NOBA

Personality Disorders
Cristina Crego & Thomas Widiger

The purpose of this module is to define what is meant by a personality disorder, identify the
five domains of general personality (i.e., neuroticism, extraversion, openness, agreeableness,
and conscientiousness), identify the six personality disorders proposed for retention in the
5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (i.e.,
borderline, antisocial, schizotypal, avoidant, obsessive-compulsive, and narcissistic),
summarize the etiology for antisocial and borderline personality disorder, and identify the
treatment for borderline personality disorder (i.e., dialectical behavior therapy and
mentalization therapy).

Learning Objectives

• Define what is meant by a personality disorder.

• Identify the five domains of general personality.

• Identify the six personality disorders proposed for retention in DSM-5.

• Summarize the etiology for antisocial and borderline personality disorder.

• Identify the treatment for borderline personality disorder.

Introduction

Everybody has their own unique personality; that is, their characteristic manner of thinking,
feeling, behaving, and relating to others (John, Robins, & Pervin, 2008). Some people are
Personality Disorders 2

typically introverted, quiet, and withdrawn; whereas others are more extraverted, active, and
outgoing. Some individuals are invariably conscientiousness, dutiful, and efficient; whereas
others might be characteristically undependable and negligent. Some individuals are
consistently anxious, self-conscious, and apprehensive; whereas others are routinely relaxed,
self-assured, and unconcerned. Personality traits refer to these characteristic, routine ways
of thinking, feeling, and relating to others. There are signs or indicators of these traits in
childhood, but they become particularly evident when the person is an adult. Personality traits
are integral to each person’s sense of self, as they involve what people value, how they think
and feel about things, what they like to do, and, basically, what they are like most every day
throughout much of their lives.

There are literally hundreds of different personality traits. All of these traits can be organized
into the broad dimensions referred to as the Five-Factor Model (John, Naumann, & Soto,

Table I: Illustrative traits for both poles across Five-Factor Model personality dimensions.
Personality Disorders 3

2008). These five broad domains are inclusive; there does not appear to be any traits of
personality that lie outside of the Five-Factor Model. This even applies to traits that you may
use to describe yourself. Table I provides illustrative traits for both poles of the five domains
of this model of personality. A number of the traits that you see in this table may describe
you. If you can think of some other traits that describe yourself, you should be able to place
them somewhere in this table.

DSM-5 Personality Disorders

When personality traits result in significant distress, social impairment, and/or occupational
impairment, they are considered to be a personality disorder (American Psychiatric
Association, 2013). The authoritative manual for what constitutes a personality disorder is
provided by the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of
Mental Disorders (DSM), the current version of which is DSM-5 (APA, 2013). The DSM provides
a common language and standard criteria for the classification and diagnosis of mental
disorders. This manual is used by clinicians, researchers, health insurance companies, and
policymakers. DSM-5 includes 10 personality disorders: antisocial, avoidant, borderline,
dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, schizoid, and schizotypal.
All 10 of these personality disorders will be included in the next edition of the diagnostic
manual, DSM-5.

This list of 10 though does not fully cover all of the different ways in which a personality can
be maladaptive. DSM-5 also includes a “wastebasket” diagnosis of other specified personality
disorder (OSPD) and unspecified personality disorder (UPD). This diagnosis is used when a
clinician believes that a patient has a personality disorder but the traits that constitute this
disorder are not well covered by one of the 10 existing diagnoses. OSPD and UPD or as they
used to be referred to in previous editions - PDNOS (personality disorder not otherwise
specified) are often one of the most frequently used diagnoses in clinical practice, suggesting
that the current list of 10 is not adequately comprehensive (Widiger & Trull, 2007).

