Personality Disorders

A new approach to the diagnosis of personality disorders was developed for DSM-5 to help address shortcomings of DSM-IV personality disorders (for example, overuse of the DSM-IV personality disorder not otherwise specified diagnosis). This alternate approach can be found in Section III, where it is provided for further research to determine whether it is potentially clinically useful and should be included in future editions of DSM. Since this alternate model still requires further study, an update of DSM-IV personality disorder criteria is provided in DSM-5 Section II.

In the Section III alternate model, the revised A criterion for the general criteria for personality disorder has been developed on the basis of a literature review of reliable clinical measures of core impairments in personality functioning central to personality pathology. It has been validated as specific for semi-structured interview diagnoses of personality disorders in samples of over 2,000 patients and community subjects.

These questions are from DSM-5 Self-Exam Questions: Test Questions for the Diagnostic Criteria, which may be preordered at http://www.appi.org/SearchCenter/Pages/SearchDetail.aspx?ItemId=62467 from American Psychiatric Publishing. The answers and rationales are posted at http://www.psychnews.org/pdfs/DSM-5_Self_Examination_QandA_4.pdf. The questions were developed under the leadership of Philip Muskin, M.D., a professor of clinical psychiatry at Columbia University College of Physicians and Surgeons. The book, available in August, contains 500 questions for all the categories of psychiatric disorders and includes Section III.

1. Which of the following best describes the diagnostic model proposed in the alternate model for personality disorders in DSM-5 to classify personality disorders?a) Categorical b) Dimensional c) Hybrid d) Polythetic e) Socratic

2. In addition to an assessment of pathological personality traits, DSM-5 requires an assessment of which of the following for a personality disorder diagnosis? a) Level of impairment in personality functioning b) Comorbidity with Axis I disorders c)  Degree of introversion versus extroversion d) Stability of the personality traits over time e) Familial inheritance of specific traits

3. Which of the following is a domain of the DSM-5 trait model of personality? a) Neuroticism b) Extraversion c) Disinhibition d) Agreeableness e) Conscientiousness ■