PERSONALITY-DISORDERS AND CULTURE IN DSM-IV - A CRITIQUE

A brief history is presented of the suggestions on personality disorde rs (PDs) made by the NIMH-sponsored Culture and Diagnosis Group to APA 's DSM-IV Task Force. A quantitative analysis of the level of acceptan ce of such suggestions in the final version of DSM-IV shows that, over all, only 27.5% of them were included, This figure increases to 51% fo r texts specifically related to 10 PD types, Paranoid and schizoid PD texts included most of the Group's recommendations whereas those for n arcissistic, histrionic, and avoidant were almost totally ignored, Con ceptually, very important notions such as a cultural dimension, self-i mage, acculturation, contextualization, exclusionary criteria, and dif ferential diagnosis were omitted, The uneven presence of culture in th e PDs section of DSM-IV calls for renewed efforts to increase research , clinical observations, and theoretical discussions in order to make the cultural perspective more visible and relevant in the national men tal health debate.