Handbook of Personality Disorders: Theory, Research, and Treatment

Handbook of Personality Disorders: Theory, Research, and Treatment

Handbook of Personality Disorders: Theory, Research, and Treatment

Handbook of Personality Disorders: Theory, Research, and Treatment

Synopsis

This major reference and text provides the authoritative account of current knowledge on personality disorders, including vital information to guide clinical decision making. Bringing together preeminent authorities in the field, the Handbook synthesizes

Excerpt

For much of its history, personality disorder was a relatively neglected domain of psychopathology. Knowledge consisted almost entirely of theoretical speculations based on observations made in the course of clinical practice and the in-depth treatment of small numbers of patients. Recently, however, this situation has changed: Over the last two decades, the field has become an active arena of empirical inquiry, with issues that were originally settled by reference to one school of thought or another, or by appeal to tradition, now more likely to be subjected to empirical scrutiny. Diverse theoretical approaches and multiple disciplines are contributing different perspectives that challenge previous ideas. These developments are beginning to forge a new understanding of the nature, origins, and treatment of personality disorder. Current approaches to classification are being challenged by empirical evaluations that offer minimal support for traditional diagnostic formulations but rather point in new directions and indicate the need for new nosological systems. Ideas about the structure of personality disorder and its relationship to other clinical syndromes are changing. Far from being fundamentally distinct entities, it appears that personality disorder and a variety of other mental disorders have at least some common origins. As these etiological links are identified, the distinction between Axis I and Axis II in the DSM system is becoming increasingly blurred.

Similar changes are occurring at the interface between normal and disordered personality. In the past, personality disorder was studied independently of studies of normal personality and little cross-fertilization of ideas occurred. Over the last few years, these distinctions have begun to break down, raising fundamental questions about the nature and definition of disorder and the way it may be differentiated from normality. Empirical and conceptual analyses fail to support categorical distinctions between normal and disordered personality. Instead, many aspects of personality disorder appear to represent the extremes of normal variation—an idea with major implications for classification and research.

In tandem with these developments, a new understanding of the etiology and development of personality disorder is emerging from work in behavior genetics and developmental psychology, and as a result of the cognitive revolution in psychology, that differs substantially from older explanations based on clinical reconstruction. Accounts of the development of personality disorder based on psychosocial factors are being supplemented by an understanding of biological and developmental mechanisms. Even our understanding of the environment is changing with recognition that individuals seek out and create environments that are consistent with their genetic predispositions and emerging personality patterns. Such developments not only challenge traditional theories about the origins of personality disorder but also question the assumptions of many treatments that have neglected the biological underpinnings of personality. At the same time, new treatment approaches are being developed to supplement and sometimes replace traditional methods.

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