from Part III - Individual Disorders and Clusters
Published online by Cambridge University Press: 24 February 2020
The Diagnostic and Statistical Manual – 5th edition (DSM-5) definitions for Cluster A personality disorders have been valuable to the clinical, scientific, and consumer communities. However, they suffer from serious issues as scientific constructs and are difficult to precisely measure. These issues have constrained our ability to meaningfully comprehend their underlying biopsychosocial mechanisms and to develop cures and treatments. The authors consider three potential ways to improve the operationalization and measurement of Cluster A disorders. First, they discuss the viability of existing alternative diagnostic systems such as the DSM-5 alternative personality disorder model, the five-factor personality model, the Research Domain Criteria (RDoC), and the Hierarchical Taxonomy of Psychopathology (HiTop) systems. Second, they explore the utility of operationalizing Cluster A disorders within a broader spectrum of schizophrenia-related disorders. Lastly, they consider the viability of objectifying cluster A disorders symptoms and behaviors using various genotyping and phenotyping technologies (e.g., mobile devices). While each potential way has its strengths and weaknesses, collectively they may help account for the complex phenotypic heterogeneity associated with Cluster A disorders, provide objective markers of their severity, and facilitate individualized assessment, prevention, and treatment.
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