Personality Disorders Are Dead; Long Live the Interpersonal Disorders: Comment on Widiger and Hines (2022)

Widiger and Hines raise a number of significant concerns with the alternative model of personality disorders (AMPD). This places the major class of psychiatric difficulties represented by the personality disorders in a precarious position because the model used in previous editions of the Diagnostic and Statistical Manual of Mental Disorders and currently reprinted in Section II is moribund if not dead, and with the AMPD's significant problems, their future is unclear. Although we agree that Widiger and Hines' criticisms have merit, they are not the whole picture. We review additional relevant research that supports the contention that what differentiates personality disorders from other psychopathology is the self and interpersonal dysfunction, as Criterion A of the AMPD currently states. We emphasize the importance of drawing a distinction between the conceptual model and its operationalization. We argue that paradoxically, to save personality disorders, we need to do away with them and replace them with the "interpersonal disorders." There is strong theory, empirical research, and ethical arguments in favor of this conceptual reframing.