Abnormal Personality Traits

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

Underlying Normal Traits within Abnormal Personality Disorders

Student

University

April 11, 2010

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

Abstract

Scholars have argued for decades concerning the fact that there are normal personality traits

underlying abnormal personality traits in people who exhibit dysfunctional personalities. The

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition is the determinative

guide on the descriptions of these personality characteristics, and it determined that there were

several models to be considered when looking for a universal clinical definition of abnormal

personality.
Researchers used either the Big Four, Big Five or other models to describe what an

abnormal personality consisted of and how it related to a normal personality as studied.

Researchers measured personality differences based on qualitative, quantitative and other key

factor differences to determine normal or abnormal functioning personalities. It was difficult to

determine one substantive definition, as the traits overlapped from normal to abnormal

characteristics noted. Later, the definition of personality dysfunctions included life skills,

personal tasks and life goals, and whether the individual was able to function as a member of his

society, while meeting the expectations of that society.
A person’s maladaptiveness and

evolutionary sense were added as part of the definition of whether the personality was normal or

abnormal, and whether a person had the skill to be able to manage personal relationships were

considered as well in the general definition of abnormal personality. Today, treatment options

are expanded from the traditional therapy treatments to include drug therapies, psychodynamic

therapy, day hospital intervention, and dialectical behavior therapy. To date, day hospital

interventions have proved very successful on non-schizophrenic patients suffering from

abnormal personality traits.

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

Introduction

Scholars have argued for decades concerning the fact that there are normal personality

traits underlying abnormal personality traits in people who exhibit dysfunctional personalities.

Recently, scholars have begun to make an argument that current category systems of personality

disorders (PDs) should be substituted by trait dimensional scheme designations in the
Diagnostic

and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric

Association, 2000). Experts are leaning towards using a Big Four model, which are “essentially

maladaptive variants of the Big Five traits of normal personality, minus Openness” (Watson,

1545). In a discussion of this issue by Watson, Clark and Chmielewski, they state that the newly

comprised Big Four model excludes odd or eccentric Cluster A PDs, (Watson, 1545) and that

their results noted from three studies show a relationship examining the factors of normal and

abnormal personalities. Their results established that the Oddity factor was considered more

broad than the Cluster A traits and more distinct from Openness and other Big Five models,

which suggested “an alternative five factor model of personality pathology (considering only

abnormal traits) and an expanded, integrated Big Six taxonomy that subsumes both normal

and abnormal personality characteristics” (Watson, 1545).

Model Theories

The Watson study explains that the Big Four structure was a result of developed

hierarchical models that combined general models, like the Big Three and the Big Five models.

These former models of personality reviews included multidimensional factors reminiscent of

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

past personality inventories. When the Big Three and Big Five models were formally combined,

it was apparent that “two higher order traits—Neuroticism/Negative Emotionality and

Extraversion/Positive Emotionality—are included in both models” (Watson, 1547). Considering

these changes, Watson proposes a “Big Four” theory which does not include Openness, but does

include many of the traits of the other theories. Watson reports that their research on the Big Five

theory also includes research on a Big Six taxonomy “that subsumes both normal and abnormal

personality dimensions (Watson, 1551).

Definitions of Abnormal Personalities

Researchers have made recent discoveries that “abnormal personalities can be modeled as

extremes of normal personality variation” (O’Connor & Doyce, 2001) (Markon, p. 139). Even

though researchers agree that it is possible to describe normal and abnormal personalities within

the same frameworks, they disagree on the structure of what the framework will encompass.

Even abnormal personality traits are seen now as a variant of the extremes that can happen when

reviewing normal personalities.

One way to make sense of the distinctions between normal and abnormal personalities is

to describe personality disorders (PDs) and develop a working definition for them. By defining

the traits for PDs, the researcher is able to develop a base for delineating personalities studied.

Once normal traits are identified, abnormal traits need to be assessed. This can be done by

reviewing the Big Five model of abnormal personalities. This is the juncture that normal and

abnormal personalities overlap. Apparently, there are similar modeling structures that can be

utilized to describe both normal and abnormal personalities. Some traits are very common

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

between the two models, and others mimic similar personality descriptions.

Meta-analytic Investigation Model

One cohesive factor that applies to both normal and abnormal personalities is the meta-

analytic investigation model. This model was proposed by O’Connor in 2002, and it stated that

there were structural relationships between normal and abnormal personalities (Markon, p. 142).

The O’Connor study in 2002 reviewed 37 personality and psychopathology inventories to

determine if dimensional structure differences existed between clinical and nonclinical

respondents (O’Connor B.P., 2002). O’Connor found similarity between normal and abnormal

populations reviewed and measured similarities “both in the number of factors that exist in the

data matrices and in the factor pattern” (O’Connor B.P., 2002).

