The Challenge of Transforming the Diagnostic System of Personality Disorders

Herpertz, Sabine C.; Huprich, Steven K.; Bohus, Martin; Chanen, Andrew M; Goodman, Marianne; Mehlum, Lars; Moran, Paul; Newton‐Howes, Giles; Scott, Lori N.; Sharp, Carla

doi:10.1521/pedi_2017_31_338

Cited by 139 publications

(112 citation statements)

References 60 publications

(63 reference statements)

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…Pathological narcissism as a whole could thus be seen as conceptually rooted somewhere between the psychopathological appearance of NPD and BPD. This suggestion corresponds with recent attempts of developing a dimensional, trait-related rather than categorical approach in the diagnosis of personality disorders, as has been widely discussed in the task forces and partially implemented in DSM-5 and the draft for ICD-11 [25, 70]. …”

Section: Discussionsupporting

confidence: 69%

Grandiose and Vulnerable Narcissism in Borderline Personality Disorder

et al. 2018

View full text Add to dashboard Cite

Background: Little is known about narcissistic traits in borderline personality disorder (BPD). This exploratory study aimed to illustrate the associations between total, grandiose, and vulnerable narcissism and gender, diagnostic features of BPD and narcissistic personality disorder (NPD), and psychopathology in BPD patients. Sampling and Methods: The Pathological Narcissism Inventory and psychometric measures for impulsivity, anger, borderline symptom severity, personality organization, depression, and rejection sensitivity were completed by 65 BPD patients. Statistical analyses were conducted using the t test, Pearson correlation, and multivariate regression analyses. Results: Male BPD patients displayed higher narcissistic scores than females (p < 0.01). Grandiose narcissism showed a stronger association with NPD than with BPD (p < 0.01) while vulnerable narcissism was only associated with BPD (p < 0.01). Rejection sensitivity (p < 0.01) and depression (p < 0.001) predicted vulnerable narcissism. Conclusion: Vulnerable narcissism is closely associated with BPD and appears to be more dysfunctional than grandiose narcissism. A comprehensive consideration of both traits is recommended. Our results might help to generate hypotheses for further research on pathological narcissism in the spectrum of personality disorders. Future studies are advised to apply complementary measures and take new diagnostic approaches of DSM-5 and ICD-11 into account.

show abstract

Section: Discussionsupporting

confidence: 69%

Grandiose and Vulnerable Narcissism in Borderline Personality Disorder

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, dimensional approaches are arguably less clinically useful: the choice of cut points to delineate variations of normal from clinical disorders is often expedient. This debate is current in the personality field [24]. In contrast, there has already been a more dimensional approach to substance use disorders in the DSM-5, with the previous categorical terms “abuse” and “dependence” being replaced by a unitary construct occurring along a continuum of severity [25].…”

Section: Diagnostic Considerationsmentioning

confidence: 99%

Personality Disorder and Alcohol Use Disorder: An Overview

Newton‐Howes

Foulds

2018

Psychopathology

Self Cite

View full text Add to dashboard Cite

Background: Clinically, personality disorder (PD) commonly coexists with alcohol use disorder (AUD), although within mainstream mental health services both of these mental disorders are routinely overlooked. Despite a rich literature examining the interactions between AUD and personality functioning, personality traits, and PD, there remains conflicting evidence as to the degree of association and impact of one on the other. Methods: A narrative review and a synthesis of the literature were done. Results: The lifetime prevalence of AUD approaches 50% in some PD populations. The rates of PD in AUD populations are less clear but likely similar. Personality influences outcomes in AUD regardless of whether a categorical personality diagnosis or dimensional trait domain approach is taken. There are, however, no good data to inform clinicians on the impact of AUD on the outcomes of PD. Understanding the extent of this impact is complicated by the multiple tools used for diagnosis (of both PD and AUD) and the statistical methods used. Overall, caution is required in interpreting the data due to the quality of the current literature; however, comorbidity between the two disorders is likely significant and the impact of PD on AUD outcomes is sufficient to require consideration. Conclusions: From a research perspective, better agreement on both diagnoses and outcomes is urgently needed to improve the overall quality of the evidence. Clinically, despite the limitations in the literature, it is unacceptable for PD services to ignore AUD and for AUD services not to screen for PD. Both are likely to have an impact on health and functioning and should be considered in routine reviews. A better conceptualization of the putative mechanisms of this interaction, as well as an understanding of the neurobiology and reasons for the impact on treatment outcomes, will help to move the field forward.

show abstract

“…Here we focus on two issues: (a) specific responses to the four instances in which Herpertz et al (2017) cite our previous commentary and (b) two suggestions for a more productive and transparent process. Herpertz et al (2017) make four statements about our previous article. First, they claim that we "argu[e] for accepting the ICD-11 proposal in its current form" (p. 582).…”

mentioning

confidence: 99%