Moving beyond Personality Disorders: A Challenge for the DSM-6.

Abstract

The authors argue that as a diagnostic category "personality disorders" falls short in offering helpful counsel to patients with difficulties in self and interpersonal functioning. The article begins with a discussion of symptom versus disorder in general medicine before critiquing the impulse of psychiatrists and humans more broadly to categorize and sort. The authors summarize well-described limitations to categorical personality disorder diagnoses, including their questionable clinical utility, unsteady empirical support, and potential to reify myriad forms of stigma. These limitations emphasize the multidimensionality of personality and bring attention to the potential harms of offering patients diagnoses so laden in negative judgements, particularly when working with minoritized patient populations. The authors advocate for a reconsidered dimensional approach that may be emphasized in future editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM).