As per DSM-IV-TR (Axis II), the idea of personality disorders as independent conditions that might or might not be related to more traditional disorders (Axis I) is relatively new. Even though many clinicians have responded positively to this new system of classifying various personality patterns, many questions & issues remain. Studies of Borderline Personality Disorder far outnumbered this of Axis II personality disorders, but there are still large gaps in knowledge about them as well as about the other categories of personality disorder.
2 questions that inevitably arise are (1) Are the personality disorders included in DSM-IV the right ones! & (2) Are there personality disorders not included in DSM-IV that should be part of classification system? It has been difficult for professionals to answer these questions because, except for a few of these disorders (probably borderline classification), research has been quite limited. Clinical experience & research also suggest adding to Axis II some classifications of personality patterns not currently represented. For example, some people show pervasive sadistic pattern of cruel demanding & aggressive behavior to other people, others show a self defeating or masochistic pattern that lead to failure, disappointment & mistreatment by others.
Another important topic concerns how information about personality disorders can most effectively be presented. In contrast with this classification model, a dimensional model focuses attention on patterns of personality characteristics. In a dimensional approach, an individual would be classified not as having a dependent or antisocial personality disorder, but rather as having a personality pattern that reflects the individual's standing on a variety of dimensions. The value of a dimensional approach is that it results in a profile for each person classified. It's important to recognize (1) the continuous nature of personality functioning & (2) the fact that personality disorders are maladaptive variants of common personality traits. Example of dimensional approach to personality is the 5 factor model, shown in the pic, which assesses 5 dimensions of personality believed to be pertinent in various degrees to both normal and disordered behavior. The understanding & treatment of personality disorders can be advanced by recognizing their multiple causes.
Comentários