Understanding Relations among Personality, Clinical Syndromes and Functioning

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; American Psychiatric Association, 2013) places clinical syndromes and personality disorder (PD) in the same conceptual space (Section II, Diagnostic Codes and Criteria; PD-II). Concurrently, an alternative PD model in Section III (Emerging Measures and Models; PD-III) includes two main criteria: (A) impairment in personality functioning, and (B) pathological personality trait(s). These two constructs, however, are difficult to distinguish conceptually and empirically, and both relate to extrinsic disability (Clark & Ro, 2013). Distinguishing impairment intrinsic to mental disorders from associated extrinsic disability has implications for their conceptualization. Thus, this study’s purpose is to examine relations among PD, clinical syndromes, and functional impairment/disability. Results indicated two main PD-III criteria overlapped substantially and together consistently predicted more extrinsic disability variance than did the PD-II model. Personality and clinical symptoms also overlapped considerably and accounted for similar variance in extrinsic disability outcomes.