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Themenschwerpunkt

Was bringt das DSM-V Neues zur Klassifikation der Persönlichkeitsstörungen?

Published Online:February 28, 2015https://doi.org/10.1024/1661-4747/a000080

Abstract

Zusammenfassung. Es stehen grundsätzliche Veränderungen in der Klassifikation von Persönlichkeitsstörungen an mit der Zielsetzung der Reduktion von Komorbidität, der Besserung von Konstrukt- und diskriminativer Validität sowie einer höheren Stabilität. Die allgemeine Definition einer Persönlichkeitsstörung stellt Kerndefizite in ihr Zentrum, die auf einer Selbst/Anderen Dimension angesiedelt sind. Vorgeschlagen wird eine Reduktion der Persönlichkeitsstörungstypen auf solche 5 Kategorien, die am besten empirisch validiert sind. Ihr Ausprägungsgrad wird hinsichtlich der Übereinstimmung mit einem Prototyp bewertet. Jeder Typ wird identifiziert anhand von Kernbeeinträchtigungen im Funktionsniveau, symptomatischem Verhalten und in pathologischen Persönlichkeitsmerkmalen. Bei allen Patienten sollen stabile Persönlichkeitsdimensionen beschrieben werden und zwar zum einen auf der Ebene von sechs übergeordneten Domänen (personality trait domains) und zum anderen anhand von feingliedrigen Fazetten. Die Domänen werden in ihrem Ausprägungsgrad beurteilt.


What does DSM-V Bring New to the Classification of Personality Disorders?

Abstract.The DSM-V proposal for the classification of personality and personality disorders implicates fundamental changes aiming at the reduction of comorbidity, the improvement of construct and discriminative validity as well as higher stability. The general definition of a personality disorder focuses on core deficits along a self/other dimension. The proposal suggests a reduction of personality disorder types to 5 categories which have been intensively and best studied in the past. A dimensional rating of the degree reflects to which extent a patient matches a prototype of personality pathology. Each prototype is identified on the basis of core impairments of personality functioning, pathological traits and symptomatic behaviors. All patients should be described with regard to stable personality dimensions, on the level of six high-order traits domains and on the level of more delicate facets related to the domains. The domains are scored with regard to the extent of their presence.

Literatur

  • American Psychiatric Association (2010). . DSM-5 Development. Retrieved June 18, 2011 from www.dsm5.org/Pages/Default.aspx, First citation in articleGoogle Scholar

  • Beck, A. T. , Freeman, A. , Davis, D. D. (2004). Cognitive therapy of personality disorders. (2nd ed.), New York: Guilford Press. First citation in articleGoogle Scholar

  • Bernstein, D. P. , Iscan, C. , Maser, J. (2007). Opinions of personality disorder experts regarding the DSM-IV personality disorders classification system.. Journal of Personality Disorder, 21, 536– 551 First citation in articleCrossref, Google Scholar

  • Bornstein, R. F. (1998). Reconceptualizing personality disorder diagnosis in the DSM-V. The discriminant validity challenge. Clinical Psychology: Science and Practice, 5, 333– 343 First citation in articleCrossref, Google Scholar

  • Costa, P. T.Jr. , Widiger, T. A. (2002). Personality disorders and the five-factor model of personality, (2nd ed.), Washington, DC: American Psychological Association. First citation in articleGoogle Scholar

  • Diamond, D. , Kaslow, N. , Coonerty, S. , Blatt, S. J. (1990). Changes in separation-individuation and intersubjectivity in long-term treatment. Psychoanalytic Psychology, 7, 363– 397 First citation in articleGoogle Scholar

  • Ekselius, L. , Lindström, E. , Knorring, L. von , Bodlund, O. , Kullgren, G. (1993). Personality disorders in DSM-III-R as categorical or dimensional. Acta Psychiatrica Scandinavica, 88, 183– 7 First citation in articleCrossref, Google Scholar

  • First, M. B. , Pincus, H. A. , Levine, J. B. , Williams, J. B. W. , Ustun, B. , Peele, R. (2004). Clinical utility as a criterion for revising psychiatric diagnoses. American Journal of Psychiatry, 161, 946– 954 First citation in articleCrossref, Google Scholar

  • Goldberg, D. , Goodyer, I. (2005). The origins and course of common mental disorders, London: Routledge. First citation in articleGoogle Scholar

