Abstract
In the revised Diagnostic and Statistical Manual DSM-5 the definition of personality disorder diagnoses has not been changed from that in the DSM-IV-TR. However, an alternative model for diagnosing personality disorders where the construct “identity” has been integrated as a central diagnostic criterion for personality disorders has been placed in section III of the manual. The alternative model’s hybrid nature leads to the simultaneous use of diagnoses and the newly developed “Level of Personality Functioning-Scale” (a dimensional tool to define the severity of the disorder). Pathological personality traits are assessed in five broad domains which are divided into 25 trait facets. With this dimensional approach, the new classification system gives, both clinicians and researchers, the opportunity to describe the patient in much more detail than previously possible. The relevance of identity problems in assessing and understanding personality pathology is illustrated using the new classification system applied in two case examples of adolescents with a severe personality disorder.
Highlights
The emergence of the self in childhood and adolescence is based on experience and perception, which becomes organized into identity, which organizes further experience and perception
Understanding the development of identity from a psychological perspective and how it is integrated in the new DSM-5 classification system are the focus of this paper
The new DSM-5 classification system has been published in May 2013
Summary
The emergence of the self in childhood and adolescence is based on experience and perception, which becomes organized into identity, which organizes further experience and perception. In two case examples we will illustrate impairment of identity integration in adolescent patients with personality disorders (PD). In their developmental considerations for the new DSM system Tackett and colleagues [3] describe a life span perspective of personality pathology from early childhood to later life. The Board of Trustees decided to keep the old criteria (with well-known lack of reliability and validity) despite the major revision proposed by the DSM-5 Personality Disorders Work Group. Diagnosing personality disorders in DSM-5 Section III The core criteria of a personality disorder are seen as significant impairments in self and interpersonal functioning that are assumed to be continuously distributed. - Maintains multiple satisfying and enduring relationships in personal and community life-
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