Personality and personality disorder: current issues and directions.

EDITORIAL Personality and personality disorder : current issues and directions" The last decade has seen a renewed interest and research effort focused on the broad areas of personality and personality disorder. Issues preoccupying researchers include problems of classification (especially categorical versus dimensional models), the absence of theoretical models, and implications of the suggested continuity between ' normal ' personality dimensions and personality disorder. One keenly debated issue concerns the respective merits of categorical versus dimensional approaches to the assessment of personality disorder (PD). The DSM system clearly shapes current theorizing and clinical diagnostic practices in this area. According to DSM-IV (APA, 1994), personality disorder is ' an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture and is manifested in at least two of the following areas : cognition, affectivity, interpersonal functioning or impulse control '. Furthermore, the enduring pattern is required to be ' inflexible and pervasive ', ' stable over time ', have an ' onset in adolescence or early adulthood ' and ' lead to clinically significant distress or impairment in social, occupational or other important areas of functioning '. DSM-IV lists 10 specific personality disorders that are grouped into three separate clusters based on descriptive similarities : Cluster A (an ' odd or eccentric ' pattern) ; Cluster B (' dramatic, emotional or erratic ') ; and Cluster C (' anxious and fearful '). Thus, the categorical model views PDs as qualitatively distinct clinical syndromes with three higher order classes or clusters. Its limitations have been well documented, most notable being the basic assumption that a disorder is either present or absent, and as a consequence, the fostering of an arbitrary distinction between normal and abnormal personality (Shea, 1995). Thus, for individual personality disorders, reliability of diagnosis is modest at best, while reaching diagnostic criteria for one personality disorder is frequently associated with also meeting criteria for several other personality disorders. Even the DSM cluster model has resisted empirical support, with two-cluster and four-cluster solutions most commonly identified and with compulsive PD loading on any fourth cluster rather than with the anxiety cluster PDs (see Parker et al. 1998). The contrasting dimensional view regards PDs as representing ' maladaptive variants of personality traits that merge imperceptibly into normality and into one another ' (APA, 1994). This now has a strong evidence base. Thus, PD features do not form …