Normal and pathological personality traits – criteria and current challenges

The concept of personality – in accordance with its structural complexity – is in a continuous reshuffle. It represents the dome under which are united all the important aspects of the existence of a human individual, therefore of a person.

The attributes of the human condition correspond to individual biological, material, psychological, social and cultural needs, as well as to the ways and mechanisms that ensure their realization. They are specific both to each individual and to most members of a social community, and allow the development of interindividual differences. And in this way, the authenticity and originality of the human person are outlined.

The ontogenesis of personality is a staged process that begins after the age of 3 years old, with the emergence of self-awareness. In the sense of developmental psychology, which today accesses information and psychological mechanisms from most psychological doctrines, personality maturation is a process in which each stage takes over from the previous stage only the adaptive attributes. Thus, in the hierarchy of parental family life associated with age, children will adopt – through introjection, imitation and identification – those traits and behaviors of their parents and grandparents that ensure their subjective comfort and can favor their adaptation in various unforeseen or stressful situations^(1,2).

The stages of personogenesis unfold on the territory between individual needs – in all their diversity – and the defense and adaptation mechanisms of the Self that participate in satisfying them. In each stage, corresponding to the level of self-evaluation and self-knowledge, the decision-making capacity intervenes, which allows establishing the mobilizing priorities of the defense mechanisms and, subsequently, of the adaptive ones⁽³⁾.

The role of the psychological maturation level, which developpes parallel to that of the personality, is thus confirmed. Today, in the formation and maturation of the individual personality, sociogenesis occupies the dominant place. Thus, the higher the social status of the parents implies better and more diversified conditions for raising and caring for children. Parents who are well-off or have higher social positions can offer more to their children in the various phases of maturation. Also, in an autocratic regime, children of people at the top of the hierarchy have their own destiny, different from other children, and they can “cultivate” their individualism and megalomania. People at the top of the hierarchy find sexual partners more easily, especially in the case of men. All boys – future men – are much more involved than girls in accessing a role or a high social position, and failures are experienced much more dramatically in their case^(4-7).

The different obligations of men and women in the parental role, in which the former are less involved due to social roles, differentiate the two sexes both in choosing partners and in selecting congeners in a friendly or friendship relationships^(7,8).

Thus, men tend to engage in a greater number of intimate relationships with female partners than women, who are more attached to relationships with a single partner. However, it is preferable for this partner to have a favorable social and professional position or stable income sufficient for the material security of the child. In return, men are more attracted to younger sexual partners. Regardless of gender, the phenomenon of jealousy can have the same frequency and intensity. Sexual infidelity is more easily tolerated by the female sex, and emotional infidelity by the male sex^(5,9,10).

In the various stages of personogenesis, the individual gets involved in friendship relationships, especially with young people of similar ages who have similar tastes and concerns or are close as neighbors. Getting closer and investing in relationships with relatives, joining sects or religions are also socially and culturally conditioned individual needs.

The motivations associated with the cultivation of parental qualities are also socially based. Child abuse is 40 times more common in stepparents than in harmonious families. Moreover, the needs of children for care and affection always exceed the parental offer, which usually tends to be uniform, without differentiation between children^(11-13).

Attachment to professional values is also an individual need that can be influenced by parental or extrafamilial models of success. In families where there are professions passed down transgenerationally, physical and psychological skills are developed that favor learning the profession by young people, which subsequently motivates the professional role in an elaborate way^(1,2).

All individual needs and expectations represent the support for the motivations of behavior in the cycles and roles of life. On the way to their fulfillment, the developing Self calls on unconscious defense mechanisms that allow it to counteract stressful factors. They operate simultaneously or alternatively, and must be understood and accepted as such. We mention in this context only affiliation, activism, altruism, self-affirmation through the expression of feelings, identification, compensation, sublimation and humor. Through repeated intervention and awareness, they become adaptation or coping mechanisms that support the self-determination of the human person^(3,14).

Adaptive mechanisms centered on emotion, avoidance, problem-centered and vigilant coping are described, which correspond to an active strategy through which a stressful situation is resolved.

As a result of the relationships between needs – therefore, individual motivations – and defense and the adaptation mechanisms involved in their satisfaction, there are outlined the structural dimensions of the human personality that are specific to the human condition. They coalesce cognitive, affective, motivational-volitional and relational components, of different intensities, expressed in individual behavior. A mature personality is aware of its structural dominants that ensure both the flexibility and predictability of behavior in existential roles and in relationships with others.

Individual behavior is also conditioned by the particularities and dynamics of mental life that interfere and mutually intercondition with personological dimensions. The way of being personal, in turn, attracts, rejects or ignores various experiences and life events and substantiates interindividual differences, as well as destiny or the course of life⁽¹⁾.

When in the different stages of the ontogenesis of the personality and the individual psyche, negative events and factors, such as affective and nutritional deficiencies, parental abuse, intense psychotraumas, existential frustrations and recurrent conflict situations, alienated patterns of behavior or conditions of isolation or social overcrowding occur, the primitive defense mechanisms of the Self become manifest, such as denial, projection, repression, regression, apathetic withdrawal through detachment from the environment, cleavage or dissociation that disrupt the dimensional structuring of the personality. They are hypertrophied, hypotrophied or caricatured and thus deform the attributes of the human condition. In this context, the territory of personality disorders is outlined. They must be differentiated and reported to the normal personality, but it has been found that the assortative links between the different typologies also favor the emergence of psycho-behavioral traits that can dim inter-individual differences^(15,16).