Description

Each of the 10 DSM-5 (and DSM-IV-TR) personality disorders is a constellation of maladaptive

personality traits, rather than just one particular personality trait (Lynam & Widiger, 2001). In
this regard, personality disorders are “syndromes.” For example, avoidant personality
disorder is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity
to negative evaluation (APA, 2013), which is a combination of traits from introversion (e.g.,
socially withdrawn, passive, and cautious) and neuroticism (e.g., self-consciousness,
Personality Disorders 4

apprehensiveness, anxiousness, and worrisome). Dependent personality disorder includes

submissiveness, clinging behavior, and fears of separation (APA, 2013), for the most part a
combination of traits of neuroticism (anxious, uncertain, pessimistic, and helpless) and
maladaptive agreeableness (e.g., gullible, guileless, meek, subservient, and self-effacing).
Antisocial personality disorder is, for the most part, a combination of traits from antagonism
(e.g., dishonest, manipulative, exploitative, callous, and merciless) and low conscientiousness
(e.g., irresponsible, immoral, lax, hedonistic, and rash). See the 1967 movie, Bonnie and Clyde,
starring Warren Beatty, for a nice portrayal of someone with antisocial personality disorder.

Some of the DSM-5 personality disorders

are confined largely to traits within one of
the basic domains of personality. For
example, obsessive-compulsive personality
disorder is largely a disorder of
maladaptive conscientiousness, including
such traits as workaholism, perfectionism,
punctilious, ruminative, and dogged;
schizoid is confined largely to traits of
introversion (e.g., withdrawn, cold, isolated,
placid, and anhedonic); borderline personality
disorder is largely a disorder of
neuroticism, including such traits as
emotionally unstable, vulnerable, overwhelmed,
rageful, depressive, and self-destructive
(watch the 1987 movie, Fatal Attraction, A person with an obsessive compulsive personality disorder may
starring Glenn Close, for a nice portrayal of have a hard time relaxing, always feel under pressure, and

this personality disorder); and histrionic believe that there isn't enough time to accomplish important

personality disorder is largely a disorder of tasks. [Image: CC0 Public Domain, https://goo.gl/m25gce]

maladaptive extraversion, including such

traits as attention-seeking, seductiveness, melodramatic emotionality, and strong attachment
needs (see the 1951 film adaptation of Tennessee William’s play, Streetcar Named Desire,
starring Vivian Leigh, for a nice portrayal of this personality disorder).

It should be noted though that a complete description of each DSM-5 personality disorder
would typically include at least some traits from other domains. For example, antisocial
personality disorder (or psychopathy) also includes some traits from low neuroticism (e.g.,
fearlessness and glib charm) and extraversion (e.g., excitement-seeking and assertiveness);
borderline includes some traits from antagonism (e.g., manipulative and oppositional) and
low conscientiousness (e.g., rash); and histrionic includes some traits from antagonism (e.g.,
Personality Disorders 5

vanity) and low conscientiousness (e.g., impressionistic). Narcissistic personality disorder

includes traits from neuroticism (e.g., reactive anger, reactive shame, and need for admiration),
extraversion (e.g., exhibitionism and authoritativeness), antagonism (e.g., arrogance,
entitlement, and lack of empathy), and conscientiousness (e.g., acclaim-seeking). Schizotypal
personality disorder includes traits from neuroticism (e.g., social anxiousness and social
discomfort), introversion (e.g., social withdrawal), unconventionality (e.g., odd, eccentric,
peculiar, and aberrant ideas), and antagonism (e.g., suspiciousness).

The APA currently conceptualizes personality disorders as qualitatively distinct conditions;

distinct from each other and from normal personality functioning. However, included within
an appendix to DSM-5 is an alternative view that personality disorders are simply extreme
and/or maladaptive variants of normal personality traits, as suggested herein. Nevertheless,
many leading personality disorder researchers do not hold this view (e.g., Gunderson, 2010;
Hopwood, 2011; Shedler et al., 2010). They suggest that there is something qualitatively unique
about persons suffering from a personality disorder, usually understood as a form of
pathology in sense of self and interpersonal relatedness that is considered to be distinct from
personality traits (APA, 2012; Skodol, 2012). For example, it has been suggested that antisocial
personality disorder includes impairments in identity (e.g., egocentrism), self-direction,
empathy, and capacity for intimacy, which are said to be different from such traits as arrogance,
impulsivity, and callousness (APA, 2012).

