The challenge of transforming the diagnostic system of personality disorders

Sabine C. Herpertz*, Steven K. Huprich, Martin Bohus, Andrew Chanen, Marianne Goodman, Lars Mehlum, Paul Moran, Giles Newton-Howes, Lori Scott, Carla Sharp

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

93 Citations (Scopus)
2032 Downloads (Pure)


While the DSM-5 alternative model of personality disorder (PD) diagnosis allows the field to systematically compare categorical and dimensional classifications, the ICD-11 proposal suggests a radical change by restricting the classification of PDs to one category, deleting all specific types, basing clinical service provision exclusively upon a severity dimension, and restricting trait domains to secondary qualifiers without defining cutoff points. This article reflects broad international agreement about the state of PD diagnosis. It is argued that diagnosis according to the ICD-11 proposal is based on broad, potentially stigmatizing descriptions of impaired functioning and ignores much of the impressive body of research and treatment guidelines that have advanced the care of adults and adolescents with borderline and other PDs. Before radically changing classification, which highly impacts the provision of health care, head-to-head field trials coupled with the views of patients as well as thorough debate among scientists are urgently needed.

Original languageEnglish
Pages (from-to)577-589
Number of pages13
JournalJournal of Personality Disorders
Issue number5
Publication statusPublished - 1 Oct 2017


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