英文心理学文献.pdf

Journal of Personality Disorders, 25(2), 136–169, 2011 © 2011 The Guilford Press Personality DisorDer tyPes ProPoseD for DsM-5 Andrew E. Skodol, MD, Donna S. Bender, PhD, Leslie C. Morey, PhD, Lee Anna Clark, PhD, John M. Oldham, MD, Renato D. Alarcon, MD, Robert F. Krueger, PhD, Roel Verheul, PhD, Carl C. Bell, MD, and Larry J. Siever, MD The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obses- sive-compulsive, and schizotypal. Each type is identified by core im- pairments in personality functioning, pathological personality traits, and common symptomatic behaviors. The other DSM-IV-TR PDs and the large residual category of personality disorder not otherwise speci- fied (PDNOS) will be represented solely by the core impairments com- bined with specification by individuals’ unique sets of personality traits. This proposal has three main features: (1) a reduction in the number of specified types from 10 to 5; (2) description of the types in a narrative format that combines typical deficits in self and interpersonal function- ing and particular configurations of traits and behaviors; and (3) a di- mensional rating of the degree to which a patient matches each type. An explanation of these modifications in approach to diagnosing PD types and their justifications—including excessive co-morbidity among DSM-IV-TR PDs, limited validity for some existing types, lack of speci- ficity in the definition of PD, instability of current PD criteria sets, and arbitrary diagnostic thresholds—are the subjects of this review. The Personality and Personality Disorder Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rate