A New Direction for Personality Disorder Diagnosis

August 24, 2017
John M. Oldham, MD, MS

Some things are easier to agree on than others. Take, for example, how personality disorders are presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Most mental health professionals would agree DSM-IV left ample room for improvement in its section addressing personality disorders. But when the workgroup that tackled a personality disorder revamp for DSM-5 created a completely new diagnostic model (which was unanimously approved by the DSM-5 task force), it was ultimately rejected by the American Psychiatric Association Board of Trustees, which decided to stick with the personality disorders section largely as it was presented in DSM-IV instead.

Thankfully, explained workgroup cochair John M. Oldham, MD, MS, the story didn’t end there. The new model wasn’t scrapped altogether from DSM-5 but was placed in Section III, “Emerging Measures and Models.” Although it didn’t replace the previous diagnostic section as the workgroup had intended, its inclusion in Section III garnered it fair game for clinicians looking for a different yet “official” approach to personality disorder diagnoses.

Dr. Oldham will give a full overview of the Alternative Model for DSM-5 Personality Disorders (AMPD), and explain how clinicians can use it, during his session at Psych Congress.

“If you like it and you want to use it in your clinical work, that's legit,” said Dr. Oldham, professor of psychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas. “You can make your diagnoses using the alternative model.”

In fact, clinicians who participated in a study published in The Journal of Abnormal Psychology in 2014 preferred the AMPD over the old version for 14 variables out of 18. Field trials yielded similar acceptance and positive results.