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6 - Categorical Models of Personality Disorders

from Part II - Models

Published online by Cambridge University Press:  24 February 2020

By
Igor Weinberg
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
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Summary

This chapter reviews and summaries current knowledge about the categorical model of personality disorders. It starts with the history of the concept from Greek philosophers and moves to the description of personality disorders in DSM-5. It then summarizes key strengths of the categorical approach. First, it provides examples of the disorder-specific concepts that help understand in depth individuals with individual disorders. Second, it reviews research findings that validate the association between personality disorders and functional impairment. Third, construct validity of each personality disorder is reviewed based on the criteria of validation of psychiatric disorders. Ability to test construct validity of each disorder is a unique feature of the categorical model. Fourth, the predictive utility of the categorical model documents that the categorical diagnosis of personality disorder predicts significant clinical and psychosocial outcomes and predicts some functional outcomes independent of the dimensional model. Fifth, clinical utility research on categorical model and its limitations is reviewed. Sixth, the chapter reviews limitations of the categorical model, such as (i) excessive diagnostic co-occurrence, (ii) phenomenological heterogeneity, (iii) arbitrary diagnostic thresholds, and (iv) inadequate coverage. The chapter offers possible resolutions to these limitations. The chapter concludes with discussion of possible future directions, including combining categorical and dimensional approaches.

Keywords

personality disorderscategorical modelcritical reviewtaxonomyvalidation of psychiatric disorders
Type
Chapter
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The Cambridge Handbook of Personality Disorders , pp. 120 - 135
Publisher: Cambridge University Press
Print publication year: 2020

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