SAGE Journal Articles

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Article 1: The New Alternative DSM-5 Model for Personality Disorders: Issues and Controversies

Abstract: Purpose: Assess the new alternative Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) model for personality disorders (PDs) as it is seen by its creators and critics.

Method: Follow the DSM revision process by monitoring the American Psychiatric Association website and the publication of pertinent journal articles.

Results: The DSM-5 PD Work Group’s proposal was not included in the main diagnostic section of the new DSM, but it was published in the section devoted to emerging models. The alternative DSM-5 PD constructs are radically different from those found in DSM, fourth edition, text revision.

Discussion: There are some positive conceptual changes in the new model, but reliability and validity are not generally improved. However, social workers may be able to benefit from the use of the personality trait domains/facets of the alternative model.

Questions to Consider:

  1. What are some of the strengths and weaknesses of the DSM-5?
  2. What was the process that the DSM-5 work groups used to revise the DSM?
  3. Why is it that reliability and validity of diagnosis has not improved in this revision?
     

Article 2: Diagnosis and Characterization of DSM-5 Nonsuicidal Self-Injury Disorder Using the Clinician-Administered Nonsuicidal Self-Injury Disorder Index

Abstract: Despite the inclusion of nonsuicidal self-injury disorder (NSSID) in the DSM-5, research on NSSID is limited and no studies have examined the full set of DSM-5 NSSID diagnostic criteria. Thus, this study examined the reliability and validity of a new structured diagnostic interview for NSSID (the Clinician-Administered NSSI Disorder Index; CANDI) and provides information on the clinical characteristics and features ofDSM-5 NSSID. Data on the interrater reliability, internal consistency, and construct validity of the CANDI and associated characteristics of NSSID were collected in a community sample of young adults (N = 107) with recent recurrent NSSI (≥10 lifetime episodes of NSSI, at least one episode in the past year). Participants completed self-report measures of NSSI characteristics, psychopathology, and emotion dysregulation, as well as diagnostic interviews of borderline personality disorder (BPD) and lifetime mood, anxiety, and substance use disorders. The CANDI demonstrated good interrater reliability and adequate internal consistency. Thirty-seven percent of participants met criteria for NSSID. NSSID was associated with greater clinical and diagnostic severity, including greater NSSI versatility, greater emotion dysregulation and psychopathology, and higher rates of BPD, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and alcohol dependence. Findings provide support for the reliability, validity, and feasibility of the CANDI.

Questions to Consider:

  1. What are the strengths and weaknesses of a structured clinical interview?
  2. Does the CANDI improve reliability and validity of the NSSID diagnosis?
  3. Was the selection process for this study’s sample appropriate and sufficient for the conclusions reached?