Validity

It is quite possible that in future revisions of the DSM some of the personality disorders
included in DSM-5 and DSM-IV-TR will no longer be included. In fact, for DSM-5 it was originally
proposed that four be deleted. The personality disorders that were slated for deletion were
histrionic, schizoid, paranoid, and dependent (APA, 2012). The rationale for the proposed
deletions was in large part because they are said to have less empirical support than the
diagnoses that were at the time being retained (Skodol, 2012). There is agreement within the
field with regard to the empirical support for the borderline, antisocial, and schizotypal
personality disorders (Mullins-Sweat, Bernstein, & Widiger, 2012; Skodol, 2012). However,
there is a difference of opinion with respect to the empirical support for the dependent
personality disorder (Bornstein, 2012; Livesley, 2011; Miller, Widiger, & Campbell, 2010;
Mullins-Sweat et al., 2012).

Little is known about the specific etiology for most of the DSM-5 personality disorders. Because
each personality disorder represents a constellation of personality traits, the etiology for the
syndrome will involve a complex interaction of an array of different neurobiological
Personality Disorders 6

vulnerabilities and dispositions with a variety of environmental, psychosocial events.

Antisocial personality disorder, for instance, is generally considered to be the result of an
interaction of genetic dispositions for low anxiousness, aggressiveness, impulsivity, and/or
callousness, with a tough, urban environment, inconsistent parenting, poor parental role
modeling, and/or peer support (Hare, Neumann, & Widiger, 2012). Borderline personality
disorder is generally considered to be the result of an interaction of a genetic disposition to
negative affectivity interacting with a malevolent, abusive, and/or invalidating family
environment (Hooley, Cole, & Gironde, 2012).

To the extent that one considers the DSM-5 personality disorders to be maladaptive variants
of general personality structure, as described, for instance, within the Five-Factor Model, there
would be a considerable body of research to support the validity for all of the personality
disorders, including even the histrionic, schizoid, and paranoid. There is compelling
multivariate behavior genetic support with respect to the precise structure of the Five-Factor
Model (e.g., Yamagata et al., 2006), childhood antecedents (Caspi, Roberts, & Shiner, 2005),
universality (Allik, 2005), temporal stability across the lifespan (Roberts & DelVecchio, 2000),
ties with brain structure (DeYoung, Hirsh, Shane, Papademetris, Rajeevan, & Gray, 2010), and
even molecular genetic support for neuroticism (Widiger, 2009).

Treatment

Personality disorders are relatively unique

because they are often “ego-syntonic;” that
is, most people are largely comfortable
with their selves, with their characteristic
manner of behaving, feeling, and relating
to others. As a result, people rarely seek
treatment for their antisocial, narcissistic,
histrionic, paranoid, and/or schizoid
personality disorder. People typically lack
insight into the maladaptivity of their
personality.

One clear exception though is borderline

Many people with personality disorders do not seek treatment.
personality disorder (and perhaps as well
Those with borderline personality disorder and avoidant
personality disorder are exceptions. High levels of neuroticism avoidant personality disorder). Neuroticism
and emotional pain may motivate them to seek help. [Image: is the domain of general personality
CC0 Public Domain, https://goo.gl/m25gce] structure that concerns inherent feelings
Personality Disorders 7

of emotional pain and suffering, including feelings of distress, anxiety, depression, self-
consciousness, helplessness, and vulnerability. Persons who have very high elevations on
neuroticism (i.e., persons with borderline personality disorder) experience life as one of pain
and suffering, and they will seek treatment to alleviate this severe emotional distress. People
with avoidant personality may also seek treatment for their high levels of neuroticism
(anxiousness and self-consciousness) and introversion (social isolation). In contrast,
narcissistic individuals will rarely seek treatment to reduce their arrogance; paranoid persons
rarely seek treatment to reduce their feelings of suspiciousness; and antisocial people rarely
(or at least willfully) seek treatment to reduce their disposition for criminality, aggression, and
irresponsibility.

