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MARTIN STEIN INTRODUCED THE PANEL BY RECOUNTING recent changes in psychiatry with regard to character disorders. He directed our attention to the Diagnostic and Statistical Manual of Mental Disorders (third edition), also known as DSM-III, published by the American Psychiatric Association. He pointed out that the authors of DSM-III state that the approach taken in the manual is atheoretical with regard to etiology or pathophysiological processes except for those disorders for which this is well established. Stein noted that the employment of such an "atheoretical" system must be based on the assumption that a purely descriptive methodology which employs no theoretical system is possible and conceptually defensible, as well as useful. He stated that it is doubtful that one can classify any body of data without a theory upon which that classification is based.
DSM-III includes a dozen diagnostic categories under the heading of "specific personality disorders." For many of these disorders the subheading "predisposing factors" is followed by "no information." Stein indicated that, on the contrary, we have an enormous amount of information about predisposing factors. The fact that there are conflicting opinions and theories about them does not warrant the conclusion that we have "no information" concerning them. He also stated that DSM-III treated character disorders without sufficient reference to considerations of development and fluctuation, i.e., that there was a tendency to put aside the history of the illness or disorder.
Stein reminded us that we have not only a theory but a great deal of information about the determinants of character derived from