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Thursday, March 17, 2011

Normal Personality and Abnormal Personality

Normal Personality and Abnormal Personality
Personality traits are enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts. Only when personality traits are infl exible and maladaptive and cause signifi cant functional impairment or subjective distress, do they constitute Personality Disorders. (American Psychiatric Association, 2000, p. 686)The personality types diagnosed as disorders were not derived from an empirically based taxonomy or comprehensive theory. Rather, they are the product of a consensus of opinion among the scientists and practitioners who made up the PDs work group authorized by the American Psychiatric Association to develop Axis II. The inclusion of normative, adaptive traits [in DSM-V ] will facilitate the provision of a more comprehensive (and accurate) description of each patient’s general personality structure; it will facilitate an integration of the diagnostic manual with basic science research on generalpersonality structure; and it will facilitate treatment decisions through the recognition of traits that contribute to an understanding of treatment responsivity.

Anthropologists and sociologists speculate that the behavioral consistencies we refer to as personality were recognized by the prehistoric peoples who formed the fi rst stable groups and societies. Philosophical accounts of individual differences in human character appeared over 2500 years ago (e.g., Thales, Empedocles, Plato), and by the time of Christ several writers from Greece (e.g., Heraclitus, Socrates, Hippocrates, Aristotle, Galen) had created sophisticated theories that explained normal and abnormal behaviors as a function of ethereal manipulation, social pressures, personal choices, and physical characteristics such as the quantity of fl uids or “humors” in the body. Although many of the observations made by these pioneers were eclipsed long ago, several important ideas remain current in the twenty-fi rst century; for example, the concepts of temperament, type, taxonomy, and continuity between normal and abnormal behaviors (Durant, 1939; Hergenhahn, 1992; Millon, 2004; Russell, 1945). Progress in understanding personality from a scientifi c perspective took a giant leap forward following Darwin’s (1859) discovery of the evolution of species. The process of natural selection provided an intriguing explanation for the development of complex behavior patterns as means for survival, adaptation, and procreation. Although Darwin did not elaborate on the origin of group and individual differences at the phenotypic (observed) level, his contemporaries and followers (e.g., Galton, Helmholtz, Wundt, James) helped create the fl edgling science of psychology from philosophy as the study of human behavior. In the late nineteenth and early twentieth centuries, scientifi c and technological advances helped psychologists develop complex explanations for behavioral consistencies as stemming from a mixture of evolutionary, biological, social, and personal variables (Goodwin, 1998; Koch & Leary, 1992). Based on his training in neurology, clinical observations of neurotic patients, and appreciation of Darwinian theory, Sigmund Freud (1895/1966; 1915/1957) sought to develop a comprehensive model of normal and abnormal human behaviors based on neurological evolution. Although many aspects of Freud’s neurobiological model did not take hold among his contemporaries, his method of understanding behavior from a psychodynamic perspective did, and later spawned rival paradigms that viewed behavior as stemming from social, familial, interpersonal, cognitive, and learning factors (e.g., Freud, 1923/1961; Goodwin, 1998; Hergenhahn, 1992). Like Darwin, Freud gave us ideas that allowed people from many disciplines to discuss human behavior from a completely new viewpoint. Freud could explain normal as well as abnormal behavior, and he could treat people with a variety of ailments using his psychoanalytic methods. However, his ideas seemed to explain some behaviors better than others; he lacked a comprehensive taxonomy, and he discouraged experimental validation. The study of personality went in many directions after Freud. In America, the psychologists Gordon Allport (1937) and Henry Murray (1938) developed a scienceof personology that was independent of abnormal behavior. European psychologists continued to be infl uenced by psychodynamic thinkers like Fenichel (1945) and Reich (1949), but some rejected Freud and his followers in favor of the taxonomic, biological observations of those such as Kraepelin (1904), Bleuler (1924), Kretschmer (1925), and Jaspers (1948). The comprehensive models of normal and abnormal personality begun in the 1930s and 1940s by Cattell (1946) and Eysenck (1947) exemplify this latter group. The Second World War (WWII) shifted the heart of science to America as well as to theories that could explain behavior from sociocultural and interpersonal perspectives (e.g., Fromm, Horney, Sullivan). Another consequence of WWII was the proliferation of nonmedically trained mental health practitioners, particularly clinical psychologists, who helped shape the future of mental health theory and treatment. By the last quarter of the twentieth century, students of human behavior could pick from dozens of theories that explained various forms of normal and abnormal functioning from intrapsychic, biological, behavioral, interpersonal, phenomenological, and sociocultural perspectives (Hall & Lindzey, 1979; Lanyon & Goodstein, 1997). Too often these theories focused on specifi c phenomena or global aspects of functioning, normal or abnormal behavior, and either etiology or treatment of dysfunction. In many ways, the person got lost in an effort to explain behavioral details or outside shaping forces. The atheoretical, multiaxial DSM-III (American Psychiatric Association, 1980) separated personality from other mental disorders and asked practitioners to consider the pathology they were treating from whatever vantage point they felt was appropriate, in the context of the whole person. Just as Darwin and Freud had galvanized the attention of scientists from many walks of life, and created a fl urry of new ideas and research, DSM-III radically changed the way behavioral scientists conducted themselves in the clinic and laboratory. Like deregulation in the modern economic marketplace, by cutting itself loose from the past DSM-III gave free reign to the scientifi c community to step in and fi ll the knowledge gaps created by the new system. This alone brought a stampade of new theorists and researchers into the area. But just as central is that by giving PDs their own axis, and asking clinicians to consider the stable trait characteristics of all their patients, personality was elevated to a level of importance it had never had before. A consequence of this is that many more patients were diagnosed with PDs (e.g., Loranger, 1990). With more PD patients to treat, better treatments were needed. More money poured into PD research, and of course, this attracted more people into the area. After DSM-III researchers began focusing on the interface between normal and abnormal behaviors. They started questioning the need for separate theories that addressed symptoms outside the scope of personality, or health beyond the scope of pathology, and helped people begin to see the similarities in theories hat previously seemed different. The hope of integrating ideas about the nature of human development, perso nality functioning, psychopathology, and treatment is again pushing through. People from different disciplines and schools of thought are now working toward a comprehensive, biopsychosocial understanding of normal and abnormal behaviors that can encompass, or be compatible with, the many perspectives that have shown promise in the past, including biological, psychodynamic, sociocultural, and interpersonal (Strack & Lorr, 1994a). In the fi rst decade of the twenty-fi rst century the study of personality has moved beyond the confi nes of the DSM (Livesley, 2001a; Widiger & Simonsen, 2005). As notedpreviously, the DSM model does not offer an empirically based taxonomy, and it has kept its categorical distinction between normality and pathology in the face of scientifi c evidence that argues against this. But just as contemporary personologists have moved away from atheoretical, dualistic conceptions of human behavior, they no longer expect a single model of behavior to encompass the vast array of human features, both normal and abnormal. There is greater tolerance for, and interest in, dimensional conceptualizations of personality and psychopathology that have empirical backing, as well as models that predict and demonstrate discontinuity in some behaviors and disorders (e.g., schizotypy; Lenzenweger & Korfi ne, 1992).