A Freudian construct lost and reclaimed: The psychodynamics of personality pathology.

Although many early 20th-century descriptions of personality pathology were unabashedly psychoanalytic, recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have attempted to frame personality disorders (PDs) in atheoretical terms. This article discusses the continuing relevance of psychoanalytic theory for PD diagnosis, research, and treatment. After reviewing the evolution of the PD concept since Freud’s time, 3 psychodynamic constructs central to a contemporary understanding of personality pathology are described: ego strength, defense style, and mental representations of self and others. Research in each area is briefly reviewed, the heuristic value of the psychodynamic perspective is discussed, and unresolved questions and future directions in the psychodynamics of personality pathology are addressed.