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Persönlichkeitsdiagnostik im DSM-5

Personality assessment in DSM-5

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Zusammenfassung

Die im Mai 2013 erschienene 5. Ausgabe des Diagnostischen und Statistischen Handbuchs Psychischer Störungen (DSM-5) enthält in Sektion III ein alternatives Modell zur Klassifikation von Persönlichkeitsstörungen. Ziel des vorliegenden Beitrags ist es, dieses Modell im deutschsprachigen Raum vorzustellen. Hierzu wird erstens verdeutlicht, warum ein neues Modell überhaupt nötig erscheint. Zweitens werden die verschiedenen Komponenten des neuen DSM-5-Modells vorgestellt, hinsichtlich ihres theoretischen und empirischen Hintergrunds beleuchtet und an einem Fallbeispiel illustriert. Drittens wird diskutiert, welche Vorteile mit dem neuen Modell gegenüber den diagnostischen Kategorien des DSM-IV verbunden sind (die in Sektion II des DSM-5 zunächst bestehen bleiben). Zum Abschluss werden offene Fragen und Probleme thematisiert, die weitere konzeptuelle und empirische Forschung erfordern.

Abstract

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013 and features (in Section III) a new model for the diagnosis of personality disorders. The aim of this paper is to introduce this model to a broader German-speaking readership. The article begins by explaining why a new model seems necessary. Secondly, the different components of the new DSM-5 model are presented, the theoretical and empirical background is explained and it is shown how the model works using a clinical case example. Thirdly, several advantages of the new model as compared to the DSM-IV diagnostic categories (which will be retained in DSM-5 Section II) are discussed. Finally, the article highlights some open questions and problems that require further conceptual and empirical research.

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Notes

  1. Genauer gesagt geht es darum sicherzustellen, dass das Verhaltensmuster nicht besser durch das Vorliegen einer anderen psychischen Störung (Kriterium E), die physiologische Wirkung einer Substanz bzw. das Vorliegen eines anderen medizinischen Befunds (Kriterium F), den individuellen Entwicklungsstand oder das soziokulturelle Umfeld der Person (Kriterium G) erklärt werden kann.

  2. Im Moment sind allerdings nur die englischsprachigen Originalversionen des PID-5 frei verfügbar. Die APA hat die Rechte für Übersetzungen des DSM-5 (inklusive aller Screening-Instrumente und Rating-Skalen) an andere Verlage abgetreten. Daher kann die bereits vorliegende, validierte deutsche Forschungsversion des PID-5 (Zimmermann et al. 2013a) vorerst nicht offiziell verwendet werden. Dies gilt auch für die deutsche Version der LPFS (Zimmermann et al. 2013b). Wann und in welcher Form deutsche Übersetzungen dieser Instrumente offiziell verfügbar sein werden, ist noch unklar.

  3. Neben Cluster- oder latenten Profilanalysen sind natürlich auch andere Verfahren denkbar, um PS-Typen empirisch abzusichern: bespielsweise der Nachweis, dass den Merkmalen eine gemeinsame Ursache zugrunde liegt Leising u. Zimmermann 2011; Zapolski et al. 2012), dass die Merkmale bei der Vorhersage von negativen Konsequenzen interagieren (Morey u. Skodol 2013) oder dass die Merkmale auf individueller Ebene in dynamischer Wechselwirkung stehen (Os et al. 2013).

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Danksagung

Die Autoren bedanken sich bei Henning Schauenburg für die Bereitstellung des OPD-Interviews sowie bei der Zentralen Forschungsförderung (ZFF) der Universität Kassel für die finanzielle Unterstützung eines Forschungsprojekts zur Persönlichkeitsdiagnostik im DSM-5.

Einhaltung ethischer Richtlinien

Interessenkonflikt. Johannes Zimmermann, Cord Benecke, Donna S. Bender, Andrew E. Skodol, Robert F. Krueger und Daniel Leising geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Institut für Psychologie, Universität Kassel, Holländische Str. 36–38, 34127, Kassel, Deutschland

    Johannes Zimmermann & Cord Benecke

  2. Department of Psychiatry, University of Arizona College of Medicine, Arizona, USA

    Donna S. Bender & Andrew E. Skodol

  3. Department of Psychology, University of Minnesota, Minnesota, USA

    Robert F. Krueger

  4. Fachrichtung Psychologie, Technische Universität Dresden, Dresden, Deutschland

    Daniel Leising

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  1. Johannes Zimmermann
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  2. Cord Benecke
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  3. Donna S. Bender
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  4. Andrew E. Skodol
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  5. Robert F. Krueger
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  6. Daniel Leising
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Correspondence to Johannes Zimmermann.

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Zimmermann, J., Benecke, C., Bender, D. et al. Persönlichkeitsdiagnostik im DSM-5. Psychotherapeut 58, 455–465 (2013). https://doi.org/10.1007/s00278-013-1009-1

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