  • Grilo, C. M. , Sanislow, C. A. , Shea, M. T. , Skodol, A. E. , Stout, R. L. , Gunderson, J. G. (2004). Two-year prospective naturalistic study of remission from major depressive disorder as a function of personality disorder co-morbidity. Journal of Consulting and Clinical Psychology, 73, 78– 85 First citation in articleCrossref, Google Scholar

  • Gunderson, J. G. , Lyons-Ruth, K. (2008). BPD’s interpersonal hypersensitivity phenotype: A gene-environment-developmental model. Journal of Personality Disorders, 22, 22– 41 First citation in articleCrossref, Google Scholar

  • Gunderson, J. , Stout, J. , McGlashan, T. , Shea, M. , Morey, L. , Grilo, C. , Skodol, A. (in press). Ten year course of Borderline Personality Disorder: Psychopathology and function from the Collaborative Longitudinal Personality Disorders Study. Archives of General Psychiatry, First citation in articleGoogle Scholar

  • Hopwood, C. J. , Malone, J. C. , Ansell, E. B. , Sanislow, C. A. , Grilo, C. M. , Pinto, A. (in press). Personality assessment in DSM-V: Empirical support for rating severity, style, and traits. Journal of Personality Disorders, First citation in articleGoogle Scholar

  • Huprich, S. K. , Bornstein, R. F. (2007). Categorical and dimensional assessment of personality disorders: A consideration of the issues. Journal of Personality Assessment, 89, 3– 15 First citation in articleCrossref, Google Scholar

  • Insel TR (2009). . Translating scientific opportunity into public health impact: a strategic plan for research on mental illness. Arch Gen Psychiatry, 66, 128– 133 First citation in articleGoogle Scholar

  • Kernberg, O. F. (1970). A psychoanalytic classification of personality pathology. Journal of the American Psychoanalytic Association, 18, 800– 822 First citation in articleCrossref, Google Scholar

  • Lenzenweger, M. F. , Clarkin, J. F. (2005). Major theories of personality disorder. (2nd ed.). New York: Guilford Press. First citation in articleGoogle Scholar

  • Livesley, W. J. (1986). Trait and behavioral prototypes of personality disorder. American Journal of Psychiatry, 143, 728– 732 First citation in articleCrossref, Google Scholar

  • Livesley, J. (2008). Journal of Personality Disorders, 22, 42– 71 First citation in articleCrossref, Google Scholar

  • Löwe, B. , Spitzer, R. L. , Williams, J. B. , Mussell, M. , Schellberg, D. , Kroenke, K. (2008). Depression, anxiety and somatization in primary care: Syndrome overlap and functional impairment. General Hospital Psychiatry, 30, 191– 9 First citation in articleCrossref, Google Scholar

  • Loffler-Stastka, H. , Ponocny-Seliger, E. , Fischer-Kern, M. , Leithner, K. (2005). Utilization of psychotherapy in patients with personality disorder: The impact of gender, character traits, affect regulation, and quality of object-relations. Theory, Research and Practice, 78, 531– 548 First citation in articleGoogle Scholar

  • Morey, L. C. , Zanarini, M. C. (2000). Borderline personality: Traits and disorder. Journal of Abnormal Psychology, 109, 733– 737 First citation in articleCrossref, Google Scholar

  • Pukrop, R. , Steinbring, I. , Gentil, I. , Schulte, C. , Larstone, R. , Livesley, J. W. (2009). Clinical validity of the Dimensional Assessment of Personality Pathology (DAPP) for psychiatric patients with and without a personality disorder diagnosis. Journal of Personality Disorders, 23, 572– 86 First citation in articleCrossref, Google Scholar

  • Regier, D. A. , Narrow, W. E. , Kuhl, E. A. , Kupfer, D. J. (2009). The conceptual development of DSM-V. American Journal of Psychiatry, 166, 645– 50 First citation in articleCrossref, Google Scholar

  • Ronningstam, E. (2005). Identifying and understanding the narcissistic personality, New York: Oxford University Press. First citation in articleGoogle Scholar

  • Rottman, B. M. , Ahn, W. K. , Sanislow, C. A. , Kim, N. S. (2009). Can clinicians recognize DSM-IV personality disorders from five-factor model descriptions of patient cases?. American Journal of Psychiatry, 166, 427– 433 First citation in articleCrossref, Google Scholar

