European Journal of Personality

Eur. J. Pers. 19: 257–268 (2005)

Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/per.559

Differentiating Normal, Abnormal, and

Disordered Personality

W. JOHN LIVESLEY* and KERRY L. JANG

Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver,
BC V6T 2A1, Canada

Abstract
Interest in the interface between normality and psychopathology was renewed with the
publication of DSM-III more than 20 years ago. The use of a separate axis to classify
disorders of personality brought increased attention to these conditions. At the same time,
the definition of personality disorder as inflexible and maladaptive traits stimulated interest
in the relationship between normal and disordered personality structure and functioning.
The evidence suggests that the traits delineating personality disorder are continuous with
normal variation and that the structural relationships among these traits resemble the
structures described by normative trait theories. Recognition that personality disorder
represents the extremes of trait dimensions emphasizes the importance of differentiating
normal, abnormal, and disordered personality. It is argued that while abnormal personality
may be considered extreme variation, personality disorder is more than statistical
variation. A definition of personality disorder is suggested based on accounts of the
adaptive functions of personality. Copyright # 2005 John Wiley & Sons, Ltd.

A puzzling feature of the study of normal and disordered personality is that psychology
and psychiatry have until recently pursued their studies independently using different
conceptual models. Psychiatry has followed a more medical model that assumes discrete
categories of disorder whereas personality psychology has tended to pursue trait models.
Recently, however, interest in the relationship between normality and the psychopathology
of personality has increased due to the publication of the Diagnostic and Statistical
Manual (DSM-III) more than 20 years ago (APA, 1980).
The DSM defined personality disorder as ‘an enduring pattern of inner experience and
behaviour that deviates markedly from the expectations of the individual’s culture, is
pervasive and inflexible, has an onset in adolescence or early adulthood, and is stable over
time’. The most recent edition (DSM-IV) lists ten disorders: paranoid, schizoid,
schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and

*Correspondence to: W. J. Livesley, Department of Psychiatry, University of British Columbia, 2255 Wesbrook
Mall, Vancouver, BC V6T 2A1, Canada. E-mail: livesley@interchange.ubc.ca

Received 7 January 2005

Copyright # 2005 John Wiley & Sons, Ltd. Accepted 30 March 2005
258 W. J. Livesley and K. L. Jang

obsessive–compulsive. Each diagnosis is defined by a cluster of traits. For example, the

criterion set for borderline personality disorder includes behaviours indicative of affective
lability, impulsivity, and insecure attachment. Traits are defined as ‘enduring patterns of
perceiving, relating to, and thinking about the environment and oneself that are exhibited
in a wide range of social and personal contexts’ (APA, 1994, p. 630). By emphasizing
traits, the DSM encouraged exploration of the interface between normal and abnormal
while implying a qualitative distinction between the two. The evidence does not support
this distinction. Researchers have been remarkably unsuccessful in identifying any point
of separation between normality and disorder (Widiger, 1993; Livesley, Schroeder,
Jackson, & Jang, 1994).
This failure along with accumulating evidence that individual differences in personality
disorder are continuously distributed has increased the importance of defining the
relationship between normal and disordered personality and the features that distinguish
them. In this paper, these issues will be considered in terms of two broad questions: (1)
Can normal and disordered personality be conceptualized using the same constructs, and is
the structure of personality the same in general population subjects and patients with
personality disorder? and (2) What do we mean by abnormal personality and personality
disorder, and what features differentiate normal from disordered personality? We begin by
considering alternative conceptualizations of the distinction between normal and
disordered personality.

CONCEPTUAL DISTINCTIONS BETWEEN NORMAL

AND DISORDERED PERSONALITY

Most students of personality disorder hold one of four conceptions of the relationship
between normal and disordered personality (Strack & Lorr, 1994). The first assumes that
normal and disordered personalities are distinct categories with a clear distinction between
normality and pathology and between different forms of disorder. This view is asserted by
categorical models of personality disorder such as the DSM-IV and ICD-10. The second
conception asserts the opposite position—that normal and disordered personality merge.
Although these are the main models, Strack and Lorr noted that some approaches combine
elements of these positions. A third model asserts that although there are only quantitative
differences between normal and disordered personality, certain combinations of traits can
lead to qualitative differences in the constellations of features defining disordered
personality. Evidence for this position would be provided by studies indicating that the
covariation among traits differed in clinical and non-clinical groups. A fourth viewpoint is
a modification of this position that asserts that the traits that constitute normal personality
can lead to distinct disorders due to the influence of specific aetiological processes.
The critical issue for differentiating normal and disordered personality raised by these
models is whether there are qualitative differences between clinical and normal groups.
Theoretically, several forms of qualitative difference may be envisioned (Livesley et al.,
1994). First, the clearest qualitative difference would be discontinuity in a distribution of
features of personality disorder in the form of either bimodality or a point of rarity
(Kendell, 1975). Although DSM diagnoses are said to be categorical in nature, the
distribution of the diagnostic criteria appears continuous. Ratings of these criteria in
patients with personality disorder (Frances, Clarkin, Gilmore, Hurt, & Brown, 1984; Kass,
Skodol, Charles, Spitzer, & Williams, 1985) and first degree relatives of psychiatric

