This post is by Konrad Banicki and Peter Zachar.
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| Book cover |
Personality disorders are among the most contentious topics in clinical psychology and psychiatry. Thus, it is surprising to see how little attention has been paid to this domain within the philosophy of psychiatry. In our recently published book Conceptualizing Personality Disorder: Perspectives from Philosophy, Psychological Science, and Psychiatry (Cambridge University Press, 2025) we set out to potentially alter the scholarly landscape by encouraging philosophers to tackle the complicated issue of personality disorder. We also wanted to invite psychologists and psychiatrists to participate in the task of bringing more philosophy to personality disorders.
One of the contexts for this volume is a loss of confidence in the neo-Kraepelinian categorical model under whose guidance personality disorders gained renewed importance in psychiatry with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980.
One impetus for this loss of confidence was the discovery of unexpected comorbidity between different personality disorders such as “borderline,” “narcissistic,” and “histrionic.” Such comorbidity calls into question the notion that these are distinct categories. The loss of confidence has led some critics to argue that the well-known categories of personality disorder are scientifically invalid.
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| Konrad Banicki (photo by Jakub Tercz) |
A highly favored alternative to qualitatively distinct categories of personality disorder is a family of over-lapping dimensional models. These models describe personality pathology using profiles of continuous traits on which every person in a population has a standing from low to high, such as “neuroticism” and “impulsivity.”
Dimensional models have the advantage of offering an empirically-based and quantitative structure for the personality disorder domain, but like the categories of both the DSM and the International Classification of Diseases (ICD), dimensional models are descriptive and do not provide organizing theories for understanding personality disorder. That is one role for conceptualizing personality disorder.
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| Peter Zachar |
The book is divided into five parts.
- Part I contains three historical chapters that cover important developments in the study of personality disorder from the 19th to the 21st century.
- Part II presents updated versions of core conceptual perspectives on personality disorder. These chapters include contemporary interpretations of psychodynamic, interpersonal, phenomenological, and evolutionary theories but also perspectives such as network theory and psychopharmacology.
- Part III, titled novel conceptual approaches to personality disorder, best represents our original vision for the book. It includes eight chapters that introduce new and exciting perspectives on personality disorder. To a large extent, these were the most interesting chapters to edit. The chapters were authored by an international group of philosophers, psychologists and psychiatrists representing both younger and more established scholars.
- Parts IV and V are more targeted with one section examining harmful consequences of diagnosing personality disorder and another looking specifically at borderline and narcissistic personality disorders. The harmful consequences chapters provide helpful reminders that personality disorder diagnoses can unfortunately be weaponized against people. The borderline and narcissistic disorders were selected because they both survived recent attempts to eliminate them from the classification system and remain fruitful topics for philosophical elaboration.