+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders

Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders

Journal of Affective Disorders 68(2-3): 143-158

A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added to the two-dimensional plane as a third (orthogonal) axis. The distance of a case from the 'ground level' of habitual behaviour corresponds with the severity of the actual psychopathological state. The specific form of that state (e.g. manic or depressive), however, varies along one the axes which define the circumplex of habitual behaviour. This three-dimensional model is, by its very nature, more complex than the unidimensional one derived from Kretschmer's typological concept, but it is clearly more in accordance with empirical data.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 010448971

Download citation: RISBibTeXText

PMID: 12063143

DOI: 10.1016/s0165-0327(02)00045-9

Related references

Stability and course of personality disorders: The need to consider comorbidities and continuities between Axis I psychiatric disorders and Axis II personality disorders. Psychiatric Quarterly (New York) 71(4): 291-307, Winter, 2000

Personality disorders 25 years later: reflections on the 25th anniversary of the establishment of the international society for the study of personality disorders and the journal of personality disorders. Journal of Personality Disorders 28(5): 607-610, 2014

Personality disorders and personality variations in relatives of patients with bipolar affective disorders. Journal Of Affective Disorders. 35(4): 173-181, 1995

DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences—part 2: bipolar disorders, schizophrenia spectrum disorders, anxiety disorders, obsessive-compulsive disorders, trauma- and stressor-related disorders, personality disorders, substance-related and addictive disorders, neurocognitive disorders. European Archives of Psychiatry and Clinical Neuroscience 265(2): 87, 2015

The prevalence of personality disorders, psychotic disorders and affective disorders amongst the patients seen by a community mental health team in London. Social Psychiatry and Psychiatric Epidemiology 37(5): 225-229, 2002

Personality and personality disorders II. The Specificity of the DAPP-model as a diagnostic system for personality disorders. Fortschritte der Neurologie-Psychiatrie 70(12): 641-646, 2002

Personality and personality disorders among patients with major depression in combination with dysthymic or cyclothymic disorders. Acta Psychiatrica Scandinavica 79(4): 363-369, 1989

Personality and personality disorders I. Universality and sensitivity of dimensional personality models as diagnostic systems for personality disorders. Fortschritte der Neurologie-Psychiatrie 70(12): 630-640, 2002

Affective phases in dynamics of personality disorders (on a model of borderline personality disorder). Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova 104(8): 18-23, 2004

Depressive personality: associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders. Journal of Abnormal Psychology 107(2): 319-327, 1998

Remitted bipolar affective disorders: Personality disorders and personality changes. Nervenarzt 64(5): 318-323, 1993

Overdiagnosis of major psychiatric disorders in individuals with substance use disorders and personality disorders: the downside of the Woodruff principle. Journal of Studies on Alcohol 59(4): 477-478, 1998

Clinician judgments of clinical utility: A comparison of DSM-IV-TR personality disorders and the alternative model for DSM-5 personality disorders. Journal of Abnormal Psychology 123(2): 398-405, 2014

A 6-year follow-up study of anxiety disorders in psychiatric outpatients: Development and continuity with personality disorders and personality traits as predictors. Nordic Journal of Psychiatry 53(6): 409-416, 1999

Personality factors in affective disorders: historical developments and current issues with special reference to the concepts of temperament and character. Journal of Affective Disorders 51(1): 1-5, 1998