Personality disorders: a dimensional approach
Keywords:
Personality disorders, Dimensional diagnosis, Categorical diagnosisAbstract
doi: 10.26439/persona2020.n023(1).4830
In the field of clinical psychology, there is a growing consensus about thedeficiencies of the categorical diagnosis system for personality disorders (PD), sinceit is insufficient to cover the dysfunctional experiences of patients. These deficiencies cause an incomplete system, since it excludes essential and idiosyncratic information necessary to better understand the patients. Moreover, this situation negatively affects the adequate conceptualization of the problems and the design of the interventions. If too many difficulties arise when implementing a diagnostic model in psychotherapy, it is possible to think that the model should be modified instead of trying to adjust psychotherapy to the model. The conceptualization of PD from the so-called “dimensional perspective” makes it possible to address the special features of each subject and, thus, improve the quality of the interventions. This work aims to explain how such dimensional perspective, which currently has a strong empirical support, can improve the clinical understanding of these disorders and their therapeutic intervention.
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References
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Simonsen, E., y Widiger, T. (2005). Alternative dimensional models of personality disorder. Journal of Personality Disorders, 19(2), 110-130.
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Widakowich, C. (2012). El enfoque dimensional vs. el enfoque categórico en psiquiatría: aspectos históricos y epistemológicos. Alcmeon, Revista Argentina de Clínica Neuropsiquiátrica, 17(4), 365-374.
Widiger, T. (2003). Personality disorder diagnosis. World Psychiatry, 2(3), 131-135.
Widiger, T. A. & Lowe, J. R. (2007). Five-Factor Model Assessment of Personality Disorder. Journal of Personality Assessment, 89(1), 16-29. https://doi. org/10.1080/00223890701356953
Witkiewitz, K., King, K., McMahon, R., Wu, J., Luk, J., Bierman, K., Coie, K., Dodge, K., Greenberg, M., Lochman, J., y Pinderhughes, E. (2013). Evidence for a multidimensional latent structural model of externalizing disorders. Journal of Abnormal Child Psychology, 41, 223-237.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-V. Washington D. C.: Autor.
Artigas-Pallarés, J., y Paula-Pérez, I. (2015). Asignaturas pendientes del DSM-5. Revista de Neurología, 60(1), 95-101.
Belloch Fuster, A., y Fernández Álvarez, H. (2010). Tratado de trastornos de la personalidad. Madrid: Síntesis.
Beutler, L., Someah, K., Kimpara, S., y Miller, K. (2016). Selecting the most appropriate treatment for each patient. International Journal of Clinical and Health Psychology, 16(1), 99-108.
Bowins, B. (2010). Personality disorders: a dimensional defense mechanism approach. American Journal of Psychotherapy, 64(2), 153-169.
Calvo, R., Mata, I., Pérez Sayes, A., y Tirapu Ustárroz, J. (2005). Propuesta de un modelo dimensional para los trastornos de personalidad. Actas Españolas de Psiquiatría, 33(4), 254-262.
Calvo, N., Valero, S., Sáez-Francàsc, N., Gutiérrez, F., Casas, M., y Ferrera, M. (2016). Borderline personality disorder and personality inventory for DSM-5 (PID-5): dimensional personality assessment with DSM-5. Comprehensive Psychiatry, 70, 105-111.
Clark, L. A. (1993). Schedule for Nonadaptive and Adaptive Personality (SNAP). Mineápolis, MN: University of Minnesota Press.
Cloninger, C. R. (1999). Personality and psychopathology. Arlington, VA: American Psychiatric Association.
Esbec, E., y Echeburúa, E. (2014). La evaluación de los trastornos de la personalidad según el DSM-5: recursos y limitaciones. Terapia Psicológica, 32(3), 255-264.
Fernández Álvarez, H., Consoli A. J., y Gómez B. (2016). Integration in psychotherapy: reasons and challenges. American Psychologist, 71(8), 820-830.