The level of severity of maladaptive behaviors – from the perspective of their consequences on the people around them – is influenced by the social and cultural environment and demographic factors.

In all cultures, antisocial behaviors are described – the most frequently studied, as well as others such as those dominated by emotional lability, anankastic rigor, or introversion and social withdrawal.

From a dimensional perspective, in individualistic societies, affective instability, nonconformism, openness to experience, curiosity and the spirit of competition are favored, while in traditional societies, stability and affective communion, agreeableness and conscientiousness are cultivated⁽⁹⁾.

In individualistic societies, moral values are assigned to an egocentric Self that can live according to its own values and beliefs, while in traditional societies the individual introjects the values of a protective and stimulating community Super Self for each individual. In general, adaptation mechanisms that are effective in one culture may prove maladaptive in another culture. Thus, assertiveness and boldness, always useful in individualistic societies, are disadvantageous in traditional ones, being appropriated by an entire community in a field such as the professional one.

In accordance with the stages of age, whose particularities do not bypass the destiny of pathological personalities, from a categorical perspective, maladaptive manifestations of the narcissistic, antisocial, borderline and histrionic type diminish with age, and those of the schizoid, schizotypal, anxious and obsessive type may increase. In a dimensional sense, emotional lability and extroversion decrease with age, and agreeableness and conscientiousness increase. The values of openness to experience increase with age, especially in individualistic societies^(17,18).

Regarding the incidence in the two sexes, narcissistic personality disorder, antisocial personality disorder and obsessive-compulsive personality disorder are predominant in males, while borderline personality disorder, histrionic personality disorder and dependent personality disorder are predominant in females. Psychopathic traits, severely maladaptive corresponding to delinquency, can complicate or progressively attach to any category of pathological personalities regardless of belonging to one sex or the other. They always bring to the forefront primitive defense mechanisms, cognitive distortions and the slippage of the self-control abilities of the individual Self.

The schematic exposition of the multitude of variables involved in the structure and destiny of personality disorders explains and motivates today the complexity, flexibility and dynamics of their diagnostic approach.

The two psychiatric nosographic systems DSM-5 and ICD-11 address also the field of pathological personalities. The first proposes a mixed model with six specific personality disorders – narcissistic personality disorder, antisocial personality disorder, borderline personality disorder, dependent personality disorder, obsessive-compulsive personality disorder and schizotypal personality disorder, along with four types whose traits are integrable to the first six. They are personality disorders defined by traits – schizoid personality disorder, paranoid personality disorder, histrionic personality disorder and avoidant personality disorder⁽¹⁹⁾.

The diagnostic criteria in DSM-5 target the relationships between the Self’s dysfunctionality, functioning in life roles and interpersonal relationships, and the pathological traits are grouped into five variants: negative affectivity, detachment, antagonism, disinhibition and psychoticism, each with five component facets. All of them are found in the structure of the PID-5 Personality Inventory. Its application also confirms the coexistence of two or more personality disorders as well as the comorbid conditions with Axis I disorders⁽¹⁸⁾.

If DSM-5 coalesces the dimensional and categorical perspectives, the ICD-11 system completely detaches itself from the latter. It highlights the continuum with normal personality and emphasizes the value of an accurate assessment of each dimension. The duration of the adaptive deficit associated with the personological diagnosis must be at least three years, and its severity depends on the number of dimensions of the structures involved. The description of each dimension is made only in relation to a mild, moderate, severe personality disorder or a personality disorder with marked traits in which the adaptive deficit is aware⁽²⁰⁾.

The six dimensions associated with the personopathic diagnosis are: negative affectivity, detachment, dissociality, disinhibition, the anankast dimension and the borderline type. In the hierarchy of severity, there are mild personality disorders – with minimal behavioral disorders, moderate – with role efficiency and deficient but preserved interpersonal relationships, and severe – with deficient Self corresponding to self-esteem, self-control and self-direction and with severe impairment of role functioning and relationships with others⁽²⁰⁾.

From whatever perspective pathological personalities are approached, they must be related to the individual narrative biography, to demographic attributes, and to the social and cultural environment. This explains the diversity of diagnostic criteria, as well as their dynamics. These must also target the relationships with normal personality, the associations between different personality disorders, the comorbidity with episodes and mental illnesses, but also the early or late nature of maladaptive manifestations on which depend the stability and severity of personality disorders. These are often masked by life roles, by special talents or attitudes and by the tolerance or ignorance of those around them. Thus, antisocial behavior can be disguised in a professional role in which boldness, incessantness, leadership skills are useful and appreciated, or it can be tolerated by a submissive or indifferent entourage. 

On the other hand – especially in the case of borderline personality disorders, dependent personality disorders, antisocial personality disorders and personality disorders with psychopathic traits, the personological diagnosis can only be established in conditions of hospitalization or detention. However, it also remains a moral approach, because it implies a particular responsibility, detachment from any prejudices, and a deep knowledge of the facets of the human condition.     

Corresponding author: Aurel Nireștean E-mail: aurelnirestean@yahoo.com

Conflict of interest: none declared.

Financial support: none declared.

This work is permanently accessible online free of charge and published under the CC-BY licence.