Sex bias in the diagnosis of personality disorders: An evaluation of the DSM-IV criteria

This study considered whether the Diagnostic and Statistical Manual of Ment al Disorders (4th ed.; American Psychiatric Association, 1994) is biased ag ainst women by requiring less dysfunction for the personality disorders tha t are more commonly diagnosed in women (e.g., histrionic). Clinicians estim ated the extent of social dysfunction, occupational dysfunction, and person al distress suggested by each of the diagnostic criteria for 6 personality disorders. The results failed to suggest a bias against women, as there was no difference in the overall level of dysfunction associated with the fema le-typed personality disorder diagnostic criteria (fewer criteria are also required for the male-typed diagnoses). However, the considerable variation in dysfunction across disorders and criteria, and the minimal degree of im pairment implied by some of the diagnostic criteria, also raise more genera l issues that should perhaps be addressed in future editions of the diagnos tic manual.