  • Schroeder, M. L. , Wormworth, J. A. , Livesley, W. J. (1992). Dimensions of personality disorder and their relationships to the big five dimensions of personality. Psychological Assessment, 4, 47– 53 First citation in articleCrossref, Google Scholar

  • Shedler, J. , Westen, D. (2004). Refining personality disorder diagnosis: Integrating science and practice. American Journal of Psychiatry, 161, 1350– 1365 First citation in articleCrossref, Google Scholar

  • Skodol, A. E. , Bender, D. S. , Oldham, J. M. , Clark, L. A. , Morey, L. C. , Verheul, R. (in press[a]). Proposed changes in personality and personality disorder assessment and diagnosis for DSM-V. Part II: Clinical application.. Personality Disorders: Theory, Research, and Treatment, First citation in articleGoogle Scholar

  • Skodol, A. E. , Bender, D. S. , Morey, L. C. , Clark, L. A. , Oldham, J. M. , Alarcon, R. D. , Siever, L. J. (in press[b]). Personality disorder types proposed for DSM-V. Journal of Personality Disorders, First citation in articleGoogle Scholar

  • Spitzer, R. L. , First, M. B. , Shedler, J. , Westen, D. , Skodol, A. E. (2008). Clinical utility of five dimensional systems for personality diagnosis: A «consumer preference» study. Journal of Nervous and Mental Disease, 196, 356– 374 First citation in articleCrossref, Google Scholar

  • Trull, T. J. , Distel, M. A. , Carpenter, R.W. (2011). DSM-V borderline personality disorder: At the border between a dimensional and a categorical view.. Current Psychiatry Reports, 13, 43– 49 First citation in articleGoogle Scholar

  • Verheul, R. , Hartgers, C. , Van den Brink, W. , Koeter, M. W. (1998). The effect of sampling, diagnostic criteria and assessment procedures on the observed prevalence of DSM-III-R personality disorders among treated alcoholics. The Journal of Studies on Alcohol and Drugs, 59, 227– 236 First citation in articleCrossref, Google Scholar

  • Westen, D , Shedler, J. (1999a). Revising and assessing Axis II, part I: Developing a clinically and empirically valid assessment method. American Journal of Psychiatry, 156, 258– 272 First citation in articleGoogle Scholar

  • Westen, D. , Shedler, J. (1999b). Revising and assessing Axis II, part II: Toward an empirically-based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 273– 285 First citation in articleGoogle Scholar

  • Westen, D. , Muderrisoglu, S. (2006). Clinical assessment of pathological personality traits. American Journal of Psychiatry, 163, 1285– 1287 First citation in articleCrossref, Google Scholar

  • Westen, D. , Shedler, J. (2007). Personality diagnosis with the Shedler-Westen Assessment Procedure (SWAP): Integrating clinical and statistical measurement and prediction. Journal of Abnormal Psychology, 116, 810– 822 First citation in articleCrossref, Google Scholar

  • Westen, D. , Defife, J. A , Bradley, B. , Hilsenroth, M. (in press). Prototype personality diagnosis in clinical practice: A viable alternative for DSM-V and ICD-11. Professional Psychology: Research and Practice, First citation in articleGoogle Scholar

  • Zanarini, M. C. , Frankenburg, F. R. , Hennen, J. , Reich, D. B. , Silk, K. R. (2005). The McLean Study of Adult Development (MSAD): Overview and implications of the first six years of prospective follow-up. Journal of Personality Disorders, 19, 505– 523 First citation in articleCrossref, Google Scholar

  • Zanarini, M. C. , Frankenburg, F. R. , Reich, D. B. , Fitzmaurice, G. (2010). Time to attainment of recovery from borderline personality disorder and stability of recovery: A 10-year prospective follow-up study. American Journal of Psychiatry, 167, 663– 667 First citation in articleCrossref, Google Scholar

  • Zimmerman, M. (1994). Diagnosing personality disorders: A review of issues and research models. Archives of General Psychiatry, 51, 225– 245 First citation in articleCrossref, Google Scholar

  • Zimmerman, M. , Rothschild, L. , Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry, 162, 1911– 1918 First citation in articleCrossref, Google Scholar

  • Zimmerman, M. (in press). A critique of the proposed prototype rating system for personality disorders in DSM-V. Journal of Personality Disorders. First citation in articleGoogle Scholar