Edited sentence: , a personality disorder diagnosis.5 and.6) for diagnoses of personality disorders over time, although use of structured interviews may improve reliability of diagnosis.689), however, this position is controversial.Because personality disorders may be defined as enduring and inflexible behavioral patterns that are not as likely to change over time, insurance companies sometimes refuse to reimburse psychotherapy fees when the patient/client has received an Axis II diagnosis, i.Finally, because the diagnostic categories are seen as less flexible than dimensional ones, a spin-off problem is created in managed care settings.However, more so than in other parts of the DSM, the classification of Axis II personality disorders—deeply ingrained, maladaptive, lifelong behaviour patterns—has come under sustained and serious criticism from its inception in 1952.Improving breadth of information may also, as Marshall and Serin note, improve reliability of diagnosis.One of the problems with diagnosis of personality disorder is that these such diagnosis typically has a lower reliability than most other disorders  - indeed, Dahl (1986; cited in Marshall & Serin, 1997) found only modest test re-test reliability coefficients (between.Others state that there is an excessive reliance on clinical judgment, and insufficient knowledge regarding non-disordered personality characteristics to determine the extent to which characteristics should be considered disordered.Some suggest that the differential diagnoses are vague and the personality disorders are insufficiently demarcated.The DSM adopts a categorical approach, assuming that personality disorders are "qualitatively distinct clinical syndromes" (p.The DSM attempts to represent a consensus view of the members of the American Psychiatric Association.Those who make this argument point to high rates of Axis II comorbidity as bolstering their claim