The ten abnormal behavior disorders listed by the DSM-IV are listed as: paranoid,

schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and

obsessive–compulsive” (Livesley & Jang, p. 258). Each of these disorders shows traits, and it is

the way that professional clinicians are able to make accurate diagnoses of abnormal personality

traits of their patients. This listing of traits by the DSM, showed that the distinction between

what was considered normal and what was considered abnormal was often defined by

distinguishing the “qualitative distinction between the two” (Livesley & Jang, p. 258).

Unfortunately, in truth researchers have come to find out that there are no true separations

between normal and abnormal disorders, and they are hard pressed to find the dividing lines

between the two entities. O’Connor asked whether the distinction can be made using former

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

models, and what exactly was normal or abnormal personality disorder. When the conceptual

distinctions between the two were reviewed, there are several models to note. The most

noteworthy working model being that there was “no evidence of discontinuity in the distributions

of 100 traits selected to provide a systematic representation of personality disorder” (Livesley &

Jang, p.
259). In other words, there was no concrete evidence that the researchers would

consistently find traits that were exclusively common or descriptive of a specific personality

disorder.

In fact, personality disorders were measured across normal and control groups. The

findings were that there were similarities within the disorder traits and that some equaled normal

and others disordered personality traits. In this way, the researchers queried whether disorder

traits could be seen in normal personalities. The answer was that there were few solid

frameworks to make the decision which would provide a definitive answer to the question. In

effect, extreme ends of the traits seemed to be deemed disorders, while extreme variations alone

may not have been considered enough to state that a personality disorder actually existed.

Quantitative Differences in Normal and Abnormal Personalities

Quantitative differences exist between the normal and abnormal personality.
The

differences often mix up and muddle the personality traits and the disorders apparent within

them. With personality disorders, often “it is difficult to see how an extreme score on dimensions

such as conscientiousness, extraversion, or agreeableness is necessarily pathological.

Researchers agreed that there were to be other additional factors that needed be present to justify

the diagnosis (Livesley & Jang, p. 262). That additional trait is inflexibility and subjective
Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

distress (Livesley & Jang, p. 259). The character trait of inflexibility is defined as one where the

person has extreme traits, but not necessarily only an extreme position noted on any given trait.

For example, a person who is extremely open and gregarious, but then is not able to tone down

his personality when necessary would be an example of this trait. Continuing with this example,

what would make the person who is considered otherwise outgoing and spontaneous a person

who is suffering from a personality disorder?

Maladaptive Personalities

The answer may come from prior work done by researchers who were determining

personality and abnormal personality disorders. Extreme actions alone were not enough to say

the person operated outside of “normal” personality parameters. The researchers at the time

believed that personality disorders were the result of someone suffering from an abnormal

variation of a personality being studied. It was measured in how much the person suffered from

the disorder. This is where the theory of maladaptation or dyscontrolled impairment came into

play (Widiger & Trull, 1991; Widiger & Sankis, 2000).

The reason the researchers sought a generalized definition is that without one, they

“would have to catalogue the various maladaptive manifestations of each trait” (Livesley & Jang,

p. 263). This was a difficult proposition, since even “normal” people were prone to exhibit

maladaptive traits at some time in their lives. Another problem came with the idea of traits as one

certain set of behaviors that were noted on subjects clinically or otherwise. Extreme exhibitions

of a trait may show some measureable amount of psychopathology, but were not exclusively

indicative of being considered classically maladaptive. In this way, the researchers determined
Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

that the “definition of personality disorder needs to incorporate features of disorder that are

separate from, although possibly correlated with, extreme trait variation” (Livesley & Jang, p.

263).

Harmful Dysfunctional Traits in Personalities

These descriptions of personality were necessary because there were more than these

factors to consider when determining a personality disorder. In fact, personality was considered

to be “a system of interrelated structures and processes” (Costa & McCrae, 1994; Mischel, 1999;

Vernon, 1964) which included a person’ dispositional traits, motives, coping mechanisms, and

ability to tame impulses are part of the process of determining normal or abnormal indications of

personality. In other words, if these traits were considered “harmful dysfunctions,” (Wakefield,

1992; Livesley & Jang, p. 263) they consisted of harmful traits that were underlying natural

functions. So, the definition of a personality disorder can be considered a harmful dysfunction in

the normally adaptive functions of a person’s personality system (Livesley & Jang, p. 263)

Another issue within the developing studies of personality disorders was that personality

functions were considered to be seen as disturbed in individuals who exhibited personality

disorders. Researcher Cantor described a person’s personality as the types of tasks a person sets

as personal goals, and they way the person looks at his or her “self, and life situations, and the

strategies used to achieve personal tasks” (Livesley & Jang, p. 263). This delineation of

personality traits offered a true to form definition of what a personality disorder consisted of for

the individual suffering from it. It was considered of a higher order than simply a dysfunction of

a personality trait. Here it was described as needing to concentrate on life tasks as the

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

determining factor to determining if an individual had a personality disorder, and was therefore

considered abnormal in terms of functioning personality.

