What is a key difference between categorical and dimensional approaches to personality disorder in DSM-5?

• A. Dimensional uses levels of functioning and trait domains
• B. Categorical uses discrete diagnoses; dimensional uses levels of personality functioning and trait domains
• C. Dimensional uses more diagnoses
• D. Categorical uses no diagnostics

Answer: (B)

The main difference is how disorders are defined: one approach assigns discrete diagnoses based on meeting specific criteria, while the other describes personality on continuous levels of functioning and trait domains. In DSM-5’s Alternative Model for Personality Disorders, the focus is on how severely personality functioning is impaired (self and interpersonal functioning) and on maladaptive trait domains (like negative affectivity, detachment, antagonism, disinhibition, and psychoticism). Traditional categorical thinking labels people with a specific disorder if they meet threshold criteria. So the statement that the categorical approach uses discrete diagnoses and the dimensional approach uses levels of functioning and trait domains captures this fundamental distinction. The other options either omit the diagnostic vs. dimensional contrast, or state things that aren’t accurate (dimensional work isn’t about more diagnoses, and categorical does involve diagnostics).