Highlights of Proposed Changes to Personality Disorder Criteria

In the past, diagnostic criteria for personality disorders were categorical and absolute; patients either met the criteria or they did not. But new proposed criteria for DSM-5 reflect the understanding that personality pathology varies by degree.

Two sets of criteria are used to derive diagnosis of a personality disorder: impairments in personality (self and interpersonal) functioning (criterion A) and the presence of pathological personality traits (criterion B).

Diagnoses for six personality disorder types (antisocial, avoidant, borderline, narcissistic, obsessive/compulsive, and schizotypal) and a diagnosis for "personality disorder-trait specified" are described by a measure of level of impairment in personality function and the presence of pathological personality traits. "Personality disorder-trait specified" replaces "personality disorder not otherwise specified" and would be diagnosed if the patient did not fit one of the six personality disorder types but still had a significant level of impairment and the presence of pathological personality traits.