Rep36 Understanding Personality Disorder

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Contents

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1.1 What is personality disorder? 
Key points:
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Personality disorders are variations or
exaggerations of normal personality attributes. 
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Although Personality disorder is often
associated with antisocial behaviour, the
majority of people with a personality disorder
do not display antisocial behaviour.
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Many people with mental health problems
also have significant problems of personality. 
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Disorders of personality reduce the
effectiveness of treatments for major mental
health problems.
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There is an urgent need for better
understanding of personality disorders.
1.1.1 Introduction
People differ in the ways that they view
themselves and others, engage in relationships,
and cope with adversity. It is quite common for
these characteristics to occasionally interfere
with a person’s ability to cope with life, and may
also lead to difficulties in social interactions.
When these difficulties are extreme and
persistent, and when they lead to significant
personal and/or social problems, they are
described as personality disorders.
From the time of the ancient Greeks, people
have tried to group individuals according to their
characteristic approach to life, but the idea of
personality as a stable feature of individuals
emerged only a hundred years ago. Because they
were the most important psychological theories of
the time, initial attempts to understand both
normal and abnormal personality were guided by
psychoanalytic or Freudian ideas (Tyrer, 2000).
During the 1930s and later, however, psychological
and psychiatric approaches developed and
changed. In particular, psychologists studying
personality tended to concentrate on the
population samples rather than individual case
studies (Cattell, 1965; Eysenck, 1967). It has been
argued that current approaches to personality
disorder in mental health settings ignore several
decades of research on personality in the general
population (Livesley, 2001).
For a time, psychologists also disagreed on
the usefulness of the idea of personality itself. In
the ‘person-situation’ debate, some argued that
the behaviours that are assumed to be
expressions of personality have more to do with
the situations in which people are observed than
with stable characteristics (Mischel, 1968). This
debate has now largely subsided with the
acceptance that behaviour depends on
characteristics of both the person and the
situation, and the psychology of personality has
flourished (Cervone & Mischel, 2002; Kenrick &
Funder, 1988). 
Some psychologists remain sceptical about
the utility of ideas of personality and personality
disorder for clinical practice. However, research
clearly shows that personality not only predicts
significant life outcomes such as occupational
functioning, health, and academic achievement,
but can also be a risk factor for psychological
problems such as depression (Krueger, Caspi,
Moffitt, Silva & McGee, 1996). Many people
referred to mental health services have
significant problems of personality (Dolan-
Sewell, Krueger & Shea, 2001), and
abnormalities of personality may reduce the
effectiveness of treatments for major mental
health problems (Reich & Vasile, 1993). We
believe that the influence of personality on
mental health problems needs to be recognised
in the interests of better mental health services. 
It is now widely accepted that personality
disorders are variations or exaggerations of
normal personality characteristics, and the
integration of traditional psychiatric and
psychological approaches to personality has
accelerated in recent years (Livesley, 2001;
Widiger & Frances, 1994). Psychologists believe
that developments in the scientific
understanding of personality will help in the
treatment and management of people with
personality disorders (Cervone & Mischel, 2002).