Alternative DSM-5 Model for Personality Disorders 771
Specifiers. The specific personality features of in dividuals are always recorded in eval-
uating Criterion B, so the comb ination of personality features characterizing an individual
directly constitutes the specifiers in each case. For example, two individuals who are both
characterized by emotional lability, hostility, and depressivity may differ such that the
first individual is characterized additionally by callousness, whereas the second is not.
Personality Disorder Scoring Algorithms
The requirement for any two of the four A criter ia for each of the six personality disorders
was based on maximizing the relationship of these criteria to their corresponding person-
ality disorder. Diagnostic thresholds for the B criteria were also set empirically to minimize
change in prevalence of the disorders from DSM-IV an d overlap with other personality
disorders, and to maximize relationships with functional impairment. The resulting diag-
nostic criteria sets represent clinically usef ul personality disorders with high fidelity, in
terms of core impairments in personality functioning of varying degr ees of severity and
constellations of pathological personality traits.
Personality Disorder Diagnosis
Individuals who have a pattern of impairment  in personality functioning and maladaptive
traits that matches one of the six defined personality disorders should be diagnosed with
that personality disorder. If an individual also  has one or even several prominent traits that
may have clinical relevance in addition to those requ ired for the diagnosis (e.g., see narcis-
sistic personality disorder), the option exists for these to be noted as specifiers. Individuals
whose personality functioning or trait pattern is substantially different from that of any of
the six specific personality disorders should be diagnosed with PD-T S. The individual may
not meet the required number of A or B criter ia and, thus, have a su bthreshold presentation