Sociocultural context and the DSM-5 alternative model of personality disorder: Comment on Widiger and Hines (2022)

Abstract

Widiger and Hines (2022) provide a brief overview of the development of the alternative model of personality disorder (AMPD) housed within Section 3 of the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). They highlight 8 issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a 9th issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: (9) How is sociocultural context to be accommodated in AMPD-and more generally personality disorder-theory, research, and treatment? The historical intraindividual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and that hold potential to adversely affect sexual and gender minoritized populations, among others. (PsycInfo Database Record (c) 2022 APA, all rights reserved).