Rep36 Understanding Personality Disorder

1.1.9 Conclusions 
The current psychiatric classifications of
personality disorder have served to focus the
attention of clinicians on this major area of
problematic human behaviour. There is,
however, general agreement that they are no
more than a crude first step in describing the
various ways in which abnormalities of
personality lead to dysfunctional behaviour. As
exaggerations or variations of normal personality
traits, personality disorders need to be thought
of in terms of continua rather than all-or-none
categories, and a dimensional approach to
describing these disorders has gained increasing
acceptance. Different forms of personality
disorder may therefore most usefully be
described by reference to the dimensions of
personality identified by several decades of
research on the normal population. Description
Can children/adolescents have personality disorders?
The classificatory system (DSM-IV) states that personality disorders consist of patterns of thought,
behaviour and emotions that can be traced back to late adolescence and early adulthood. DSM-IV
cautions against diagnosing personality disorders in adolescence because of the significant
developmental changes that occur during this time. To diagnose personality disorder in an
individual under the age of eighteen, the features of that personality disorder must have been
present for at least one year. The one exception to this is antisocial personality disorder, which
cannot be diagnosed in individuals less than eighteen years of age. Many clinicians have concerns
regarding the diagnosis of personality disorder in adolescents as it would be difficult to be certain
that their presentation represents a repetitive or inflexible aspect of their psychological make up,
which would be necessary for a diagnosis of personality disorder. Diagnosing adolescents could
produce harmful results as the person may receive inappropriate treatment, an inaccurate label
that may undermine their self esteem and lead other people to discriminate against them,
including the denial of mental health services. However, it is also possible that failing to diagnose
personality disorder accurately could result in an adolescent not receiving treatment that could
help to alleviate their difficulties. Therefore, a cautious and conservative approach to the diagnosis
of personality disorder in this group would be recommended. An alternative could be to focus
upon formulating an adolescent’s functional strengths and weaknesses; leading to a more needs
based approach.

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9
is not, however, sufficient for explanation and
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effective clinical interventions. There is an
urgent need to integrate knowledge of abnormal
personality developed by psychiatrists and
psychologists in clinical studies with theory and
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generally. Without a clear conceptualisation of
what needs to be changed, progress in delivering
services for people with personality disorder will
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