Personality and psychological disorders

265 Pages·2003·4.023 MB·English

by  Davis, Caroline;Claridge, Gordon

PERSONALITY AND
PSYCHOLOGICAL
DISORDERS
Dedication
To the 21 Oxford students on whom we tested an early version of this
book.
PERSONALITY AND
PSYCHOLOGICAL
DISORDERS
G O R D O N C L A R I D G E a n d
C A R O L I N E D AV I S
First published in Great Britain in 2003 by
Arnold, a member of the Hodder Headline Group,
338 Euston Road, London NW1 3BH
http://www.arnoldpublishers.com
Distributed in the United States of America by
Oxford University Press Inc.
198 Madison Avenue, New York, NY10016
© 2003 Gordon Claridge and Caroline Davis
All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means, electronically or mechanically,
including photocopying, recording or any information storage or retrieval
system, without either prior permission in writing from the publisher or a
licence permitting restricted copying. In the United Kingdom such licences
are issued by the Copyright Licensing Agency: 90 Tottenham Court Road,
London W1T 4LP.
The advice and information in this book are believed to be true and
accurate at the date of going to press, but neither the author[s] nor the publisher
can accept any legal responsibility or liability for any errors or omissions.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN 0 340 807148 (hb)
iv ISBN 978 0 340 807156 (pb)
2 3 4 5 6 7 8 9 10
Typeset in 11/12.5pt Garamond 3 by Dorchester Typesetting Group Ltd
Printed and bound in India
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Contents
Preface ix
Chapter 1 Connecting personality and disorder 1
Some theoretical issues 1
An historical perspective 6
Layout of the book 8
Chapter 2 Description, classification, and models of disorder 11
The medical classification 11
The dimensional approach 16
Historical considerations: HJ Eysenck 16
Comments on Eysenck’s theory 19
A dimensional model of psychological disorder 20
From continuity to discontinuity 23
Summary and conclusions 28
Chapter 3 Personality dimensions: description and biology 31
Historical antecedents and Eysenck’s theory 31
The Eysenck dimensions 33
v
Eysenck’s ‘causal’ theories 34
A note on the status of Psychoticism (P) 37
Temperament and personality compared 38
Contemporary theorists 40
Gray 40
Cloninger 44
Zuckerman 46
Five-factor theory (Costa & McCrae) 48
An integrated view of the theories 50
Genetic considerations 53
Behaviour genetics 53
Molecular genetics 56
The developmental perspective 57
Summary and conclusions 59
Chapter 4 Personality disorders 60
Some basic features 60
Personality disorders in DSM-IV 62
Personality disorders and models of the abnormal 66
Approaches to the explanation of personality disorders 67
Five-factor theory and Axis II 68
Cloninger revisited 70
The work of Millon 71
Beck’s cognitive approach 72
Particular personality disorders 74
Antisocial personality disorder (psychopathy) 75
Borderline personality disorder 80
Summary and conclusions 86
Chapter 5 Mood and anxiety disorders 88
Introduction 88
Animal models 91
Common symptoms of mood and anxiety disorders 95
Fearfulness 96
Anxiousness 101
Melancholy 106
vi
Chapter 6 Obsessive–Compulsive Disorder 113
Introduction 113
Natural history of the disorder 115
Causal explanations of OCD 117
Biological models 117
Cognitive models of OCD 121
Personality factors in OCD 124
Obsessive-Compulsive spectrum disorders 128
Chapter 7 Addictive behaviours 131
Introduction 131
Clinical features 133
The neurobiology of addiction 136
Chronic use of addictive behaviours 140
Vulnerability to addiction 141
Sensitivity to reward (SRT) 143
Impulsive behaviour 147
Proneness to anxiety and negative mood 150
Chapter 8 Eating disorders 155
Introduction 155
Clinical features 156
Historical perspectives 158
Research methodology 160
Temperament and personality 164
Obsessionality and the eating disorders 165
Perfectionism and the eating disorders 167
Impulsivity and the eating disorders 169
Anxiousness and the eating disorders 170
Sensitivity to reward, addiction, and the eating disorders 175
The pathophysiology of eating disorders 177
Conclusions 180
Chapter 9 Psychotic disorders 181
Definitions and descriptions 181
The issue of heterogeneity 185
vii
One psychosis or two? 185
One schizophrenia or several? 186
Dimensional aspects of schizophrenia 187
Quasi- versus fully dimensional models 188
Measurement of schizotypy 190
Explaining schizophrenia 192
Research problems and strategies 192
Genetics and risk for schizophrenia 193
Experimental psychopathology of schizophrenia 197
Brain systems in schizophrenia 201
Manic depression 205
The unitary psychosis issue 205
Dimensionality of manic depression 206
Conclusions 207
Chapter 10 Final remarks 211
References 217
Index 245
viii
P r e f a c e
As is often the case, this book had a serendipitous beginning. More precisely,
it started after one of us could not resist voicing his opinion to Arnold that
there was a need for a book like ‘Personality and Psychological Disorders’.
Before we knew it, we were writing one! And having finished it we can now
see why there hasn’t been one before, at least one at a factual level of
complexity sufficient to be informative, but not too detailed to be inaccessible
to the readers for whom it is mainly intended. We hope we have come some
way towards striking that difficult balance; for each of the two areas covered
is itself a huge branch of psychology, with many different viewpoints and
examples that clamour to be represented. Indeed, the two topics – individual
differences and psychological disorders – are generally taught separately in
psychology degree courses and, in our experience, reference from one to the
other, even if occurs, is sketchy and tentative. This is a pity because, as we try
to show in this book, the study of personality may be usefully enriched by
looking beyond the average and the healthy; whilst the deviant states of mind
ix
and behaviour that constitute the subject matter of abnormal and clinical
psychology can scarcely be understood without reference to some concept of
normality.
As described in the early chapters of the book, the arguments we develop
and the material we present, concentrate on a certain way of thinking about
the connection between normal and abnormal: one that draws particularly on
its biology, yet without embracing a straightforwardly disease view of
psychological disorder. This perspective has not always been uncontroversial –
and that is still the case in some quarters. We chose it because it is well-
grounded in the history of ideas about the topic, is supported by considerable
past and present scientific evidence, and, looking to the future, is likely to