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Reasons for overlap between the various DSM–III personality disorders are discussed. It is concluded that overlap may always take place when no hierarchical rules are applied, because of the orthogonal dimensional nature of the personality structure. Data are presented showing the localization of the various personality disorders in an orthogonal three–dimensional space, established by means of a questionnaire that measures oral, obsessive, and hysterical personality traits. It is observed that the dependent, avoidant and the passive–aggressive personality disorders are located close to one another, as are the obsessive and the paranoid; the histrionic, narcissistic, and the borderline; and finally the schizoid and the schizotypal personality disorder in a fourth cluster. A fourth dimension is proposed measuring reality–weakness and a decision tree is presented, which will make it possible to proceed to the DSM-III-R personality disorder diagnoses without overlap. Finally a new system of personality disorders is derived from dichotomizing the four dimensions, resulting in 16 disorders; these include the current DSM–III–R diagnoses but also some new ones that are combinations of the already existing personality disorders.
Torgersen et al. (Fri,) studied this question.
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