Models of personality

The study of the personality has been based on two types of model—categorical and dimensional. Categorical models

Categorical models consider discontinuous personality categories. This type of model is used in DSM-IV (14) and ICD-10(1..5) because of the need for a specific diagnostic, i.e. a categorical approach.

In modern nosology the categorization of illness is based on the presenting symptoms and not on their aetiopathology, and says nothing about the nature of the disorders themselves. In the case of personality disorders, the categorization does not affirm or deny that they are disorders or illnesses, nor does it indicate where the symptoms differ from non-morbid behaviour patterns.

There is a high comorbidity among personality disorders and between personality disorders and other mental disorders. The main problem is to determine the exact nature of this comorbidity. In comorbid cases, the personality disorder could be a predisposing factor, a consequence, or an attenuated form of the mental disorder, or it could be independent of the mental disorder. The fact that the association between a mental disorder and a personality disorder is not always fortuitous has been shown by the observation that effective treatment of the former can lead to the disappearance of the latter, as has been demonstrated in the treatment of obsessive-compulsive patients with pharmacotherapy and behavioural therapy.(16)

The better a personality disorder is understood and the more biological correlations are found in it, the more likely it is to be transferred from Axis II to Axis I of DSM-IV, i.e. to be classified as a 'real' disorder. Epileptic personality, depressive personality, cyclothymic personality, and even schizothymic personality are now classified as Axis I disorders in ICD-10.

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