Beyond Defending or Abolishing Criterion A: Comment on Morey et al. (2022)

In their target article, Morey et al. (2022) provided a comprehensive overview of research on Criterion A of the alternative DSM-5 model for personality disorders over the past 10 years. Although this overview is undoubtedly informative and helpful, it offers little guidance on both certain weaknesses of Criterion A and research gaps and needs. A structural reason for this could be that the scientific field is divided into 2 camps with respect to Criterion A: Some authors focus mainly on confirmatory results and want to defend Criterion A in its current form, whereas others take the same results as an opportunity to call for its abolition. In this situation, there is little room for a nuanced and constructive discussion of the empirical and conceptual strengths and weaknesses of Criterion A. In this commentary, I use 2 examples to illustrate what research aimed at revising Criterion A might look like. From an empirical point of view, studies that take into account the peculiarities of the latent structure of the Level of Personality Functioning Scale are important because they can reveal local misspecification and challenges for the assessment of single cases. From a conceptual point of view, a more consistent definition of Criterion A in terms of impairments in “capacities” could allow for a more coherent distinction from maladaptive “traits”. This commentary hopes to strengthen a discourse that moves beyond the alternatives of defense or abolition towards the concrete improvement of Criterion A.