ABSTRACT
In 1980, the American Psychiatric Association (APA) published the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980), which introduced the innovative multiaxial classification system. Axis II was devoted primarily to personality dysfunction, owing to the prevalence of maladaptive personality traits in general clinical practice, the substantial impact that these traits can have on the course and treatment of other mental disorders, and the tendency of clinicians to miss comorbid maladaptive personality functioning as their attention is drawn to concerns regarding anxiety, depression, substance usage, or other form of psychopathology (Frances, 1980). This multiaxial system has been instrumental in the increased recognition of personality disorders within clinical practice (Loranger, 1990) and research (Blashfield & Intoccia, 2000). The multiaxial system, however, has been deleted in DSM-5 (American Psychiatric Association, 2013). No explanation for this decision was provided by the APA. However, a commonly expressed concern with respect to the multiaxial system was that few clinicians were actually using it, at least the components for indicating presence of a medical disorder, level of functioning, and social stressors (Frances, First, & Pincus, 1995).
