RECONCEPTUALIZING PERSONALITY-DISORDER DIAGNOSIS IN THE DSM-V - THE DISCRIMINANT VALIDITY CHALLENGE

Research on personality disorder (PD) diagnostic reliability, comorbid ity, and treatment confirms that Po diagnoses lack discriminant validi ty: Our ability to describe different PDs in an abstract sense has out stripped our ability to diagnose them accurately in real-world clinica l settings. Here an alternative model of PD diagnosis is presented whe rein three types of information are coded on Axis II: (a) an overall r ating of level of personality pathology, (b) separate intensity and im pairment ratings for each relevant Po dimension, and (c) a listing of personality traits (including PD-related traits) that enhance adaptati on and functioning. Possible objections to the alternative model are c onsidered (e.g., problems of diagnostician compliance, disciplinewide resistance to a new diagnostic framework), and advantages of the model over the current diagnostic system are discussed (e.g., greater heuri stic value, increased predictive validity).