What is a personality Disorder? - Personality Psychology

What is a personality Disorder?

A personality disorder is an enduring pattern of experience and behavior that differ greatly from the expectations of the individual’s culture. As discussed traits are patterns of experiencing, thinking about, and interacting with oneself and the world. Traits are observed in a wide range of social and personal situations. For example, a person who is high on conscientiousness is hardworking and persevering. If a trait becomes maladaptive and inflexible and causes significant impairment or distress, then it is considered to be a personality disorder. For example, if someone were so conscientious that he or she checked the locks on the door 10 times each night and checked every appliance in the house 5 times before leaving in the morning, then we might consider the possibility of a disorder.

General Criteria for Personality Disorders

1. An enduring pattern of inner experience and behavior that deviates from the expectations of the individual’s culture. This pattern is manifest in two or more of the following areas:

• Cognition (i.e. ways of perceiving the self, others, and events)
• Affectivity (i.e. the range, intensity, ability, and appropriateness of emotional responses)
• Interpersonal functioning.
• Impulse control

2. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

3. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

4. The pattern is stable and of long duration, and its onset can be traced back to adolescence or early adulthood.

5. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. 

6. The enduring pattern is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition, such as head trauma.

 American psychiatric association, 1994

The essential features of a personality disorder, according to the American Psychiatric Association (1994), are presented in the following table. A personality disorder is usually manifest in more than one area: in how people think, in how they feel, in how they get along with others, or in their ability to control their own behavior. The pattern is rigid and is displayed across a variety of situations, leading to distress or problems in important areas of life, such as at work or in relationships, for example, an overly conscientious man might drive his wife crazy with the constant checking of his household appliances. The pattern of behavior that defines the personality disorder typically has a long history in the person’s life and can often be traced back to manifestations in adolescence or even childhood. To be classed as a personality disorder, the pattern must not result from drug abuse, medication, or a medical condition, such as head trauma.

Varieties of Personality Disorder.

The DSM-IV lists 10 personality disorders. These 10 disorders, in turn, fall into 3 groups. All personality disorders involve impaired social relations and trouble getting along with others. A person with a personality disorder causes difficulties for other people. Personality disorders are unique in that, in addition to suffering themselves, persons with these disorders make those around them suffer as well.

Categories or Dimensions?

One way to view personality disorders is as distinct categories: people without a particular disorder are in one category. And people with the disorder are in another category. This categorical view is the dominant approach in psychiatry and clinical psychology today. A person either is diagnosed with the disorder or is not. For example, a study of more than 600 serious offenders in maximum security prisons in Canada concluded that antisocial personalities were a distinct category representing a segment of the prison population (Harris, Rice, and Quinsey, 1994). The categorical view holds that there is a qualitative break between people who are antisocial and people who are not. And this concept is applied to all disorders, viewing disorders as distinct and qualitatively different from normal extremes on each trait.

In contrast to this categorical view, each disorder is seen as a continuum, ranging from normality at one end to severe disability or disturbance at the other. According to this view, people with and without the disorder differ in degree only. For example, part of being an antisocial psychopath is not caring about the feelings of others, and there are degrees to which this lack of social caring manifests itself. For example, some people might simply be aloof and unconcerned about the feelings of others. Further out on this dimension, a person might lack the desire to help others, being both aloof and uncaring. Even further out on this dimension is the person who actively hurts or takes advantage of others. And, finally, at the greatest extreme is someone like “Monster”. The person introduced at the start of this chapter, who takes pleasure in harming or terrorizing others, is motivated to social crime because he or she enjoys seeing others suffer.

Research on American college students suggests that antisocial traits, such as impulsivity, quick temper, lack of remorse, manipulativeness, and callous social attitudes, are normally distributed. This implies that these traits are dimensions, which range from low to high, not distinct categories. Viewing a personality disorder as part of a continuum, ranging from highly agreeable and cooperative at one end to extremely uncaring and lacking in social interest at the others. The dimensional view implies that certain patterns of behavior, in various amounts, contribute to the disorder, making the person a problem to themselves and to others. Many modern theorists (e.g. Costa and Widiger, 1994, 2000) argue that the dimensional view provides a more reliable and meaningful way to describe disorders as extreme forms of normal personality traits.