The General Criteria for Personality Disorders Assessed by Interview: Do They Still Have a Role to Play?

Abstract

On the path to developing dimensional models of personality disorder (PD), we are at risk of leaving key diagnostic aspects behind. The general criteria for PD may be important ones because they reflect the defining aspects of personality pathology: long duration, independence from psychopathological states, and harmfulness. We assessed these criteria by interview in a sample of 362 psychiatric outpatients after administering the Personality Diagnostic Questionnaire–4+. The result was a 42.5% fall in self-reported endorsements, due to misinterpretations (11.5%), short duration of traits or contamination by state psychopathology (9.8%), and traits being non-harmful (21.2%). However, not all personality traits and disorders underwent correction to the same extent, and ultimately, the interview did not improve the prediction of clinical variables. These findings raise doubts about the practical relevance of the general criteria for PD and support the role of self-report questionnaires for diagnostic purposes.

Severity in the ICD-11 personality disorder model: Evaluation in a Spanish mixed sample

“…For example, negative emotionality has proven to be definitely impairing with regard to a broad range of clinical outcomes, whereas all other dimensions are associated to only a few detrimental outcomes or are clinically inconsequential ( 71 ). In fact, anankastic features such as perfectionism, workaholism, rigidity, or even the obsessive-compulsive PD, have shown to be fairly harmless ( 29 , 72 , 73 ), or even beneficial in certain areas ( 71 , 74 ), and the same is true of disinhibition and dissociality ( 71 , 75 – 77 ). In accordance with this, these domains are also unrelated in our study to either caseness or the WHO scales.…”