The Clinical Nature of Personality Disorders: Answering the Neo-Szaszian Critique

This article describes five models that could be used to demonstrate that personality disorders are valid clinical kinds: the vulnerability model, the pathoplasticity model, the spectrum model, the decline in functioning model, and the defect model (of which there are three versions). It is argued that the empirically based vulnerability and pathoplasticity models make the best case, given the current evidence, for the clinical relevance of personality disorders. It remains a possibility that a version of the defect model may in due course be developed that provides an acceptable theory of the pathological processes underlying personality disorders and thus more directly validate their clinical status.