This commentary on Livesley's paper in this special issue on International Classification of Diseases (ICD)‐11's personality disorder (PD) section addresses each of four issues that Livesley claims are impeding progress towards an evidence‐based system for the classification of personality pathology. I focus my commentary on the third issue, but also comment briefly on the others. Regarding, first, the complexity of personality pathology and, second, problematic assumptions about the nature of personality pathology, I contend that Livesley's comments are accurate, but omit that the fundamental impediment is the refusal of the Diagnostic and Statistical Manual of Mental Disorders (DSM) establishment to allow the official classification to reflect the reality of personality pathology that he describes, in contrast to its acceptance in the ICD‐11. In response to Livesley's third claim that a viable alternative to categorical diagnosis is not available, I take issue with various aspects of his assertions and develop arguments that the ICD‐11 PD model provides a useful, although admittedly imperfect, system. Finally, I agree with Livesley that the revision processes for official classifications are conservative and open to non‐scientific influences, but maintain that whereas the Diagnostic and Statistical Manual of Mental Disorders establishment held fast to the status quo, the ICD‐11 PD Working Group made considerable progress towards a valid PD diagnostic system. © 2020 John Wiley & Sons, Ltd.

中文翻译：

---

利物浦对人格病理分类的哀叹：评论

在本期《国际疾病分类（ICD）-11人格障碍（PD）》特刊中，对Livesley论文的评论针对Livesley声称阻碍其发展为基于证据的人格病理学分类系统的四个问题。我的评论集中在第三个问题上，但也简要地评论了其他问题。关于第一，人格病理学的复杂性，其次，关于人格病理学性质的有问题的假设，我认为Livesley的评论是准确的，但忽略了基本障碍是拒绝《精神疾病诊断和统计手册》（DSM）。）的建立，以使官方分类能够反映出他所描述的人格病理学的现实，这与ICD-11接受的情况相反。为了回应Livesley的第三个主张，即没有可用的替代分类诊断方法，我对他的断言的各个方面都持怀疑态度，并提出了ICD-11 PD模型提供有用的（尽管公认的是不完美的）系统的论点。最后，我同意Livesley的观点，即官方分类的修订过程是保守的，并且对非科学的影响开放，但我坚持认为，《精神疾病诊断和统计手册》的建立可以保持现状，ICD-11PD工作组在建立有效的PD诊断系统方面取得了长足的进步。分级为4 +©2020 John Wiley＆Sons，Ltd.