Nevertheless, maladaptive personality traits will be evident in many individuals seeking

treatment for other mental disorders, such as anxiety, mood, or substance use. Many of the
people with a substance use disorder will have antisocial personality traits; many of the people
with mood disorder will have borderline personality traits. The prevalence of personality
disorders within clinical settings is estimated to be well above 50% (Torgersen, 2012). As many
as 60% of inpatients within some clinical settings are diagnosed with borderline personality
disorder (APA, 2000). Antisocial personality disorder may be diagnosed in as many as 50% of
inmates within a correctional setting (Hare et al., 2012). It is estimated that 10% to 15% of the
general population meets criteria for at least one of the 10 DSM-IV-TR personality disorders
(Torgersen, 2012), and quite a few more individuals are likely to have maladaptive personality
traits not covered by one of the 10 DSM-5 diagnoses.

The presence of a personality disorder will often have an impact on the treatment of other
mental disorders, typically inhibiting or impairing responsivity. Antisocial persons will tend to
be irresponsible and negligent; borderline persons can form intensely manipulative
attachments to their therapists; paranoid patients will be unduly suspicious and accusatory;
narcissistic patients can be dismissive and denigrating; and dependent patients can become
overly attached to and feel helpless without their therapists.

It is a misnomer, though, to suggest that personality disorders cannot themselves be treated.

Personality disorders are among the most difficult of disorders to treat because they involve
well-established behaviors that can be integral to a client’s self-image (Millon, 2011).
Nevertheless, much has been written on the treatment of personality disorder (e.g., Beck,
Freeman, Davis, & Associates, 1990; Gunderson & Gabbard, 2000), and there is empirical
support for clinically and socially meaningful changes in response to psychosocial and
pharmacologic treatments (Perry & Bond, 2000). The development of an ideal or fully healthy
personality structure is unlikely to occur through the course of treatment, but given the
considerable social, public health, and personal costs associated with some of the personality
Personality Disorders 8

disorders, such as the antisocial and borderline, even just moderate adjustments in
personality functioning can represent quite significant and meaningful change.

Nevertheless, manualized and/or empirically validated treatment protocols have been

developed for only one personality disorder, borderline (APA, 2001).

------------------------------------------------------------------------------------------------------------------------------------------------------

Focus Topic: Treatment of Borderline Personality Disorder

Dialectical behavior therapy (Lynch & Cuyper, 2012) and mentalization therapy (Bateman &
Fonagy, 2012): Dialectical behavior therapy is a form of cognitive-behavior therapy that draws
on principles from Zen Buddhism, dialectical philosophy, and behavioral science. The
treatment has four components: individual therapy, group skills training, telephone coaching,
and a therapist consultation team, and will typically last a full year. As such, it is a relatively
expensive form of treatment, but research has indicated that its benefits far outweighs its
costs, both financially and socially.

------------------------------------------------------------------------------------------------------------------------------------------------------

It is unclear why specific and explicit treatment manuals have not been developed for the
other personality disorders. This may reflect a regrettable assumption that personality
disorders are unresponsive to treatment. It may also reflect the complexity of their treatment.
As noted earlier, each DSM-5 disorder is a heterogeneous constellation of maladaptive
personality traits. In fact, a person can meet diagnostic criteria for the antisocial, borderline,
schizoid, schizotypal, narcissistic, and avoidant personality disorders and yet have only one
diagnostic criterion in common. For example, only five of nine features are necessary for the
diagnosis of borderline personality disorder; therefore, two persons can meet criteria for this
disorder and yet have only one feature in common. In addition, patients meeting diagnostic
criteria for one personality disorder will often meet diagnostic criteria for another. This degree
of diagnostic overlap and heterogeneity of membership hinders tremendously any effort to
identify a specific etiology, pathology, or treatment for a respective personality disorder as
there is so much variation within any particular group of patients sharing the same diagnosis
(Smith & Zapolski, 2009).

