact or Fiction - Term Paper Example

Personality Disorders: Fact or Fiction Personality Disorders: Fact or Fiction Personality disorders have been a long-standing debate concerning DSM. Understandably, one would constantly struggle with the DSM of mental disorders, especially since the medical literature is revised every several years with very slight noteworthy changes in the argument. The case is the same on the issue of personality disorders (Rottman, Ahn, Sanislow, & Kim, 2009, p. 427). I believe that the confusion on whether personality disorders should be included or not as a diagnostic category in the next version of the DSM arises from that fact that the literature on personality disorders are either biased or unfair when compared to literature on other medical concerns.

The issue with personality disorders in DSM is not in whether they should be considered as a diagnostic category, but in how the representation should be improved (Rottman, Ahn, Sanislow, & Kim, 2009, p. 429). Upon conducting personal research, two alternative models can be used as assessment paradigm regarding the clinical utility of personality disorders in DSM. Before going into this, one must first understand that the categorical conceptualizations of personality disorders in DSM are limited due to: 1) the large incidents of co-occurrence among the different personality disorders, 2) excessive incidents of heterogeneity among patients that are similarly diagnosed, 3) subjective diagnostic boundaries for the thresholds between normal and pathological personality, and; 4) not enough amount of analysis of personality psychopathology resulting in having most diagnoses of personality disorders that are not specified (PDNOS) (First, et al., 2004, p. 948-9).

Therefore, a need to revise the approach to personality psychopathology is very much needed in DSM. This is crucial in order to attain fully the ultimate purposes of DSM: 1) to improve intervention and caring for patients, and; 2) to increase clinical utility (First, et al., 2004, p. 951). Kupfer states that the approach to the assessment paradigm of personality disorder needs to be reevaluated. There has been no laboratory indicator that focuses on specific information for conditions as defined in DSM.

The available literature on various clinical studies shows instability in diagnosis and even excessive instances of co-occurrence and comorbidity. Furthermore, it seems that the common occurrence is the lack of methods of treatment for the disorder, when this should actually be the exception. In fact, one of the crucial terminology issues that need to be cleared in DSM-V is the question on whether mental disorders (personality disorders included) should be represented by various classifications or by sets of psychopathology scopes (Kupfer, First, & Regier, 2002, p.

xxv-xxiii). Furthermore, in an article by Rounsaville, et al. (qtd. in Kupfer, First, & Regier, 2002), it is discussed that:There is a clear need for dimensional models to be developed and their utility compared with that of existing typologies in one or more limited fields, such as personality. If a dimensional system performs well and is acceptable to clinicians, it might be appropriate to explore dimensional approaches in other domains. (p. 13)It is true, however, that some clinicians may not be familiar with dimensional models especially if they are trained in assessment using the medical paradigm.

Supporters of this idea, nevertheless, argue that some of those that are considered “miracles’ in medicine lead to significant categorical diagnosis. A good example of this is blood pressure and hypertension. In the field of psychiatry, dimensional models have also proved to some clinical singularities such as that of low intelligence scores and functional impairment (Kupfer, First, & Regier, 2002).ReferencesFirst, M. B., Pincus, H. A., Levine, J. B., Williams, J. B., Ustun, B., & Peele, R. (2004). Clinical utility as a criterion for revising psychiatric diagnoses.

The American Journal of Psychiatry, 161, 6, 946-54.Kupfer, D. J., First, M. B., & Regier, D. A. (2002). A research agenda for DSM-V. Washington, D.C: American Psychiatric Association.Rottman, B. M., Ahn, W. K., Sanislow, C. A., & Kim, N. S. (2009). Can clinicians recognize DSM-IV personality disorders from five-factor model descriptions of patient cases?. The American Journal of Psychiatry, 166, 4, 427-33.