The Transition to a Dimensional System for Personality Disorders: Main Advances and Limitations

• Guillermo Alfonso ^[1] ; Bruno César Franco ^[1] ; Mauricio Cervigni ^[1] ; Pablo Martino ^[1] ; María Gabriela Valdez Paolasini ^[2] ; Augusto Pascual Ítalo Gargiulo ^[3] ; Pascual Ángel Gargiulo ^[3]
  1. [1] Universidad Nacional de Rosario
  2. [2] University of Buenos Aires (UBA)
  3. [3] National University of Cuyo

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• Localización: Psychiatry and Neuroscience Update: From Epistemology to Clinical Psychiatry – Vol. IV / Pascual Angel Gargiulo (ed. lit.), Humberto Luis Mesones Arroyo (ed. lit.), 2021, ISBN 978-3-030-61721-9, págs. 527-536
• Idioma: inglés
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• Resumen

  • The debate between categorical and dimensional systems has marked the history of psychiatry and psychology from its origins. The former has often been criticized as reductionist, while the latter have been considered as anti-scientific. DSM-5 retained the categorical classification of previous editions for personality disorders (PD) but integrated an alternative evaluation system with dimensional bases. This “compromise solution” between the need to preserve the clinical tradition and the imperative of overcoming important diagnostic restrictions opened the doors for a better approach. This chapter summarizes the advantages and limitations of each perspective, considering the observations that have been made to the most widespread theories of personality, as well as to evaluation instruments that derive from them. The aim is to enrich the theoretical approaches without rejecting the baggage achieved so far. We propose a moderation of the use of self-records of the patient and a deeper analysis of the experiential psychopathological history. We conclude that the dimensional alternatives do not solve all the clinical problems – cutoff point for diagnosis, overlapping of diagnostic criteria, distinction between axis I and axis II disorders, preponderance of the conscious aspects – but provide valuable resources tending to the constant refinement that is expected from any discipline.