Of course, this diagnostic overlap and complexity did not prevent researchers and clinicians
from developing dialectical behavior therapy and mentalization therapy. A further reason for
the weak progress in treatment development is that, as noted earlier, persons rarely seek
treatment for their personality disorder. It would be difficult to obtain a sufficiently large group
Personality Disorders 9

of people with, for instance, narcissistic or obsessive–compulsive disorder to participate in a

treatment outcome study, one receiving the manualized treatment protocol, the other
receiving treatment as usual.

Conclusions

It is evident that all individuals have a personality, as indicated by their characteristic way of
thinking, feeling, behaving, and relating to others. For some people, these traits result in a
considerable degree of distress and/or impairment, constituting a personality disorder. A
considerable body of research has accumulated to help understand the etiology, pathology,
and/or treatment for some personality disorders (i.e., antisocial, schizotypal, borderline,
dependent, and narcissistic), but not so much for others (e.g., histrionic, schizoid, and
paranoid). However, researchers and clinicians are now shifting toward a more dimensional
understanding of personality disorders, wherein each is understood as a maladaptive variant
of general personality structure, thereby bringing to bear all that is known about general
personality functioning to an understanding of these maladaptive variants.
Personality Disorders 10

Outside Resources

Structured Clinical Interview for DSM-5 (SCID-5)

https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5

Web: DSM-5 website discussion of personality disorders

http://www.dsm5.org/ProposedRevision/Pages/PersonalityDisorders.aspx

Discussion Questions

1. Do you think that any of the personality disorders, or some of their specific traits, are ever
good or useful to have?

2. If someone with a personality disorder commits a crime, what is the right way for society
to respond? For example, does or should meeting diagnostic criteria for antisocial
personality disorder mitigate (lower) a person’s responsibility for committing a crime?

3. Given what you know about personality disorders and the traits that comprise each one,
would you say there is any personality disorder that is likely to be diagnosed in one gender
more than the other? Why or why not?

4. Do you believe that personality disorders can be best understood as a constellation of

maladaptive personality traits, or do you think that there is something more involved for
individuals suffering from a personality disorder?

5. The authors suggested Clyde Barrow as an example of antisocial personality disorder and
Blanche Dubois for histrionic personality disorder. Can you think of a person from the
media or literature who would have at least some of the traits of narcissistic personality
disorder?
Personality Disorders 11

Vocabulary

Antisocial
A pervasive pattern of disregard and violation of the rights of others. These behaviors may
be aggressive or destructive and may involve breaking laws or rules, deceit or theft.

Avoidant
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative
evaluation.

Borderline
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and
marked impulsivity.

Dependent
A pervasive and excessive need to be taken care of that leads to submissive and clinging
behavior and fears of separation.

Five-Factor Model
Five broad domains or dimensions that are used to describe human personality.

Histrionic
A pervasive pattern of excessive emotionality and attention seeking.

Narcissistic
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of
empathy.

Obsessive-compulsive
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and
interpersonal control, at the expense of flexibility, openness, and efficiency.

Paranoid
A pervasive distrust and suspiciousness of others such that their motives are interpreted as
malevolent.

Personality
Characteristic, routine ways of thinking, feeling, and relating to others.
Personality Disorders 12

Personality disorders
When personality traits result in significant distress, social impairment, and/or occupational
impairment.

Schizoid
A pervasive pattern of detachment from social relationships and a restricted range of
expression of emotions in interpersonal settings.

Schizotypal
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and
reduced capacity for, close relationships as well as perceptual distortions and eccentricities
of behavior.
Personality Disorders 13

References

Allik, J. (2005). Personality dimensions across cultures. Journal of Personality Disorders, 19, 212–
232.

American Psychiatric Association (2012). Rationale for the proposed changes to the personality
disorders classification in DSM-5. Retrieved from http://www.dsm5.org/ProposedRevision/­
Pages/PersonalityDisorders.aspx.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders:
DSM-5. Washington, D.C: American Psychiatric Association.

American Psychiatric Association. (2001). Practice guidelines for the treatment of patients with
borderline personality disorder. Washington, DC: Author.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental

disorders (4th ed., text rev.) Washington, D.C: American Psychiatric Association.

