761Alternative DSM-5 Model for
Personality Disorders
The current approach  to personality disorders appe ars in Section II of DSM-5,
and an alternative model developed for DSM-5 is presented here in Section III. The inclu-
sion of both models in DSM-5 reflects the de cision of the APA Board of Trustees to pre-
serve continuity with current clinical practi ce, while also introducing a new approach that
aims to address numerous shor tcomings of the current approa ch to personality disorders.
For example, the typical patient meeting criter ia for a specific personality disorder fre-
quently also meets criteria for other personalit y disorders. Similarly, other specified or un-
specified personality disorder is  often the correct (but mostly  uninformative) diagnosis, in
the sense that patients do not tend to present with patterns of symptoms that correspond
with one and only one personality disorder.
In the following alternative DSM-5 model, personality disorders are characterized by
impairments in personality functioning  and pathological personality traits.  The specific
personality disorder diagnoses that may be derived from this model include antisocial,
avoidant, borderline, narcissis tic, obsessive-compulsive, an d schizotypal personality dis-
orders. This approach also includes a diagno sis of personality disorder—trait specified
(PD-TS) that can be made when a personality disorder is considered  present but the crite-
ria for a specific disorder are not met.
General Criteria for Personality Disorder
General Criteria for Personality Disorder
The essential features of a personality disorder are
A. Moderate or greater impairment in personality (self/interpersonal) functioning.
B. One or more pathological personality traits.
C. The impairments in personality functioning and the individual’s personality trait expres-
sion are relatively inflexible and pervasive across a broad range of personal and social
situations.