When it comes to understanding personality disorders, the conventional approach has been fraught with limitations and stigma. Carla Sharp, PhD, a professor at the University of Houston (UH) and the director of the Developmental Psychopathology Lab at UH, joins this episode of the Mind Dive podcast to share her invaluable insights into the developmental trajectory of personality disorders. 
Dr. Sharp’s research has uncovered the need for early intervention and a dynamic understanding of the nature of personality disorders to better diagnose and treat patients. The discussion begins with an examination of the alternative model in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a model that Dr. Sharp has played a crucial role in developing. The new model shifts away from rigid categories towards a more dimensional understanding of personality disorders, allowing for a nuanced view that captures the complexity of individual experiences. 
Dr. Sharp’s model considers levels of personality organization, which is a concept casually referenced among professionals yet often lacks a clear definition in broader discussions. Dr. Sharp stresses the importance of recognizing the range of personality functioning and the implications for targeted treatments. 
One of the focal points of the episode is the Hierarchical Taxonomy of Psychopathology (HITOP) model, which Dr. Sharp explores in detail. It identifies major dimensions of psychopathology – internalizing, externalizing, and psychoticism – providing a framework that encapsulates the general symptoms found in the DSM. The conversation also touches upon Otto Kernberg's theory of personality's organizing function, a theory that aligns closely with the Level of Personality Functioning Scale (LPF). The LPF serves as a critical tool in assessing the severity of personality dysfunction, facilitating a deeper understanding of disorders like borderline personality disorder (BPD). 
Dr. Sharp addresses the sensitive issue of the terminology used to classify personality disorders by diving into the term "borderline," unpacking its historical connotations and the impact such diagnostic labels have on individuals. The conversation highlights the anticipated changes proposed by the American Psychiatric Association, which seeks to adopt a more patient-centric framework. Dr. Sharp’s hope is that these changes can shift the way practitioners approach disorders like BPD and create more specialized treatment plans for patients.  
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