Diagnosing Personality Disorders: What Does It Mean and Why Is It Crucial?
Personality disorders are enduring patterns of thinking about oneself and others, feeling, behaving, and relating to others that are largely maladaptive and cause distress to the person affected. They can lead to repeated difficult interpersonal experiences and the accompanying feelings of hurt, sadness and other emotions, which in turn can generate serious health problems such as depression or various types of anxiety disorders.
It’s worth emphasizing that having certain personality traits is natural and common. A personality disorder is only considered when these traits become inflexible, maladaptive, and ultimately lead to significant distress or serious difficulties in daily functioning and relationships.
There is no single, simple cause for the development of personality disorders. Most often, it is a complex combination of biological (e.g., temperament), psychological (e.g., high reactivity), and familial factors, including difficult experiences in childhood and adolescence, low emotional reactivity in parents, and a history of mental disorders in the family.
Why is diagnosis so important?
The primary goal of diagnosis is to identify or rule out personality disorders. It often precedes or accompanies the diagnosis of comorbid emotional disorders, providing a basis for planning appropriate interventions and treatments that can help manage symptoms and improve the patient’s quality of life. Diagnosis helps the patient and their loved ones understand the source of certain behaviors and difficulties.
Who is diagnosed with personality disorders?
Personality disorders are diagnosed in adults. Although symptoms most often appear during adolescence, in adolescents, the term “personality disorder” is often used to describe a “disorderly developing personality.” If you observe disturbing ways of experiencing yourself and the world in young people, it’s worth consulting a psychologist to take steps to support their development.
The process of diagnosing personality disorders
The diagnostic process consists of several stages.
- Detailed interview: The first stage involves conducting a detailed interview about the patient’s development, family history, and current problems.
- Specialized Tests: The second part of the diagnosis involves conducting specialized tests that enable a comprehensive and comprehensive assessment of the individual’s functioning. Among these, the MMPI-2 and/or SCID-5-PD tests are often used. 15
- Discussing the results and planning support: The diagnostic process concludes with a discussion of the results and planning the most appropriate support strategies.
Key diagnostic tools
1. MMPI-2 (Minnesota Multiphasic Personality Inventory)
The MMPI-2 is one of the best tests for diagnosing personality disorders and other psychological difficulties. It assesses functioning and perception of reality, and identifies ways of regulating emotions and interacting with others. The participant is asked to respond to the statements contained in the questionnaire, confirming or denying their truthfulness, or alternatively, stating “I don’t know.” The MMPI-2 can be administered in two formats: in-person and online. Interpretation of the test is based on an assessment of the intensity of various traits. Combined with the results of other tests and a clinical interview, it allows an experienced diagnostician to diagnose or rule out personality disorders, as well as symptoms of other difficulties, and to tailor support and treatment methods to the patient’s individual needs. If the diagnostician deems it appropriate, the MMPI is preceded by an assessment of the SCID-5-PD22 test.
2. SCID-5-PD Test (Structured Clinical Interview for the Diagnosis of Personality Disorders)
The SCID-5-PD is a semi-structured clinical interview designed to identify DSM-5 personality disorders and to aid in the diagnosis of specific personality disorders, such as borderline, narcissistic, or paranoid personality disorder. The SCID-5-PD is a type of interview conducted by a specialist with a patient. This interview is “semi-structured,” meaning it covers standard areas of concern for clinicians and the questions they ask, but the therapist flexibly adapts specific questions to the patient’s situation and abilities. The test also includes the SCID-5-SPQ Personality Screening Questionnaire, a self-report tool for patients or participants.
Post-Diagnosis Therapy: A Path to Improving Quality of Life
Once a diagnosis is made, planning appropriate interventions and treatment is crucial. Personality disorder therapy is typically a long-term process, requiring the commitment of both the patient and specialists. Commonly used therapeutic approaches include dialectical behavioral therapy (DBT), schema therapy, and dyschodynamic therapy. Their primary goals are to learn how to more effectively manage difficult emotions, improve interpersonal functioning, and change entrenched, maladaptive patterns of thinking and behavior.
The role of the multidisciplinary team and psychoeducation
Diagnosing and treating personality disorders often requires the collaboration of various specialists, such as a psychologist, psychiatrist, or therapist. This multidisciplinary team ensures a comprehensive approach to the patient’s problem.
Psychoeducation is an extremely important element supporting the treatment process. Understanding the origins of certain behaviors and difficulties helps both the patient and their loved ones. Education about the disorder, its symptoms, and coping strategies promotes better support from those around them and builds a greater sense of control over one’s life.
Self-help and support strategies
In addition to professional therapy, it’s also important to develop individual self-help strategies. These can include mindfulness techniques, building a strong social support network, and maintaining a healthy lifestyle (regular physical activity, a balanced diet, and adequate sleep). All of these elements can support the therapeutic process and contribute to overall well-being.
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