Integrating and differentiating personality and psychopathology: A psychodynamic perspective

Patrick Luyten,Peter Fonagy

doi:10.1111/jopy.12656

Abstract

Several strands of research converge to suggest that personality and psychopathology can be integrated in the form of a hierarchical model of individual differences. The notion that personality and psychopathology are intrinsically linked has a long tradition within psychodynamic approaches. In this article, we first summarize empirical evidence supporting two related key assumptions of psychodynamic approaches to personality and psychology: that a developmental, person-centered approach is needed to complement a static, disorder-centered approach in the conceptualization and treatment of psychopathology; and that personality and psychopathology are best conceptualized as dynamic attempts at adaptation. Research in each of these areas supports the notion that personality and psychopathology are difficult to separate and may be moderated by severity (i.e., general psychopathology) such that increasing levels of severity result in increased intrinsic coupling between the two. We then discuss these findings in the context of a newly emerging social-communicative approach to human development that suggests that personality and psychopathology are better conceptualized in terms of a disorder of social communication, and that the purported rigidity and stability typically attributed to them are largely explained by the stability of the environmental mechanisms that underpin them, rather than by stable intrapersonal traits. The implications of these new views for the future of the science of personality and psychopathology, and for treatment strategies, are discussed.

Highlights

A descriptive, atheoretical, and disorder-centered approach has dominated psychiatry and clinical psychology over the past decades
We have summarized psychodynamic approaches to personality in relation to psychopathology
More pertinently, contemporary psychodynamic approaches are based on the assumption of a fundamental continuity between normal and disrupted personality development, and between personality and psychopathology

Summary

| INTRODUCTION

A descriptive, atheoretical, and disorder-centered approach has dominated psychiatry and clinical psychology over the past decades. With the increasing realization that psychological disorders often share common mechanisms, there has been a renewed interest in transdiagnostic interventions (Barlow et al, 2014; Weisz et al, 2012) This realization has led to a resurgence of interest in psychodynamic approaches to the conceptualization and treatment of psychological disorders (Blatt & Luyten, 2010), most clearly demonstrated by the influence of psychodynamic formations concerning the centrality of different levels of impairments in self and relatedness in classifying and diagnosing personality disorders in DSM-5 (American Psychiatric Association, 2013) in an attempt to improve the reliability and validity of personality disorder classification (Skodol, 2012). We close this article with a discussion of the implications of these views for ongoing research on the nature of psychiatric disorders and their treatment

PSYCHOLOGICAL DISORDERS

PERSONALITY TRAITS

Gendered Style

Findings

| CONCLUSIONS AND