Psych · Foundations — personality theory
Personality theory for psychiatrists
Also known as Five-factor model · Big Five personality · Temperament and character · Dimensional personality · AMPD · PID-5 · Level of personality functioning · Trait theory psychiatry
Exam-exhaustive fellowship reference on personality theory for psychiatrists — trait models (FFM/Big Five, Cloninger), psychodynamic and cognitive-interpersonal frames, continuum to personality disorder, AMPD and ICD-11 dimensional models, assessment, formulation, and clinical application. FRANZCP-primary, globally tagged.
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Red flags
- Late-onset or abrupt personality change requires organic and substance work-up before trait reification
- Acute risk (suicide, violence, severe self-neglect) overrides elective personality formulation
- Do not use 'personality' pejoratively to deny crisis care or therapy access
- State illness inflates neuroticism and affective scores — reassess traits after stabilisation
- Pathologising culturally normative reserve, deference, or expressivity is a formulation error
- Missing treatable comorbidity (mood, trauma, ADHD, autism, substance) under a personality label
Meet the patient
A 28-year-old woman arrives after an overdose. The referral reads "borderline traits — probably personality". On the ward she is furious one minute, tearful the next, and convinced the team is about to abandon her. Her partner rings to add that she has been "like this since her teens" — but also that she lost her job and stopped sleeping two weeks ago.[8][13]
Two questions are now live on every ward round that touches her, and both are exam questions: is this trait or state? and is that label earning her care, or blocking it? The rest of this topic is the consultant-depth answer to both.[7][13]
References16ShowHide
- [1]McCrae RR, John OP An introduction to the five-factor model and its applications J Pers, 1992.PMID 1635039
- [2]Goldberg LR The structure of phenotypic personality traits Am Psychol, 1993.PMID 8427480
- [3]McCrae RR, Costa PT Validation of the five-factor model of personality across instruments and observers J Pers Soc Psychol, 1987.PMID 3820081
- [4]McCrae RR, Costa PT Personality trait structure as a human universal Am Psychol, 1997.PMID 9145021
- [5]Cloninger CR, Svrakic DM, Przybeck TR A psychobiological model of temperament and character Arch Gen Psychiatry, 1993.PMID 8250684
- [6]Clark LA, Watson D Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications J Abnorm Psychol, 1991.PMID 1918611
- [7]Clark LA, Watson D, Mineka S Temperament, personality, and the mood and anxiety disorders J Abnorm Psychol, 1994.PMID 8040472
- [8]Kotov R, Gamez W, Schmidt F, Watson D Linking "big" personality traits to anxiety, depressive, and substance use disorders: a meta-analysis Psychol Bull, 2010.PMID 20804236
- [9]Krueger RF The structure of common mental disorders Arch Gen Psychiatry, 1999.PMID 10530634
- [10]Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE Initial construction of a maladaptive personality trait model and inventory for DSM-5 Psychol Med, 2012.PMID 22153017
- [11]Kotov R, Krueger RF, Watson D, et al. The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies J Abnorm Psychol, 2017.PMID 28333488
- [12]Samuel DB, Widiger TA A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: a facet level analysis Clin Psychol Rev, 2008.PMID 18708274
- [13]Tyrer P, Reed GM, Crawford MJ Classification, assessment, prevalence, and effect of personality disorder Lancet, 2015.PMID 25706217
- [14]Bach B, First MB Application of the ICD-11 classification of personality disorders BMC Psychiatry, 2018.PMID 30373564
- [15]Bender DS, Morey LC, Skodol AE Toward a model for assessing level of personality functioning in DSM-5, part I: a review of theory and methods J Pers Assess, 2011.PMID 22804672
- [16]Roberts BW, Walton KE, Viechtbauer W Patterns of mean-level change in personality traits across the life course: a meta-analysis of longitudinal studies Psychol Bull, 2006.PMID 16435954