Clinical Assessment and Management of Personality Disorders in Social Work Practice-An Updated Review
Abstract
Background: Personality disorders represent enduring patterns of cognition, affect, and behavior that deviate markedly from cultural expectations and lead to significant functional impairment. Their classification and understanding have evolved from early temperament theories to contemporary diagnostic systems, particularly the DSM‑5‑TR, reflecting increasing recognition of their clinical complexity and public health impact.
Aim: This review aims to synthesize current knowledge on the historical development, etiology, epidemiology, pathophysiology, clinical assessment, and management of personality disorders, with a specific focus on implications for social work and multidisciplinary mental health practice.
Methods: A narrative, integrative review approach was employed, drawing on DSM‑5‑TR diagnostic frameworks, epidemiological data, neurobiological and psychodynamic models, and evidence‑based clinical literature. Emphasis was placed on longitudinal assessment, differential diagnosis, and functional evaluation across social and clinical contexts.
Results: Personality disorders affect approximately 6% of the general population and up to 30% of psychiatric populations, with marked variation across DSM clusters. Etiology is multifactorial, involving genetic predisposition, temperament, neurobiological vulnerabilities, environmental adversity, and psychodynamic defense mechanisms. Neuroimaging and psychophysiological studies implicate dysregulation of cortical–limbic circuits, particularly within Cluster B disorders. Psychotherapeutic interventions remain the cornerstone of treatment, while pharmacotherapy plays a symptomatic and adjunctive role.
Conclusion: Personality disorders require longitudinal, biopsychosocial assessment and individualized management. Integrating categorical and dimensional models enhances diagnostic precision and supports tailored interventions, underscoring the essential role of social workers within multidisciplinary care teams.
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Copyright (c) 2025 Khaled Abdullah Mohammed Al-Asmari, Saeed Ghazi Abdullah Alasmari, Magbulaha Habas Alshamri, Hassan Yahya Salem Khard, Muhaya Ali Khalifah Alotaibi, Nazih Khalil Ghalfan Kamili
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