1/ This is the DSM error—conflating two different things & discussing them as if same. 1. You can assess/diagnose personality at level of multifaceted syndromes or narrow traits. Clinicians *always* think in terms of syndromes. 2. Irrespective of whether addressing syndromes or
2/ traits, you can treat phenomena as categories (present/absent) or continuaa (eg, no narcissistic personality characteristics through moderate to strong to extreme). This is what DSM-5 work groups failed to grasp. Clinicians think in terms of syndromes not traits. Severity of
3/ syndromes are continuaa, not categories. Obvious solution is to diagnose *syndromes* and treat them as continua. We DID it. It works, clinically & empirically. Academic psychology researchers (who have never seen a pt in their lives) sold DSM workgroups a bill of goods,
4/ convinced everyone that dimensional=traits. Claimed to be advocating “dimensional” approach when in fact selling clinically-naive ideology that 100 years of accrued clinical knowledge about personality syndromes should be thrown away. And everyone involved w DSM was so mired
5/ in limiting DSM assumptions made 40 years ago that they couldn’s see solution in front of their noses. We showed it.We published ~100 papers on it. And everyone kept repeating same mistake—unable to grasp that “dimensional”≠ trait model. swapassessment.org/wp-content/upl…
6/ it’s really not that complicated. A personality syndrome is a collection of *functionally related* characteristics and psychological processes. It’s a pattern. It’s not defined by summing separate parts. It the *pattern* that matters. We don’t recognize people’s faces by
7/ independently assessing characteristics of noses, lips, eyes, etc. we see & recognize * the pattern,* not deconstructed parts & pieces. Our brains are designed to recognize *patterns*. It’s a scientifically-established fact.
8/ its not hard. Describe pattern & do it well. We called these descriptions diagnostic prototypes. Now diagnose whether pt fits pattern. 1=no match (eg, not narcissistic personality), 3= moderate match (moderately narcissistic personality, 5=strong match (extremely narcissistic)
9/ DSM contributors couldn’t come up with this in 40 years. No one could see past original incorrect assumptions.
