18 Conclusion The long history
of personality theories helps put DSM classifications of personality disorders into perspective. DSM-II (1968) was influenced by psychoanalysis19; in DSM-II, some personality disorders had to be differentiated from the neuroses of the same name (eg, hysterical, obsessive-compulsive, and (neurasthenic personalities and neuroses). In DSM-III (1980),20 and the subsequent DSM-III-R (1987) and DSM-TV (1994), personality disorders were described as discrete types, grouped into three clusters, placed on a separate axis (axis II). This categorical Inhibitors,research,lifescience,medical approach was in line with the medical model advanced by Emil Kraepelin. Borderline and narcissistic personality disorders, which entered DSM-III, were adapted from psychoanalytical concepts. The preparation of DSM-5 questioned the merits of combining typological and dimensional models Inhibitors,research,lifescience,medical of personality, reopening a century-old debate.
The groundwork for the preparation of the fifth edition of the DNA Damage inhibitor diagnostic and Statistical Manual of Mental Disorders (DSM) began in 1999, under
the direction of David Kupler. In A Research Agenda for DSM-V,1 Michael First, in his chapter on personality Inhibitors,research,lifescience,medical disorders, announced a shift towards dimensional classification in response to growing user dissatisfaction with the DSM’s diagnostic categories. Following discussions at the APA/WHO/NIH Personality Disorders Conference Inhibitors,research,lifescience,medical held in Arlington in December 2004, Thomas Widiger et al published a monograph on the 18 main dimensional models describing normal and pathological personalities.2 The 27 members of the DSM-5 Task Force then drew up a first plan for the new revision of the DSM.
Inhibitors,research,lifescience,medical The initial recommendations of the personality disorders working group chaired by Andrew Skodol included several major innovations, which were posted on the DSM Web site (www.dsm5.org) on 10 February 2010. These were principally a new general definition of personality disorders, new diagnostic criteria (W. John Livesley), a 5-point assessment of the level of personality functioning (Donna Bender), the introduction of a dimensional model inspired by the 5- factor model, with six domains covering 37 clinical facets (Lee A. Clark and Robert Krueger), and a reduction in the number of personality disorder categories from 10 to 5: antisocial, avoidant, borderline, obsessive, and Adenylyl cyclase schizotypal. The other disease entities figure in the DSM as a personality disorder with, depending on the case, specific traits: histrionic, narcissistic, paranoid, schizoid, dependent, depressive, or passive-aggressive. The main argument that Skodol et al3,4 put forward for limiting the number of categories was the inadequacy of published empirical justifications of the validity of the other categories.