DSM axis II: personality disorders or adaptation disorders?

Area of Science:

• Psychiatry and Psychology
• Clinical Psychology
• Mental Health Research

Background:

• Current categorical diagnostic criteria for personality disorders are overlapping and lead to inadequate study samples and questionable results.
• The field of personality disorder research faces challenges in establishing clear diagnostic and research directions.

Purpose of the Study:

• To review the current state of personality disorder research and propose a new conceptual framework.
• To advocate for a shift from categorical to dimensional conceptualizations of personality disorders.
• To reframe personality disorders as disorders of adaptation.

Main Methods:

• Literature review of existing research on personality disorders and their diagnostic criteria.
• Analysis of the concept of personality disorders and their underlying dimensional structures.
• Review of available methods for assessing maladaptation.

Main Results:

• The literature consistently supports a dimensional model for personality disorders, with four dimensions frequently identified.
• Extreme personality traits are not inherently dysfunctional; dysfunction arises from maladaptation.
• Existing methods for assessing maladaptation are critically reviewed.

Conclusions:

• The diagnosis 'personality disorder' should be replaced with 'adaptation disorders' to more accurately reflect the nature of the condition.
• This diagnostic shift is expected to reduce stigma by emphasizing efforts toward adaptation.
• Revising the diagnosis and adopting a dimensional approach will likely advance both treatment and research in this area.