In this series, I dig a little deeper into the meaning of psychological terms. This week’s term: personality trait vs. disorder
Wikipedia defines personality traits as “habitual patterns of behaviour, thought, and emotion” that are mostly stable across time and context. Some traits fall on a continuum, such as introversion/extraversion. It’s unclear the extent to which biology and developmental factors each play a role in shaping us into who we are.
The “big five” personality trait model breaks down human personality into five broad dimensions: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. High levels of neuroticism and low levels of conscientiousness have been associated with an increased risk for common mental illnesses.
\The Myers-Briggs Type is another way of looking at how personality traits combine. It includes introversion/extraversion, sensing/intuition, thinking/feeling, and perceiving/judging.
Some other major personality traits include self-esteem, honesty-humility, harm avoidance, novelty-seeking, perfectionism, rigidity, impulsivity, disinhibition, and obsessionality. Many of these may be influenced by episodes of mental illness, even if they’re not present at the underlying personality level. I suspect there are also some traits that may be present at a low level when things are going well that become more activated under stressful conditions.
Personality disorders do not correspond to specific individual traits; instead, they are a broader construct. Wikipedia says that personality disorders are:
characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual’s culture. These patterns develop early, are inflexible, and are associated with significant distress or disability.
Personality disorders in the DSM-5 are grouped into three clusters: cluster A is odd/eccentric (paranoid, schizoid, schizotypal), cluster B is dramatic/emotional/erratic (borderline, histrionic, narcissistic, antisocial), and cluster C is anxious/fear (avoidant, dependent, obsessive-compulsive). It’s possible to have traits of multiple different personality disorders.
Personality disorders are diagnosed based on the presence of a number of characteristics encompassing both inner experience (thoughts and emotions) and behaviour. A certain number of symptoms/characteristics must be met in order to receive a personality disorder diagnosis. People who have some elements a disorder and experience some distress as a result, but do not meet the full diagnostic criteria, might be diagnosed as having (e.g.) borderline personality traits.
Many people display some of the characteristics associated with some personality disorders at least some of the time. What sets personality disorders apart are the inflexibility of responses, the enduring and pervasive maladaptive responses, and the significant impact on social, work, and other important areas of functioning. Therapy for personality disorders doesn’t try to change the individual’s personality, but instead focuses on learning to respond more skillfully to avoid disruptive and maladaptive patterns.
While the DSM breaks down personality disorders into particular categories, some researchers have proposed a dimensional approach, such as describing personality disorders based on the big five dimensions of personality. The Wikipedia personality disorder page has quite an interesting chart that lays this out.
For myself, I think most of my personality traits have stayed reasonably consistent over time, although perhaps there has been variability in the extent to which I’ve embraced those traits behaviourally (I’m thinking of introversion, in particular). I’ve observed that when my depression is bad and I’m under stress a lot of ugly things jump out and make an appearance that normally stay stored away in a mental box somewhere. Sometimes I wonder if that’s the real me that I normally keep a tight leash on. I don’t really think it is, but then again, the ugly bits are always there and ready when I need (?) them.
You can find the rest of my What Is series here.
My book Making Sense of Psychiatric Diagnosis breaks down the different categories of DSM-5 diagnoses, explaining the diagnostic criteria and providing first-hand stories of the various illnesses. It’s available on the MH@H Store, as well as Amazon and other online retailers.