Personality
We all have one. It makes us unique. It shapes how we understand and interact
with the world
3 P’s3 P’s
Pattern of relating to self, other and the world that deviates from Pattern of relating to self, other and the world that deviates from cultural norm.cultural norm.
50-78% prisoners believed to meet criteria for one or more PD.50-78% prisoners believed to meet criteria for one or more PD. 10% of people in the community would meet criteria for PD.10% of people in the community would meet criteria for PD. A helpful way of thinking about PD relates to the 3 P’sA helpful way of thinking about PD relates to the 3 P’s
Persistent – happens frequently – happens frequently
PPervasiveervasive – across different circumstances – across different circumstances
PProblematicroblematic – and cause problems for themselves and others – and cause problems for themselves and others
Immune system metaphorMillon (2004)
Robust immune system responds constructively & appropriately to our environment.
PD = system that interacts with the environment
Personality = Psychological equivalent of
body’s immune system
Rigidity in strategies + Others reactions =
Repeated bad one-act play
Classification into PD types
Akin to diagnosing a disease that you either have or don’t have
Categories based on “pure” prototype. Assumes each personality disorder is
distinct
Diagnostic systemsDiagnostic systems
DSM IV-TRDSM IV-TRParanoidParanoidSchizoidSchizoid
SchizotypalSchizotypalAntisocialAntisocialBorderlineBorderlineHistrionicHistrionic
NarcissisticNarcissisticAvoidantAvoidant
Dependent Dependent Obsessive CompulsiveObsessive Compulsive
Not Otherwise Specified Not Otherwise Specified
ICD-10ICD-10ParanoidParanoidSchizoidSchizoidDissocialDissocial
Emotionally unstable Emotionally unstable HistrionicHistrionic
AnankasticAnankasticAnxiousAnxious
DependentDependentOther specific PDOther specific PDUnspecified PDUnspecified PD
Mixed and other PDMixed and other PD
Character Assassination Character Assassination
Schizoid
Schizotypal
Borderline
Histrionic
Antisocial/ Psychopathy
Pros and Cons of Types
Facilitates communication by the use familiar language between professionals. It’s best we’ve got at the moment.
Enables quick signposting to services
Rarely find “pure types” in real life. People are individuals. BPD = 5 of 9 criteria = potentially only 1
symptom overlap. Lack of empathic understanding of the origins and maintenance of the
problem which is central to therapy. Stigma facilitates reactions in others which perpetuates the problem
(eg. verbal attack driven by paranoid interpretation is met by defensiveness, which further creates suspicion in the individual).
Dimensional perspective
1) Personality represented by severity of traits rather than distinct categories.
2) Or, ASPD variations = Normal variation:
Adventurer, Independent, Courageous
Pathological variation
Callous, Lacking conscience Breaks rules Impulsive
‘Normal’ continua of Antisocial
Normal variation Adventurer, lives life on the edge, pioneers, risk-takers, courageous and
tough.
Slight pathological normal variation Does things own way, flirts with legal boundaries, dislikes daily routine,
action-oriented, independent thinkers, confrontational and masterful leaders.
Cusp No forensic history but only due to being good at covering their tracks,
will deceive and exploit by minimising negatives and exaggerating positives but not physically cruel, industrialists, exploit legal technicalities and loopholes for personal gain, “smooth-talking businessman”, “dodgy used-car salesman”.
‘Normal’ continua of Paranoid
Normal variation Highly independent, value their freedom, sensitive to issues of
power, authority and domination. Cautious and reserved with others and enter relationships only after careful consideration. Touchy, but not intimidated, when given criticism
Paranoid “style” Distant from others, places premium on honesty and loyalty.
Plays cards closely to chest with acquaintances. Attuned to subtleties and nuances of communication at many levels. Skeptical.
Dimensions of personality Five Factor Model (Costa & McCrae, 1992) - five dimension (primary traits):Five Factor Model (Costa & McCrae, 1992) - five dimension (primary traits):
OOpenness to experience penness to experience vs tradition/conventionvs tradition/conventiona general appreciation for art, emotion, adventure, unusual ideas, imagination, a general appreciation for art, emotion, adventure, unusual ideas, imagination,
curiosity, curiosity, and variety of experienceand variety of experience
CConscientiousness onscientiousness vs negligencevs negligence
tendency to show self-discipline, act dutifully, and aim for achievement. tendency to show self-discipline, act dutifully, and aim for achievement. Preference for planned rather than spontaneous behaviourPreference for planned rather than spontaneous behaviour
EExtraversion xtraversion vs introversionvs introversion
characterized by positive emotionscharacterized by positive emotions engagement with the external world enthusiastic, action-oriented individuals
AAgreeableness greeableness vs antagonisticvs antagonistic tendency to be compassionate and cooperative rather than suspicious and tendency to be compassionate and cooperative rather than suspicious and
antagonistic antagonistic towards otherstowards others
NNeuroticism euroticism vs emotional stabilityvs emotional stability
emotionally reactive and vulnerable to stressemotionally reactive and vulnerable to stress
DAPP (Livesley & Jackson 2009)
Cluster label Contributing dimensions
Emotional dysregulation Affective lability AnxiousnessCognitive dysregulation Identity problemsInsecure attachment OppositionalitySubmissiveness
Dissocial Behaviour Conduct problems CallousnessNarcissism RejectionStimulus seeking
Social Avoidance Intimacy problems Low affiliationRestrictive expression
Compulsiveness Compulsivity
Pros and Cons of Dimensions
Research gives greater support to the dimensional view of personality
Engenders a more compassionate understanding of personality Diagnostic types can be translated into dimensions
No consensus about nature and number of dimensions More complex picture of personality = more difficult to comprehend
and communicate to other clinicians