Assessment and diagnosis of personality disorder : Perennial issues and an emerging reconceptualization

• Published in: Annual review of psychology 2007, Vol.58 (1), p.227-257
• Main Author: CLARK, Lee Anna
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Adult and adolescent clinical studies; Age Factors; Alcoholism - diagnosis; Alcoholism - psychology; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Biological and medical sciences; Character; Comorbidity; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Diagnostic and Statistical Manual of Mental Disorders; Feeding and Eating Disorders - diagnosis; Feeding and Eating Disorders - psychology; Health risk assessment; Humans; Medical sciences; Middle Aged; Models, Psychological; Morbidity; Personality Assessment; Personality disorders; Personality Disorders - diagnosis; Personality Disorders - psychology; Personality Inventory; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Social Adjustment; Substance-Related Disorders - diagnosis; Substance-Related Disorders - psychology; Temperament
• ISSN: 0066-4308; 1545-2085
• DOI: 10.1146/annurev.psych.57.102904.190200

This chapter reviews recent (2000-2005) personality disorder (PD) research, focusing on three major domains: assessment, comorbidity, and stability. (a) Substantial evidence has accrued favoring dimensional over categorical conceptualization of PD, and the five-factor model of personality is prominent as an integrating framework. Future directions include assessing dysfunction separately from traits and learning to utilize collateral information. (b) To address the pervasiveness and extent of comorbidity, researchers have begun to move beyond studying overlapping pairs or small sets of disorders and are developing broader, more integrated common-factor models that cross the Axis I-Axis II boundary. (c) Studies of PD stability have converged on the finding that PD features include both more acute, dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable-similar to normal-range personality traits-with increasing stability until after 50 years of age. A new model for assessing PD-and perhaps all psychopathology-emerges from integrating these interrelated reconceptualizations.