Assessment and DSM‐IV Diagnosis of Personality Disorders: A Primer for Counselors

Abstract

The DSM‐IV categorizes 10 personality disorders, long‐term patterns of personality traits that result in impairment of social and occupational functioning. The author details steps in the recognition and diagnosis of personality disorders, with emphasis on using the DSM‐IV diagnostic framework.

A Voice From the Trenches: A Reaction to Ivey and Ivey (1998)

“…In other words, appropriate use of the DSM should enhance the developmental process of building diagnostic data. It is essential that diagnosis be understood and taught as a process and as an integral part of effective counseling (Fong, 1993(Fong, , 1995. Of the human service providers available in our country, I can think of one group of practitioners who are very effective at such a process-counselors.…”

“…Although the DSM has been widely used throughout the world, it is not assured that DSM language, largely used by American and European practitioners, translates into other cultures (Morrison, 1995). Furthermore, inherent in any diagnostic process is the possibility of error, for example, giving a client a diagnosis when the disorder is not present or giving the wrong diagnosis (false positive), or not detecting a disorder or not making a diagnosis when a disorder is present (false negative) (Fong, 1993(Fong, , 1995. The sociocultural implications of such error, as sensitively suggested by Ivey and Ivey, should not be overlooked by counselors.…”

Counselor Identity: Conformity or Distinction?

“…Social constructionism, psychoeducation, healthy development and wellness, and existentialism have each been put forth as such a basis (Bauman & Waldo, 1998;Dinkmeyer, 1991;Guterman, 1994;Hershenson, 1993;Ivey, 1989;Myers, 1991). However, other counselor educators (Fong, 1995;Hinkle, 1994;Hohenshil, 1993Hohenshil, , 1996Seligman, 2004) have countered that failure to embrace the currently dominant medical, diagnostic model will leave counselors at a serious disadvantage; this controversy shows no sign of resolving itself any time soon.…”

“…Second, counselors have debated whether to adopt one of the many approaches mentioned as a basis for their common identity; however, no consensus has emerged regarding the various approaches put forth. Finally, they have debated whether to conform to the currently dominant medical model or to retain their own distinctive, humanistic approach (Fong, 1995;Hansen, 2003;Hinkle, 1994Hinkle, , 1999Hohenshil, 1993Hohenshil, , 1996McLaughlin, 2006;Seligman, 2004).…”

Assessment and Diagnosis of Conduct Disorder

“…T he ability to accurately assess and diagnose individual clients using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994) is an established requirement of professional counselors and other mental health professionals (Fong, 1995;Hohenshil, 1993Hohenshil, , 1994. Although diagnostic procedures have been criticized as a negative labeling process, diagnosis is central to professional communication, treatment planning, counseling research, and third party reimbursement for mental health services (Morrison, 1995;Seligman, 1996;Szasz, 1961).…”