693 – Critical approach to dimensional models of personality in DSM-V

Introduction In past years, research in personality disorders has been mainly focused on dimensional models based in statistical methods like factorial analysis. Some different factors have been proposed lately, but most of these developed models seem to accept a model of four or five proposals. However, clinical and research groups disagree in the inclusion of these models in DSM-V.Our aim is to discuss some epistemological questions in dimensional models of personality. Methods A critical review of dimensional models of personality and their limitations from a hermeneutical perspective is presented. Results Three main limitations in dimensional models of personality disorders have been reported: 1. Mental states and behaviour are de-contextualized, so subjectivity (which is responsible for its relevance), is neglected. 2. Temporal dimension of human behaviour is lost, so there is a narrow understanding of subjectivity. 3. An blind epistemological priority is given to first person perspective. The hermeneutic approach takes into account these limitations and can, certainly, be very helpful with our daily work. Some questions it develops are: 1. The other's subjectivity is out of reach. Our relation with the other is ethical rather than epistemological 2. Subject-Environment interdependence 3. Time as an existential dimension of subjectivity Conclusions The epistemological assumptions of dimensional models based on statistical factors have important limitations so they can not be useful for clinical purposes.Using the bases of hermeneutical philosophy of the twentieth century, some psychiatrists (Stanghellini, Ramos and Rejon) re-introduce the subjectivity question and open a broader field to our daily work.