The researchers assumed that as a person lives his life, he orders his tasks as to what he

sets as priorities for completing goals and meeting the needs of his immediate surrounding

community and culture. This comes under the order of living in society and meeting the

expectations of people who live near the individual, or a way of fitting in within his community.

It also had to do with the person’s mean biology, or biological features characteristic of the

individual. In fact, these tasks did vary depending on where the person lived and what the person

had do to be able to survive in his culture. These may come under the umbrella of life skills, and

they are definitely different considering where a person lived or had grown up. For example, a

person who grew up in a small native Alaskan out island would have different life skills that

would a person who grew up and lived in a borough of Manhattan, NY. The two personalities of

these individuals might be similar, but their life skills would be developed in obviously different

ways. The person living in the native island village would have an understanding of the elements

and what is necessary for bare-bones survival in possibly extreme conditions. While, the person

who grew up in the city would have to understand how to be “street smart” and may need to

know how to survive in even a potentially violent atmosphere if the neighborhood suggested

those skills were essential to survive on a daily basis. Each individual may otherwise be soft

spoken, or be considered similarly warm-hearted or kind. But decidedly, their life skills would

separate them and put them a world away from each other in what they knew and needed to

depend on to survive in their environment on a daily basis.

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

Universal Tasks Underlying Personality Traits

The researchers then understood that there would need to be a set of universal tasks that

needed to be identified. These universal tasks were considered of “evolutionary significance”

and featured four universal challenges as set by Plutchik (1980). These were the four ways a

person’s identity was developed and they included:

the solution to the problems of dominance and submissiveness created by

hierarchy that is characteristic of primate social hierarchies; development

of a sense of territoriality or belongingness; and solution to the problems

of temporality, that is, problems of loss and separation. This allowed the researchers studying personality disorders to come to the conclusion that

personality disorders prevented an individual from managing the adaptive answers or solutions

that were considered universally applicable to everyone, or a person’s life tasks. When an

individual had a deficit in any of these areas, there was a noted “harmful dysfunction” and the

person was unable to adapt to be able to function in his environment or society. The life tasks

then seen as either being fulfilled or being abandoned by the individual, probably because of this

identified deficit. Personality disorder was seen as different from other disorders by the fact that

these failures “should be enduring and traceable to adolescence or at least early adulthood and

they should be due to extreme personality variation rather than another pervasive and chronic

mental disorder such as a cognitive or schizophrenic disorder” (Livesley & Jang, p. 264).

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

Evolutionary Sense Within Personality Traits There was talk of the individual not being able to adapt to his environment in an

“evolutionary sense” which spoke to whether the person had garnered enough skills for ensuring

adaptive social behavior to allow reproduction and survival (Livesley & Jang, p. 264). This was

explained as stating that the adaptive traits would contribute to the person adapting to his

environment and society in general, and the person adapting to his family unit would move the

person towards being able to rear children and eventually reproduce to pass down his traits to

offspring later on. This is the general definition of people who have self confidence in their

dealings with others, and are able to live in harmony in stable relationships, while becoming

productive members within their society or community. These can be seen to be part of the

ancestral or evolutionary needs of every individual, whether the person had an abnormal

personality or normal personality.

The more common description of an abnormal personality comes from what the common

person observes when someone has problems dealing within a relationship. Rutter (1987) stated

that personality disorders were characterized by “persistent, pervasive abnormality in social

relationships and social functioning generally” (Rutter, p. 454). Also, Tyrer (2001) stated that

“we do not necessarily need to know everything about someone's personality to recognise the

elements that make it disordered” (Tyrer, p. 83). Tyrer states quite honestly that psychiatrists

view these descriptive axioms as something to be deferred, and says “personality disorder and

mental retardation are stigmatic terms that psychiatrists like to avoid” (Tyrer, p. 83).

So the question is, how can one determine the underlying normality within the abnormal

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

personality? For this the clinician and the layperson need review the DSM-III, considered the

premier source of personality disorder classification (American Psychiatric Association, 1980).