Fernández Álvarez, H., y Fernández Álvarez, J. (2017). Terapia cognitivo conductual integrativa. Revista de Psicopatología y Psicología Clínica, 22, 157-169.
Hernández-Guzmán, L., Del Palacio, A., Freyre, M., y Alcázar-Olán, R. (2011). La perspectiva dimensional de la psicopatología. Revista Mexicana de Psicología, 28(2), 111-120.
Livesley W. J., y Jackson, D. N. (2009). Manual for the Dimensional Assessment of Personality Pathology-Basic Questionnaire. Port Huron, MI: Sigma Press.
McCrae, R. R., y Costa, P. T. (1996). Toward a new generation of personality theories: Theoretical contexts for the five-factor model. En J. S. Wiggins (Ed.), The fivefactor model of personality: theoretical perspectives (pp. 51-87). Nueva York, NY: The Guilford Press.
McCrae, R. R., y Costa, P. T. (2002 [1978]). Inventario de Personalidad Neo Revisado (NEO PI-R). Madrid: TEA Ediciones.
Mellor Marsá, B., y Aragona, M. (2009). De la categoría a la dimensión: una mirada crítica a la evolución de la nosografía psiquiátrica. Revista de la Asociación Española de Neuropsiquiatría, 29(103), 217-228.
Millon, T., y Grossman, S. D. (2006). Goals of a theory of personality. En J. C. Thomas, D. L. Segal y M. Hersen (Eds.), Comprehensive handbook of personality and psychopathology, Vol. 1: Personality and everyday functioning (pp. 3-22). Hoboken, NJ: John Wiley & Sons Inc.
O’Connor, B. (2005). A search for consensus on the dimensional structure of personality disorders. Journal of Clinical Psychology, 61(3), 323-345.
Prochaska, J. M., y Prochaska, J. O. (2001). ¿Por qué no se mueven los continentes? ¿Por qué no cambian las personas? Revista de Psicoterapia, 12(46-47), 17-36.
Reynolds, S., y Clark, A. (2001). Predicting dimensions of personality disorder from domains and facets of the five-factor model. Journal of Personality, 69(2), 199-222.
Simonsen, E., y Widiger, T. (2005). Alternative dimensional models of personality disorder. Journal of Personality Disorders, 19(2), 110-130.
Trull, T. J., y Widiger, T. A. (1997). Structured Interview for the Five-Factor Model of Personality. Odessa, FL: Psychological Assessment Resources.
Um, M., Hershberger, A., Whitt, Z., y Cyders, M. (2018). Recommendations for applying multi-dimensional model of impulsive personality to diagnosis and treatment. Borderline Personality Disorder and Emotion Dysregulation, 5(6), 1-17.
Widakowich, C. (2012). El enfoque dimensional vs. el enfoque categórico en psiquiatría: aspectos históricos y epistemológicos. Alcmeon, Revista Argentina de Clínica Neuropsiquiátrica, 17(4), 365-374.
Widiger, T. (2003). Personality disorder diagnosis. World Psychiatry, 2(3), 131-135.
Widiger, T. A. & Lowe, J. R. (2007). Five-Factor Model Assessment of Personality Disorder. Journal of Personality Assessment, 89(1), 16-29. https://doi. org/10.1080/00223890701356953
Witkiewitz, K., King, K., McMahon, R., Wu, J., Luk, J., Bierman, K., Coie, K., Dodge, K., Greenberg, M., Lochman, J., y Pinderhughes, E. (2013). Evidence for a multidimensional latent structural model of externalizing disorders. Journal of Abnormal Child Psychology, 41, 223-237.
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2020-07-07
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How to Cite
Gamba, F., Graziola, M. ., Marino, J., Urgorri, M., & Castellaro, M. (2020). Personality disorders: a dimensional approach. Persona, 23(1), 11-20. https://revistas.ulima.edu.pe/index.php/Persona/article/view/4762
