Dimensional models of personality disorders: Challenges and opportunities

Summary

This review argues that the traditional categorical view of personality disorders, treating affected individuals as qualitatively distinct from the general population, is no longer tenable given accumulated criticism. It surveys the growing evidence for dimensional models that place normal and pathological personality on shared trait continua, as reflected in the DSM-5 Alternative Model and ICD-11. The authors weigh the practical and scientific challenges of adopting these models, including the need for measurement across both poles of each trait, multimethod assessment, intensive longitudinal designs, and attention to social desirability. They also identify opportunities, emphasising that broader clinician training and clear demonstrations of incremental treatment benefit are required for routine clinical use. The paper frames the shift toward dimensional models as both necessary and achievable with continued methodological development and public-health support.