This paper aims to introduce The Shedler and Westen Assessment Procedure (SWAP-200), a new personality disorder taxonomy, as an alternative to the DSM. For the past two decades, the DSM-IV Axis II has been largely used as the world-standard language to understand personality disorders. However, at the same time, it has been often said to be of no help in understanding these disorders and providing treatments: For example, the comorbidity of axis II disorders is too high. A client often receives four to six out of a possible 10 diagnosis. The taxonomy of axis II artificially dichotomizes diagnostic criteria into present or absent in top-down fashion, which risks excluding potential new understanding of personality traits. In the diagnostic process, the client's self-report comes first before the clinician's professional observations, although clients with personality disorders often lack self-awareness. In other words, the DSM has sacrificed so-called "clinical knowledge," representing a way to understand the uniqueness of the individual, to enhance "scientific knowledge," representing objectivity based on statistical validity and reliability. Although the DSM-V was published last year, these problems were not resolved. On the other hand, the SWAP-200 was designed to capture personality disorders by sorting out 200 items describing personality traits without jargon. In addition, the descriptions have been revised several times based on feedbacks from clinicians in order to properly reflect their professional observations. The SWAP-200 has enhanced the convergent and discriminant validity in different ways from the DSM, and those validities have been confirmed in several different countries. It can be also utilized in Japan as a new common language to understand clients with personality disorders holistically. However, as long as personality depends on culture, it must be examined whether its items can properly describe Japanese personality traits and tendencies. In addition, the bottom-up type of assessment tool such as the SWAP-200 can well reflect "clinical knowledge" but it means that the result of assessment is likely to be influenced by the clinician's bias. In using the SWAP-200 in Japan, it will be desirable and necessary to set up systems to support clinician to use it properly and effectively for the client's benefit.
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