Special section. DSM-IV reviews of the personality disorders: Introduction to special series

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Abstract

A concern raised by several authors regarding the DSM-III and DSM-III-R personality disorders was the potential absence of sufficient justification and empirical support for the addition of diagnoses and for the revision of criteria sets (e.g., Caplan, 1987; Gunderson, 1983; Kaplan, 1983; Kernberg, 1984; Michels, 1984; Millon, 1981; Perry, 1990). The rationale and justification for some of the additions and revisions have been published (e.g., Kass, Spitzer, Williams, and Widiger, 1989; Spitzer, Williams, and Skodol, 1980; Widiger, Frances, Spitzer, and Williams, 1988), but these papers have typically appeared after the publication of the manual. Work began on DSM-IV in 1988 and it is scheduled to appear in 1993. The development of DSM-IV was prompted by the concurrent development of the 10th edition of the International Classification of Diseases (Frances, Widiger, and Pincus, 1989), but the anticipation of further revisions to the personality disorders section has already generated criticism and concern (Blashfield, Sprock, and Fuller, 1990; Caplan, in press; Zimmerman, 1988). One concern is that frequent changes disrupt research and do not allow sufficient empirical review of the nomenclature to develop. As a result, DSM-IV might include arbitrary revisions that largely reflect the theoretical or empirical biases of the committee members. These concerns are shared by the DSM-IV Task Force and Work Groups. The process by which DSM-IV is being developed includes a number of safeguards to minimize the occurrence of arbitrary, biased, and/or whimsical revisions (Frances, Pincus, Widiger, Davis, and First, 1990). One such safeguard has been to require written reviews of the empirical and clinical literature for each issue, proposal, or diagnosis and to subject the reviews themselves to critical review (discussed further below). The publication of personality disorder reviews in this special series of the Journal of Personality Disorders is part of this effort to provide an open, explicit, and systematic review of the evidentiary basis for proposed revisions.

Original languageEnglish
Pages (from-to)122-134
Number of pages13
JournalJournal of Personality Disorders
Volume5
Issue number2
DOIs
StatePublished - 1991

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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