The DSM classifies what is considered normal and abnormal in terms of personality. The

professionals in the field disagree to the proposed stereotyping of this group of classifications, on

the basis of the fact that such profiling is considered “quite inappropriate in such a complicated

field” (Tyrer, p. 84). In fact, it appears that there are burgeoning alternative and substitute

classifications being used for determining personality disorders in surveys, trials, studies and

private practice. Most people would be surprised to find out that this topic has been heatedly

debated over the past two decades. Many people most likely assume that there is one clinical

definition of what is normal, and what is not normal when it comes to personality disorders. The

media plays into this, as well as the television and movie plots. The person seen as abnormal is

cloaked in symbolic black, speaks in a raspy voice or has otherwise obvious mentally deviant

behaviors that even the least sophisticated person in the audience could confidently label as the

“bad guy.”

Personality Disorders Studied Abroad

Even the study of personality disorders abroad have led researchers to agree to disagree in

the area of determining how to describe profiles for patients with underlying normal traits within

their abnormal personality profiles. In a study performed by McCrae (2001) in The People’s

Republic of China, 1,909 psychiatric patients were examined to determine the accuracy of the

hypotheses determined from the Interpretive Report of the Revised NEO Personality Inventory

(McCrae, p. 155). The researchers determined that the PDs were not separate categories that

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

could be determined in a vacuum. They realized that they needed to consider a more

comprehensive and forgiving system of personality traits, to be considered an accurate measure

of the patient’s personality issues and concerns.

The researchers found that the personality traits of the patients did not fit into the DSM-IV

defined traits. They did “draw on the same five underlying personality traits” (McCrae, p. 171),

and were considered redundant, but there were several areas of overlap to be considered

conclusive. In fact, over 60% of the patients that were being treated for maladaptive personalities

were not meeting the criteria defined in the DSM-IV, as relating to any criteria for a PD (McCrae,

p. 171). The maladaptive behaviors, the person’s habits and personal attitudes were all measured

to find a comprehensive scale for measuring the personality traits of the patients. It was

determined that the results were insignificant, and concluded that personality profiles were

“modest predictors of categorical PDs, but they are immensely informative about people”

(McCrae, p. 172).

Treatment Options for Abnormal Personality Traits

But clinicians and psychiatrists are still interested in treating and helping people who

exhibit the traits of these personality disorders identified above. They are in disagreement

whether there are normal traits that are underlying the abnormal personality traits that deserve to

be treated in an effort to offer the patient an opportunity to live a full and productive life. This is

a critical option for people who have normal personality traits, but also exhibit the identified

borderline abnormal personality traits as well within their psyche.

Over a half decade ago, the best treatments were heralded as therapeutic, and they seemed

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

to promise the greatest success overall. But today, there are many alternate treatments available

for individuals exhibiting abnormal personality disorders. They include drug therapies,

psychodynamic therapy, day hospital intervention, and dialectical behavior therapy (Linehan,

1992, Tyrer, p. 84). Other methods of treatment that carry high success for the patients are the

partial hospitalization of patients (Bateman & Fonagy, 1999). Bateman & Fonagy compared the

effectiveness of treating patients exhibiting borderline personality disorders with partial

hospitalization s a standard psychiatric care. They studied thirty-eight patients with borderline

personality disorder and offered them individual and group psychoanalytic psychotherapy, for up

to 18 months (Bateman & Fonagy, 1999). The results were that the patients who had been

partially hospitalized did exhibit less problems, with “An improvement in depressive symptoms,

a decrease in suicidal and self-mutilatory acts, reduced inpatient days, and better social and

interpersonal function began at 6 months and continued until the end of treatment at 18 months”

(Bateman & Fonagy, 1999). Their conclusion was that the partial hospitalization was determined

as a far superior type of psychiatric care for those patients exhibiting borderline personality

disorder. This treatment option was in opposition with the standard treatment options of the

therapies listed above. These results were similar in the study by Piper, (1993) where a day

treatment program at the University of Alberta Hospital in Edmonton, Alberta was studied. The

patients were referred from the day treatment program and walk-in clinic, and utilized

participants with “chronically disturbed non-schizophrenic patients, who usually have affective

and personality disorders” (Piper, p. 757). The results of the study were that day treatment

programs were considered effective for patients with long-term nonschizophrenic disorders. The

Running Head: NORMAL TRAITS WITHIN ABNORMAL PERSONALITY DISORDERS

patients noted significant improvement in “four of the five areas studied—interpersonal

functioning, symptomatology, life satisfaction, and self-esteem—as well as in several of

disturbance associated with individual objectives (Piper, p. 762).

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