 755
There is a substantial body of research on 
personality traits and structure, which is 
quite evident from the chapters in this vol -
ume. There is also a body of literature and 
research concerning personality disorders, 
the conceptualization and diagnosis of which 
is governed within the United States by the 
fifth edition of the American Psychiatric As -
sociation’s (2013) Diagnostic and Statisti -
cal Manual of Mental Disorders (DSM-5). 
Historically, there was little integration of 
the psychiatric understanding of personal -
ity disorders with the psychological research 
on general personality structure (Widiger 
& Frances, 1985). Nevertheless, over the 
past few decades there has been an effort by 
many researchers to conceptualize the per -
sonality disorders of the American Psychiat -
ric Association in terms of dimensional trait 
models developed within psychology, more 
specifically, the five-  factor model (Widiger 
& Costa, 1994).
Section II of DSM-5 (American Psychi -
atric Association, 2013) provides the of -
ficial diagnostic categories, including 10 
personality disorders: antisocial, avoidant, 
borderline, dependent, histrionic, narcissis -
tic, obsessive–  compulsive, paranoid, schiz -
oid, and schizotypal. Proposed for DSM-5, 
however, was the deletion of four to five of these categories, as well as a significant re -
formulation of those retained, replacing the 
specific and explicit criterion sets that were 
a major innovation of DSM-III (Kendler, 
Muñoz, & Murphy, 2010) with paragraph 
descriptions consisting of 10–17 often com -
plex sentences, with no rules or guidance as 
to how many of the features need to be pres -
ent, or even a requirement that each sentence 
be considered (Skodol, 2012). “Diagnosti -
cians rate the overall similarity or ‘match’ 
between a patient and the prototype . . . con -
sidering the [narrative] prototype as a whole 
rather than counting individual symptoms” 
(Westen, Shedler, & Bradley, 2006, p. 847). 
Also included within the initial proposal 
was a six-  domain, 37-trait model (eventu -
ally reduced to five domains and 25 traits) 
that was to be used to describe patients who 
did not meet criteria for one of the five to six 
retained syndromes.
The narrative paragraphs were eventually 
abandoned due to an absence of adequate 
empirical support and concerns over poor re -
liability (Widiger 2011; Zimmerman, 2011). 
The narrative paragraphs were replaced 
with another novel proposal, identified as 
a “hybrid model,” in which each personal -
ity disorder is diagnosed on the basis of a 
combination of four self–  interpersonal defi -CHAPTER 36
Personality and  Personality Disorder
Thomas A. Widiger  
Joshua  R. Oltmanns