Psy 270 Appendix G

Axia College Material

Appendix G

The DSM-IV

The DSM-IV is an important tool for clinicians. It provides a standard for diagnoses to be standardized across psychology; however, the DSM-IV is not as precise for diagnosing personality disorders as some psychologists would like.

Give an example of each of the following problems identified in your readings and explain how these problems could negatively affect a diagnosis.

1. Some criteria used for reaching a diagnosis cannot be observed directly.

Most of today’s clinicians believe that personality disorders are important and troubling patterns, yet these disorders are particularly hard to diagnose and easy to misdiagnose. These difficulties indicate serious problems with validity (accuracy) and reliability (consistency) of the DSM categories (Jablensky, 2002). One problem is that some of the criteria used to diagnose personality disorder, for example, clinicians must ask not only whether people avoid forming close relationships but also why. In other words, the diagnoses often rely heavily on the impressions of the individual clinician. A related problem is that clinicians differ widely in their judgments about when normal personality style crosses the line and deserves to be called a disorder (Clark, 2002). Some even believe that is wrong ever to think of personality styles as mental disorders, however troublesome they may be (Kendell, 2002).

2. Personality disorders can be similar to each other.

The similarity of personality disorders within a cluster, or even between clusters, poses yet another problem (Grilo et al., 2002). Within the “anxious” cluster, for example, there is considerable overlap between the symptoms of avoidant personality disorder and those of dependent personality disorder. When clinicians see similar feelings of inadequacy, fear of disapproval and the like is reasonable to consider them separate disorders (Bornstein, 1998; Livesley at al., 1994)? Also, the many...