Transitioning to a dimensional model of personality disorder in DSM 5.1 and beyond

PURPOSE OF REVIEW: To propose options for gradually transitioning to a thoroughgoing dimensional model of personality disorder. RECENT FINDINGS: The American Psychiatric Association was less willing to implement a dimensional approach to the diagnosis of personality disorder than the leadership of the DSM-5 anticipated. The next opportunity to implement such an approach will be in the ICD-11 and the DSM 5.1. SUMMARY: Instead of seeking a revolutionary change, attempting a more gradual transition that leads to something significantly better in the long run is likely to be more successful. For the long run, in addition to clinical utility and scientific validity, new diagnostic models must possess user acceptability. Professionals will be more likely to accept a new model if they believe it will allow them to do good work. Competent use of a dimensional model is not only a matter of increased familiarity with personality trait profiles, it requires a different kind of clinical expertise.