An Integrative Conceptual Framework for Assessing Personality and Personality Pathology

As a contribution to the ongoing debate over the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, we present a framework for jointly conceptualizing personality and personality pathology. The key element is an explicit distinction between personality description (which is the realm of basic personality psychology) and personality evaluation (which is the realm of clinical personality psychology). Previous diagnostic systems did not acknowledge this crucial distinction. We created a sample diagnostic system, to illustrate how a practical application of our conceptual framework may look like. The system comprises two ingredients: First, a list of personality dispositions that may become problematic. These are described at a “basic level” of abstraction (i.e., the level at which patients and clinicians intuitively communicate about personality problems). Second, a list of negative consequences that are used to evaluate the extent to which a patient's personality pattern is “problematic.” A sample of therapists used the system for describing actual patients and found it to be better than the International Classification of Diseases (ICD)-10 and DSM–IV. Based on our conceptual deliberations, we analyze the DSM-5 proposal for personality and personality disorders. The proposal contains three different sets of “higher-order concepts” (personality traits, personality types, and levels of personality functioning). Only the first of these is sufficiently supported by empirical evidence, including analyses of our own set of personality dispositions.