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Book Review   |    
Personality Characteristics of the Personality Disordered
Scott Stuart, M.D.
Psychiatric Services 1998; doi:
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edited by Charles G. Costello, Ph.D.; New York City, John Wiley & Sons, 1996, 340 pages, $55

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The last decade has witnessed much debate about the nosology of personality, and personality disorders in particular. Although DSM-IV continues to use a categorical system of diagnosis for personality disorders, the majority opinion among researchers in the field is that using dimensional descriptions of personality traits is a much more valid method of describing personality. Personality Characteristics of the Personality Disordered takes this dimensional approach to personality taxonomy, arguing that a better appreciation of the underlying biochemical and dynamic influences on personality can be gained using a trait approach to personality.

The book is a compilation of invited chapters from a number of leading researchers in the field of personality research. Included are sections on aggressiveness, emotional instability, impulsiveness, dependency, narcissism, detachment, peculiarity, paranoia, obsessiveness, and sensation seeking. Each chapter begins with a description of the trait being discussed and subsequently focuses on the research pertinent to the trait under consideration. Readers interested in personality disorder research will appreciate the extensive review of the literature and collected references in each chapter.

The chapters on aggressiveness and on emotional instability are particularly notable for their discussion of the biological underpinnings of behavior and personality. Both focus on the putative neurotransmitter systems that are thought to be involved in the generation of the behavior, and both very thoroughly cover the extant neurophysiological research in the respective areas.

The chapters about dependency and narcissism are also excellent, but they take a psychodynamic approach in describing the evolution of the interpersonal patterns that characterize these traits. Both review the literature from the object relations branch of psychodynamic psychotherapy to conceptualize the traits; the chapter on narcissism also contrasts the self-psychology approach to understanding the disorder in a way that clearly illuminates the theoretical differences between the two schools of thought.

The heterogeneous approach in which some chapters use neurophysiology to explain behavior and other chapters use psychodynamic theory as a basis for understanding personality is both a highlight and a limitation of the book. The strength of this approach is that it allows each of the authors to draw on their expertise and on the most current research in the field. However, the lack of a consistent theoretical approach to the etiology of the personality traits leads to a lack of cohesion, and it is akin to the atheoretical approach to personality disorder diagnoses in DSM-IV that has been criticized by advocates of the dimensional personality nomenclature.

Also left unanswered is a fundamental question about the construct of “personality”: is personality simply the behavioral manifestation of neurochemical processes, as suggested by the biologically inclined authors in the book, or is personality an intrinsic pattern of thought and motivation, as suggested by the psychodynamically oriented contributors?

Personality Characteristics of the Personality Disordered is an excellent resource for readers interested in the various aspects of personality traits. Readers looking for a comprehensive view of personality or a theoretically consistent understanding of personality dimensions, however, may find themselves disappointed.

Dr. Stuart is assistant professor of psychiatry at the University of Iowa School of Medicine in Iowa City.

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