Diagnostic Manual and Statistics, fourth edition, text review [American Psychiatric Association. DSM-IV-TR, Washington, 2000] - or DSM-IV-TR for short - defines Axis II personality disorder as "rooted, negative, lifelong behavioral patterns". But the DSM separation model that it has been using since 1952 has been critically criticized as sadly inadequate by many experts and staff.
DSM is part. It states that personality disorders are "different clinical syndromes" (p. 689). But this is to tally unacceptable. As we have seen in my previous article and in the blog entry, experts cannot even agree on what it means "normal" and how they can distinguish between "disturbed" and "unusual". The DSM does not provide a clear "threshold" or "critical weight" in which the victim should be considered a mentally ill person.
In addition, DSM diagnostic methods are polytheism. In other words, it is enough to satisfy only the subset of the process of identifying personality disorders. Therefore, people diagnosed with the same personality disorder may share only one condition or nonexistence. This association of heterogeneity (large variability) is unacceptable and unscientific.
In another article we discuss five diagnostic axes employed by the DSM to visualize clinical illnesses (such as anxiety, emotions, eating disorders), general health conditions, psychological and environmental problems, chronic child and growth problems, and functional problems. Contact personality issues.
However, DSM's "clothing list" hides rather than clarifies the interaction between various axes. As a result, the distinctive diagnosis that should help us distinguish one person's disorder from all others is unclear. In mental language: personality disorders are not sufficiently isolated.
This negative state of affairs leads to extreme co-operation: many human diseases are found in the same topic. Therefore, psychopaths (Antisocial Personality Disorder) are often found as narcissists (Narcissistic Personality Disorder) or borderline (Borderline Personality Disorder).
DSM also fails to distinguish between personality, personality traits, character, attitude, personality styles (Theodore Milan's contribution) and the full human distraction. It does not allow for personality disorders caused by circumstances (responsive personality problems, such as Milan's suggestion "Acquired Situational Narcissism").
Nor does it deal effectively with personality problems resulting from medical conditions (such as traumatic brain injury, metabolic conditions, or chronic toxicity). The DSM had to turn to classifying other personality problems such as NOS's "unspecified otherwise", "diagnostic" category, meaningless, useless, and dangerously vague.
One of the reasons for this negative taxonomy is the lack of research and well-documented clinical information about both disorders and various treatment options. Read this week’s article to learn about another major DSM failure: many of the personality problems are “culturally bound”. They reflect social and modern bias, values, and prejudices rather than real and consistent structures and institutions.
The DSM-IV-TR distances itself from the phase model and suggests the emergence of an alternative: size method:
"Another way the class is the dimensional view that Personality Disorders represents a vicious variety of personality traits that blend invisibly into one another and become one another" (p.689)
According to discussions by the DSM V Committee, the following version of this reference work (to be published in 2010) will address the issues that have been neglected:
The longitudinal course of the disorder (s) and their temporary stability from childhood onwards;
The genetic and biological foundations of human disorders;
The development of human psychopathology in childhood and its emergence in adolescence;
The link between physical health and disease and personality disorders;
The effectiveness of various therapies - speech therapies and psychopharmacology.
very nice
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