Livesley's lament on classifying personality pathology: A commentary

AbstractThis commentary on Livesley's paper in this special issue on International Classification of Diseases (ICD) ‐11's personality disorder (PD) section addresses each of four issues that Livesley claims are impeding progress towards an evidence‐based system for the classification of personality pathology. I focus my commentary on the third issue, but also comment briefly on the others. Regarding, first, t he complexity of personality pathology and, second, problematic assumptions about the nature of personality pathology, I contend that Livesley's comments are accurate, but omit that the fundamental impediment is the refusal of theDiagnostic and Statistical Manual of Mental Disorders (DSM) establishment to allow the official classification to reflect the reality of personality pathology that he describes, in contrast to its acceptance in theICD ‐11. In response to Livesley's third claim that a viable alternative to categorical diagnosis is not available, I take issue with various aspects of his assertions and develop arguments that theICD ‐11 PD model provides a useful, although admittedly imperfect, system. Finally, I agree with Livesley that the revision processes for official classifications are conservative and open to non ‐scientific influences, but maintain that whereas theDiagnostic and Statistical Manual of Mental Disorders establishment held fast to the status quo, theICD ‐11 PD Working Group made considerable progress towards a valid PD diagnostic sy...
Source: Personality and Mental Health - Category: Psychiatry Authors: Tags: Special Issue Article Source Type: research