Expert Preferences for Categorical, Dimensional, and Mixed/Hybrid Approaches to Personality Disorder Diagnosis

The authors asked 361 personality disorder experts to rank order their preferences for a categorical, dimensional, or mixed/hybrid approach to personality disorder diagnosis in manuals such as the DSM and ICD. Respondents reported a general preference for the mixed/hybrid approach over a purely dimensional approach, and a clear preference against a categorical model. Although there were some statistically significant differences in the rates across training background, age, and gender, this overall pattern of preferences held across these factors. Preferences were notably similar to those reported by Bernstein et al. (2007) prior to the beginnings of deliberations on DSM-5 that ultimately led to a hybrid model. Results are informative for discussions regarding how to classify personality disorders in diagnostic manuals