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The DSM-III personality disorders section: a commentary

The American Journal of Psychiatry

|September 1, 1980

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This review examines the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) personality disorder diagnoses. It highlights challenges in reliability and suggests improvements for future diagnostic systems.

Area of Science:

Psychiatry
Psychological diagnostics

Background:

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) introduced a multiaxial system, including personality disorders.
Previous diagnostic nomenclatures suffered from low reliability in personality disorder assessment.

Purpose of the Study:

To review the DSM-III section on personality disorders.
To discuss controversial diagnoses and propose alternatives.
To identify obstacles to diagnostic reliability and suggest improvements.

Main Methods:

Literature review of the DSM-III personality disorder section.
Analysis of diagnostic criteria and their limitations.
Discussion of state and role factors influencing diagnoses.

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Main Results:

The DSM-III personality disorder diagnoses face challenges due to unclear boundaries with normality and other disorders.
State and role factors confound the accurate diagnosis of personality disorders.
Despite limitations, the DSM-III multiaxial system and specified criteria improved diagnostic reliability compared to prior systems.

Conclusions:

Clearer diagnostic criteria and consideration of state/role factors are crucial for enhancing personality disorder diagnosis reliability.
The DSM-III represented a step forward, but further refinement is needed for robust personality disorder assessment.