On an international level, there is a grand plan to ditch old Freudian categories like narcisissm, borderline, etc. in the upcoming ICD11.
There was never much evidence for such diagnostic categories, and I was told that if you look at notes from old proceedings of the DSM-III committee that their inclusion was an artifact of the political need to get buy-in from the then-powerful psychoanalytic groups at the time.
The ICD11 plan to have a single personality disorder bucket makes more sense to me. At its core, a personality disorder consists of a heavily reinforced and entrenched cluster of behavior that is significantly self-defeating and that actively resists common intervention strategies. From that perspective, you could either have endless personality disorder categories or a single category that summarizes the phenomenon.
The restructuring is not complete, though: a concession was granted to allow borderline personality disorder to remain for the time being due to industry concerns related to reimbursement, but the plan remains to ditch it eventually.
There was never much evidence for such diagnostic categories, and I was told that if you look at notes from old proceedings of the DSM-III committee that their inclusion was an artifact of the political need to get buy-in from the then-powerful psychoanalytic groups at the time.
The ICD11 plan to have a single personality disorder bucket makes more sense to me. At its core, a personality disorder consists of a heavily reinforced and entrenched cluster of behavior that is significantly self-defeating and that actively resists common intervention strategies. From that perspective, you could either have endless personality disorder categories or a single category that summarizes the phenomenon.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881116/