Despite recent revisions, the classification of personality disorder remains a matter of dispute, and there is little evidence of consistent progress toward an evidence‐based system. This essay examines four issues impeding taxonomic progress and explores how they might be addressed. First, the phenomenological and aetiological complexity of personality disorder poses a formidable challenge to traditional taxonomic methods. Second, current classifications incorporate assumptions such as a stringent version of medical model and an essentialist philosophy that are inconsistent with empirical evidence. Third, despite the claims of trait psychology, a viable alternative to categorical diagnosis is not available. Contemporary trait models have not gained widespread clinical acceptance and substantial conceptual and methodological limitations compromise their clinical value. Finally, the processes used to revise official classifications are biased toward conservative revisions and difficult to shield from non‐scientific influences. It is suggested that rather making further attempts to develop a general monolithic classification that meets all needs, consideration be given to developing a more flexible and multifaceted framework that combines diagnosis and assessment. © 2020 John Wiley & Sons, Ltd.

中文翻译：

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为什么基于证据的人格障碍分类如此难以捉摸？

尽管最近进行了修订，但人格障碍的分类仍然存在争议，而且几乎没有证据表明循证系统取得了持续进展。本文探讨了阻碍分类学进展的四个问题，并探讨了如何解决这些问题。首先，人格障碍的现象学和病因学复杂性对传统的分类方法提出了巨大挑战。其次，当前的分类包含了一些假设，例如严格的医学模型版本和与经验证据不一致的本质主义哲学。第三，尽管有特质心理学的主张，但还没有一种可行的分类诊断替代方案。当代特征模型尚未获得广泛的临床认可，并且大量的概念和方法限制损害了它们的临床价值。最后，用于修订官方分类的过程偏向于保守的修订，难以避免非科学影响。建议与其进一步尝试开发一个满足所有需求的通用整体分类，不如考虑开发一个更灵活和多方面的框架，将诊断和评估结合起来。© 2020 约翰威利父子公司 建议与其进一步尝试开发满足所有需求的通用整体分类，不如考虑开发一个更灵活和多方面的框架，将诊断和评估相结合。© 2020 约翰威利父子公司 建议与其进一步尝试开发满足所有需求的通用整体分类，不如考虑开发一个更灵活和多方面的框架，将诊断和评估相结合。© 2020 约翰威利父子公司