A unifying perspective on personality pathology across the life span: Developmental considerations for the fifth edition of theDiagnostic and Statistical Manual of Mental Disorders

Abstract

Proposed changes in the fifth edition of theDiagnostic and Statistical Manual of Mental Disorders(DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs inDSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informingDSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs inDSM-Vand highlight the advantages of a dimensional model in unifying PD perspectives across the life span.