The Conceptualization of Personality Disorders: Categories Versus Dimensions

Abstract

The classification of mental disorders is organized as a categorical system, such that each disorder is a separate entity defined by an exclusive list of symptoms. Research has revealed many problems with the categorical conceptualization of mental disorders, and currently there is push for a dimensional system to replace the categorical framework, especially for personality disorders. In the current study, 115 psychologists from three different states described nine case vignettes using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), the Five Factor Model (FFM), and the Global Assessment of Functioning (GAF). The usefulness of the diagnostic systems, known as clinical utility, was measured through self-report and behavioral procedures. Results show that the psychologists in this study were more familiar and confident using the DSM-IV-TR; however, they were able to employ the FFM and GAF systems better than the DSM-IV-TR when generating personality profiles of the case vignettes. In regards to behavioral evidence, participants utilized more FFM terminology when communicating information about the case vignettes. In light of the upcoming arrival of the DSM-V and the potential shift to a dimensional approach for personality disorders, more research is needed to examine how mental health professionals use different models of personality classification to improve communication, conceptualization, comprehensiveness, and treatment planning.