0.9 Trait theories of personality  (Page 40/41)

(see Widiger, et al., 1994)

So, given the possibility of reconceptualizing personality disorders within the FFM, is it something we should do? Millon suggests that we view personality as the psychological equivalent of the body’s biological systems. Personality is, in this conception, a psychic system of structures and functions that lead to characteristic patterns of thought, feeling, and behavior. These characteristics cannot be viewed as simply normal or abnormal, since any specific element of the personality might be adaptive in one situation but maladaptive in another. Thus, the dimensional approach to describing personality provides a comprehensive picture in which little information of potential significance is lost (Millon, 1994). McCrae questions the very validity of Axis II of the DSM system, which appears to have little empirical support. He suggests that clinicians include in their diagnosis of patients a global assessment of the five personality factors. Thus, the diagnostic report would provide the necessary information on personality pertaining to the common symptoms and problems associated with either high or low scores on each factor (McCrae, 1994; Widiger, 1994). For example:

High Neuroticism: chronic negative affects, difficulty in inhibiting impulses, irrational beliefs

Low Neuroticism: lack of appropriate concern for potential problems in health or social adjustment, emotional blandness

High Agreeableness: gullibility, excessive candor and generosity, inability to stand up to others, easily taken advantage of

Low Agreeableness: cynicism and paranoid thinking, inability to trust, quarrelsomeness, too ready to pick fights, exploitative and manipulative, lying, rude and inconsiderate

(see McCrae, 1994)

Perhaps the most valuable aspect of any model used for classifying the personality disorders is its ability to provide guidelines for conceptualizing a treatment strategy. Sanderson and Clarkin (1994) have indeed found the NEO-PI useful in differential treatment planning. For example, the NEO-PI, in conjunction with a clinical interview, helps describe the typical interpersonal patterns of the patient, suggesting areas of difficulty needing treatment regardless of whether the therapy format is individual, family, or a group setting. In addition, the NEO-PI can help to identify which therapy format might be best suited to each particular patient. Although Sanderson and Clarkin (1994) caution that such conceptions still await empirical confirmation, they do offer some examples from their own supportive clinical experience. Likewise, MacKenzie (1994) offers numerous specific examples from cases in which factor scores provided clear target areas for focusing therapy. For example, a women who scored high in agreeableness acknowledged that she repeatedly got into relationships in which she felt used, a teacher who scored very high on openness was overly stimulated in new situations and felt overwhelmed with creative ideas, and a man who scored low on conscientiousness felt stuck in life, having worked only itinerant construction jobs despite having earned a graduate degree in college. In each case, the NEO-PI data matched the clinical presentation quite well, suggesting that the FFM would indeed be an effective conceptualization of treatment strategies for personality disorder issues (as well as, presumably, for other psychological and adjustment disorders).