An Ecumenical Approach to Conceptualizing and Studying the Core of Personality Psychopathology: A Commentary on Hopwood et al.

Abstract

The DSM-5 process has generated an inordinate amount of controversy, division, and loss of good sense among those of us who study and treat personality disorders, and more broadly. During this unsettling historyof-science moment, we stand at an interesting and challenging crossroads in our field. It is important that we contextualize these recent experiences, recalling that the evolution and promulgation of the DSM has occurred within a particular psychiatric socioeconomic and political culture that has in many regards continually marginalized the representation of personality disorders. Given these considerations, I read with a great deal of satisfaction the Hopwood, Wright, Ansell, and Pincus (2013) article positing an interpersonal core of personality pathology. I suggest that what these authors propose is no less than a way forward for our field: not in the privileging of one theory, or the promotion of a circumplex model, but through emphasizing an organizing principle that can be conceptualized, studied, and clinically applied across a diversity of perspectives. The point of convergence lies in the notion that personality psychopathology emanates from problematic thinking and behavior centered on the self-inrelation-to-others. To briefly recap, the new approach to personality psychopathology proposed for DSM-5, to be published in its “Section III: Emerging Measures and Models” (American Psychiatric Association [APA], 2013) is a hybrid model of personality functioning, traits, and types. As has been represented in this journal and elsewhere, reactions to this mixed approach have ranged from florid rants to measured wisdom to enthusiastic welcome, and it remains to be seen what its future will be. However, what