New directions for an old construct: Depressive personality research in the DSM‐5 era

Abstract

The DSM-5 Personality and Personality Disorders Work Group has suggested that the DSM-IV depressive personality disorder (DPD) construct be assessed within a proposed set of trait domains, which include anxiousness, depressivity, and anhedonia, and that the diagnostic category itself be removed from the DSM-5. A review of studies on DPD has demonstrated many challenges and limitations to DPD research, despite strong evidence of its validity and clinical utility. Nevertheless, there remains much interest in how a depressive personality construct fits into a dimensionalized framework of assessing psychopathology. In this paper, I offer three major research directions that can help advance our understanding of the depressive personality construct. These directions can inform researchers and clinicians how depressive personality fits within broad trait dimensions of classification, as well as the internal psychological processes, dynamics and content that characterize this type of psychopathology.

Co-Morbidity of DSM-IV Personality Disorder in Major Depressive Disorder Among Psychiatric Outpatients in China: A Further Analysis of an Epidemiologic Survey in a Clinical Population

“…The result of high prevalence and correlation with MDD of depressive PD, a PD subtype in DSM-IV appendix and now removed from the DSM-5 category, was parallel to previous studies, supporting that depressive PD is one of the most commonly diagnosed personality subtypes (61) and highly overlaps with MDD (62). Although this diagnoses was no longer included in current classification systems of mental disorders, partly because it overlaps with other diagnoses (63), there're still some arguments that depressive PD should be included as a diagnostic type (64, 65). Considered of these reasons, the result of depressive PD was retained in the analysis and might provide further evidence to future studies.…”

Are malignant self‐regard and vulnerable narcissism different constructs?

“…By contrast, the MSR construct arose of the theoretical and empirical literature that described developmental and empirical overlap among individuals described as having a masochistic/self‐defeating, depressive, or vulnerably narcissistic personality (Huprich, ). As noted by Huprich (), part of the failure in adopting depressive PD into the DSM‐5 might have been an inadequacy in capturing the personality dynamics associated with the DSM‐IV description of depressive personality. MSR is a construct that can readily identify the chronic mood disturbances often seen in many patients whose pathology seemed to be poorly represented by a chronic mood disorder, and who seem to possess a number of interrelated personality characteristics, including feelings of guilt/shame/inadequacy, self‐criticism, hypersensitive self‐focus, pessimism, perfectionism, desires for approval and acceptance, masochism, and problematic management of anger.…”

Malignant Self-Regard

“…Due to insufficient support both for its utility and for its distinctiveness from other disorders, and despite evidence to the contrary, this disorder was not included in DSM-IV. 10, 18 Huprich 9,19 has suggested, however, that these disorders may have been inadequately assessed as described in the DSM, due, in part, to the focus on patients' self-reported symptoms that tend to overlap with other mood or personality disorders. This PD was characterized by a chronic dysphoric and unhappy mood state; by low-self-esteem and a sense of inadequacy; and by pessimism, self-criticism, brooding and frequent worrying, and feelings of guilt.…”