Bateman, A. W., & Fonagy, P. (2012). Mentalization-based treatment of borderline personality

disorder. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 767–784).
New York, NY: Oxford University Press.

Beck, A. T., Freeman, A., Davis, D., and Associates (1990). Cognitive therapy of personality
disorders, (2nd ed.). New York, NY: Guilford Press.

Bornstein, R. F. (2012). Illuminating a neglected clinical issue: Societal costs of interpersonal

dependency and dependent personality disorder. Journal of Clinical Psychology, 68, 766–781.

Caspi, A., Roberts, B. W., & Shiner, R. L. (2005). Personality development: Stability and change.
Annual Review of Psychology, 56, 453–484.

DeYoung, C. G., Hirsh, J. B., Shane, M. S., Papademetris, X., Rajeevan, N., & Gray, J. (2010). Testing
predictions from personality neuroscience: Brain structure and the Big Five. Psychological
Science, 21, 820–828.

Gunderson, J. G. (2010). Commentary on “Personality traits and the classification of mental

disorders: Toward a more complete integration in DSM-5 and an empirical model of
psychopathology.” Personality Disorders: Theory, Research, and Treatment, 1, 119–122.

Gunderson, J. G., & Gabbard, G. O. (Eds.), (2000). Psychotherapy for personality disorders.
Washington, DC: American Psychiatric Press.

Hare, R. D., Neumann, C. S., & Widiger, T. A. (2012). Psychopathy. In T. A. Widiger (Ed.), The
Oxford handbook of personality disorders (pp. 478–504). New York, NY: Oxford University
Press.

Hooley, J. M., Cole, S. H., & Gironde, S. (2012). Borderline personality disorder. In T. A. Widiger
Personality Disorders 14

(Ed.), The Oxford handbook of personality disorders (pp. 409–436). New York, NY: Oxford
University Press.

Hopwood, C. J. (2011). Personality traits in the DSM-5. Journal of Personality Assessment, 93,
398–405.

John, O. P., Naumann, L. P., & Soto, C. J. (2008). Paradigm shift to the integrative Big Five trait
taxonomy: History, measurement, and conceptual issues. In O. P. John, R. R. Robins, & L.
A. Pervin (Eds.), Handbook of personality. Theory and research (3rd ed., pp. 114–158). New
York, NY: Guilford Press.

John, O. P., Robins, R. W., & Pervin, L. A. (Eds.), (2008). Handbook of personality. Theory and
Research (3rd ed.). New York, NY: Guilford Press.

Livesley, W. J. (2011). Confusion and incoherence in the classification of personality disorder:

Commentary on the preliminary proposals for DSM-5. Psychological Injury and Law, 3, 304–
313.

Lynam, D. R., & Widiger, T. A. (2001). Using the five factor model to represent the DSM-IV
personality disorders: An expert consensus approach. Journal of Abnormal Psychology, 110,
401–412.

Lynch, T. R., & Cuper, P. F. (2012). Dialectical behavior therapy of borderline and other
personality disorders. In T. A. Widiger (Ed.), The Oxford handbook of personality disorders
(pp. 785–793). New York, NY: Oxford University Press.

Miller, J. D., Widiger, T. A., & Campbell, W. K. (2010). Narcissistic personality disorder and the
DSM-V. Journal of Abnormal Psychology, 119, 640–649.

Millon, T. (2011). Disorders of personality. Introducing a DSM/ICD spectrum from normal to

abnormal (3rd ed.). New York, NY: John Wiley & Sons.

Mullins-Sweatt; Bernstein; Widiger. Retention or deletion of personality disorder diagnoses

for DSM-5: an expert consensus approach. Journal of personality disorders 2012;26
(5):689-703.

Perry, J. C., & Bond, M. (2000). Empirical studies of psychotherapy for personality disorders.
In J. Gunderson and G. Gabbard (Eds.), Psychotherapy for personality disorders (pp. 1–31).
Washington DC: American Psychiatric Press.

Roberts, B. W., & DelVecchio, W. F. (2000). The rank-order consistency of personality traits from
childhood to old age: A quantitative review of longitudinal studies. Psychological Bulletin,
126, 3–25.

