Unraveling Personality in the DSM-5

Defining Personality

• Personality refers to a person's unique pattern of thinking, feeling, and behaving that persists over time and across situations.
• According to Kaplan & Saddock (1998), a person's personality is described as "a unique and relatively enduring pattern of thoughts, feelings, and actions."

Personality Disorders

• A personality disorder typically involves a pattern of inner experience and behavior that deviates markedly from the expectations of an individual's culture.
• Such patterns are inflexible and pervasive across a broad range of personal and social situations.
• A personality becomes 'disordered' when it causes distress or impairment in social, occupational, or other areas of functioning.

Characteristics of Personality Disorders

• According to the DSM-5, traits associated with personality disorders are characterized as inflexible, maladaptive, and causing distress or impairment.
• Maladaptive traits are those that hinder adaptation to the environment.
• Traits are considered 'pervasive and inflexible' when they are consistent across different situations and over time.
• Personality traits lead to distress or impairment when they result in disturbances in cognition, affectivity, interpersonal functioning, or impulse control.

Models of Personality Disorders

• The DSM-5 uses a hybrid model that combines elements of the categorical and dimensional models.
• The categorical model conceptualizes personality disorders as distinct categories, each with a specific set of diagnostic criteria.
• The key distinction in the categorical model is the presence or absence of a specific disorder.
• The main drawback of the categorical model is that it fails to account for the variation in personality traits within each category.
• The dimensional model conceptualizes personality disorders as existing on a continuum of personality traits.

Diagnosing Personality Disorders

• According to the DSM-5, a diagnosis of a personality disorder requires that an individual exhibit impairments in at least two of the following areas: cognition, affectivity, interpersonal functioning, and impulse control.
• A common requirement for a personality disorder diagnosis is that the pattern of thinking, feeling, and behaving is stable across time and situations.
• The onset of a personality disorder pattern typically dates back to adolescence or early adulthood.

Epidemiology of Personality Disorders

• The estimated prevalence of personality disorders in the general population is around 10-15%.
• Among those in outpatient treatment, an estimated 30-50% of individuals have personality disorders.

Aetiology of Personality Disorders

• The DSM-5 represents multiple theoretical perspectives on the aetiology of personality disorders.

Classification of Personality Disorders

• The DSM-5 describes three clusters of personality disorders based on their core features: Cluster A (odd or eccentric), Cluster B (dramatic, emotional, or erratic), and Cluster C (anxious or fearful).
• Cluster A includes paranoid, schizoid, and schizotypal personality disorders.
• Cluster B includes borderline, histrionic, and narcissistic personality disorders.
• Cluster C includes avoidant, dependent, and obsessive-compulsive personality disorders.