On identity

DSM-5 is on the market and found an enormous amount of attention in the media but also critique from scientists and clinicians. In the focus of the debate are reservations against establishing new disorders and lowering the threshold to diagnose mental disorders with the danger of mislabeling normal people [1]. The ambitious goal of the DSM-5 Task Force was to produce a shift of paradigm in psychiatry by introducing a dimensional approach. This was especially true for Axis II of DSMIV-TR, the section of personality disorders that had been under debate for insufficient reliability and validity and for being too non-specific. This critique is not surprising bearing in mind that the general criteria for personality disorders in DSM-IV didn’t have a sufficient empirical basis. However, after long lasting controversies, the American Psychiatric Association (APA) Board of Trustees decided in December 2012 that DSM-5 maintains the categorical model and the DSM-IV-TR criteria of personality disorders. The alternative hybrid dimensional-categorical model is now included in a separate chapter in Section III of DSM-5 to encourage further empirical research [2]. Thus, a process of more than a decade’s intensive work has been stopped abruptly as the Personality Disorder Work Group was obviously not able to reach consensus or to convince the Board of Trustees of the superiority of the new model. What are the main aims of a classification system? In clinical practice a classification system should guide clinicians to use the appropriate treatment approaches developed for specific disorders, and in research to yield a nosological system that helps to disentangle the complex etiology of mental disorders. For research in the field of personality disorders the decision to keep the old model with all its well-known shortcomings is a major step back, and it will amplify the shift away from the study of diagnoses towards a focus on dimensions of observable behavior and neurobiological measures as it is proposed by the NIMH in the Research Domain Criteria Project (RDoC) [3]. However, with the decision to keep the old system and to