Abnormal Psychology: Mental Health and Mental Illness

Disorders of Personality

What are the strengths and limitations of the DSM-IV diagnoses for personality disorders?

The DSM-IV diagnoses have shown high inter-rater reliability and internal consistency. In other words, different raters reliably diagnose people in similar ways and the different criteria of each diagnosis strongly correlate with one another. Moreover, they have been shown to predict to many important clinical features (e.g., suicidality, drug abuse, interpersonal problems, criminal activity). In other words, the DSM personality diagnoses are clinically relevant. Nonetheless, there are problems with this system. For one, the categorical approach does not account for severity. It does not say whether you are mildly or severely borderline, which may matter more than the discrete diagnoses. Secondly, the diagnoses are not mutually exclusive, and people may meet criteria for more than one diagnosis. Thirdly, the diagnoses are far from exhaustive and many types of personality pathology are not easily diagnosed in DSM-IV.


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