Shedler, J., Beck, A., Fonagy, P., Gabbard, G. O., Gunderson, J. G., Kernberg, O., ... Westen, D.
(2010). Personality disorders in DSM-5. American Journal of Psychiatry, 167, 1027–1028.
Personality Disorders 15

Skodol, A. (2012). Personality disorders in DSM-5. Annual Review of Clinical Psychology, 8, 317–
344.

Smith, G. G., & Zapolski, T. C. B. (2009). Construct validation of personality measures. In J. N.

Butcher (Ed.), The Oxford Handbook of Personality Assessment (pp. 81–98). New York, NY:
Oxford University Press.

Torgerson, S. (2012). Epidemiology. In T. A. Widiger (Ed.), The Oxford handbook of personality

disorders (pp. 186–205). New York, NY: Oxford University Press.

Widiger, T. A. (2009). Neuroticism. In M. R. Leary and R.H. Hoyle (Eds.), Handbook of individual
differences in social behavior (pp. 129–146). New York, NY: Guilford Press.

Widiger, T. A., & Trull, T. J. (2007). Plate tectonics in the classification of personality disorder:
Shifting to a dimensional model. American Psychologist, 62, 71–83.

Yamagata, S., Suzuki, A., Ando, J., One, Y., Kijima, N., Yoshimura, K., … Jang, K. L. (2006). Is the
genetic structure of human personality universal? A cross-cultural twin study from North
America, Europe, and Asia. Journal of Personality and Social Psychology, 90, 987–998.
About Noba

The Diener Education Fund (DEF) is a non-profit organization founded with the mission of re-
inventing higher education to serve the changing needs of students and professors. The initial
focus of the DEF is on making information, especially of the type found in textbooks, widely
available to people of all backgrounds. This mission is embodied in the Noba project.

Noba is an open and free online platform that provides high-quality, flexibly structured
textbooks and educational materials. The goals of Noba are three-fold:

• To reduce financial burden on students by providing access to free educational content

• To provide instructors with a platform to customize educational content to better suit their
curriculum

• To present material written by a collection of experts and authorities in the field

The Diener Education Fund is co-founded by Drs. Ed and Carol Diener. Ed is the Joseph Smiley
Distinguished Professor of Psychology (Emeritus) at the University of Illinois. Carol Diener is
the former director of the Mental Health Worker and the Juvenile Justice Programs at the
University of Illinois. Both Ed and Carol are award- winning university teachers.

Acknowledgements

The Diener Education Fund would like to acknowledge the following individuals and companies
for their contribution to the Noba Project: The staff of Positive Acorn, including Robert Biswas-
Diener as managing editor and Peter Lindberg as Project Manager; The Other Firm for user
experience design and web development; Sockeye Creative for their work on brand and
identity development; Arthur Mount for illustrations; Chad Hurst for photography; EEI
Communications for manuscript proofreading; Marissa Diener, Shigehiro Oishi, Daniel
Simons, Robert Levine, Lorin Lachs and Thomas Sander for their feedback and suggestions
in the early stages of the project.
Copyright

R. Biswas-Diener & E. Diener (Eds), Noba Textbook Series: Psychology. Champaign, IL: DEF
Publishers. Retrieved from http://noba.to/67mvg5r2

Copyright © 2020 by Diener Education Fund. This material is licensed under the Creative
Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy
of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_US.

The Internet addresses listed in the text were accurate at the time of publication. The inclusion
of a Website does not indicate an endorsement by the authors or the Diener Education Fund,
and the Diener Education Fund does not guarantee the accuracy of the information presented
at these sites.

Contact Information:

Noba Project
www.nobaproject.com
info@nobaproject.com
How to cite a Noba chapter using APA Style

Crego, C. & Widiger, T. (2020). Personality disorders. In R. Biswas-Diener & E. Diener (Eds),
Noba textbook series: Psychology. Champaign, IL: DEF publishers. Retrieved from
http://noba.to/67mvg5r2