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 Normal, abnormal, and disordered personality 259

patients (Zimmerman & Coryell, 1990) are continuously distributed. Similarly, the
distribution of the criteria for specific disorders in community samples shows evidence of
continuity (Nestadt et al., 1990). Also, little evidence of discontinuity has been found in
the distributions of personality disorder traits. Livesley, Jackson, and Schroeder (1992)
found no evidence of discontinuity in the distributions of 100 traits selected to provide a
systematic representation of personality disorder. However, it should also be noted that
bimodality seems to be a necessary but not sufficient indicator of qualitative differences
(see Grayson, 1987). The strongest evidence of discontinuity comes from taxometric
analyses (Meehl, 1973, 1992; Meehl & Golden, 1982; Waller & Meehl, 1998) of
schizotypy which suggest the occurrence of a discrete taxon. There is also some
suggestion of a taxon for psychopathy (Harris, Rice, & Quinsey, 1994) and possibly
borderline personality disorder, but studies of other forms of personality disorder have not
provided strong evidence of discontinuity (see Haslam, 2003a, 2003b).
A second form of qualitative difference could occur when the features of personality
disorder are continuous with normal variation but the dysfunction associated with the
disorder shows a threshold effect when a given level of a trait occurs. The evidence does
not support this model. Functional impairment assessed with the Global Assessment of
Functioning Scale is continuously distributed and increases progressively with the number
of criteria exhibited with little evidence of a major increase in dysfunction when diagnostic
thresholds are reached (Nakao et al., 1992).
A third view is that a qualitative difference would occur if patients with personality
disorder exhibited traits that are not found in healthy individuals. There is little evidence,
however, that there are traits specific to personality disorder. Perusal of the clinical
literature, including the DSM-IV diagnostic criteria for personality disorder, indicates that
the terms used to describe personality pathology are identical to those used to describe
normal personality. An extensive content analysis of the clinical literature of personality
disorder failed to identify traits that are specific to personality disorder (Livesley, 1986).
Moreover, scales developed to assess personality disorder traits appear to be equally
applicable to the assessment of personality in healthy individuals (Clark, 1990; Livesley
et al., 1992; Helmes & Jackson, 1994). Evaluation of the means, standard deviations,
distributional plots, and internal consistency supports the view that the scales of
personality disorder traits retain their coherence when administered to non-clinical
samples. Finally, the same traits could characterize normal and disordered personality but
the configuration of these traits could differ in clinical groups. The evidence on this point
will be considered in the following section.

THE STRUCTURE OF PERSONALITY DISORDER

If trait organization differs in clinical and non-clinical groups, the constellation of traits
selected to represent personality disorder should be more crystallized in a group of patients
with clear evidence of personality disorder and trait structure should vary across groups.
Comparisons of normal and clinical groups show differences in the magnitude of scores on
trait scales but not in the structure of their principal component loadings.

Comparisons across normal and clinical groups

Studies of the structure of personality disorder traits consistently report that a few major
dimensions (usually four) underlie personality disorder diagnoses (Mulder & Joyce,

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260 W. J. Livesley and K. L. Jang

1997). The first empirical investigations of the structure of personality disorder traits were
reported in the 1970s (Presly & Walton, 1973; Tyrer & Alexander, 1979). Since then the
structure has been confirmed across studies in which the items examined were DSM
personality disorder criteria (Austin & Deary, 2000; Mulder & Joyce, 1997), more
extensive criteria that included personality features of Axis I disorders (Clark, 1990), and
extensive lists of traits identified by systematic literature review (Livesley, 1991; Livesley,
Jang, & Vernon, 1998). The structure is independent of method of measurement: it is
identified in studies using structured interviews (Tyrer & Alexander, 1979; Austin &
Deary, 2000) and self-report measures (Clark, 1993; Livesley et al., 1998).
Tyrer and Alexander (1979) found that the four factor structure underlying 24 traits
descriptive of personality disorder was similar in patients with personality disorder and
those with other psychiatric disorders. Livesley (1986, 1987) used a modification of the
lexical approach that led to the five factor approach to normal personality to identify the
terms used to represent personality disorder. Items identified through a content analysis of
the clinical literature were reduced to 100 traits using a combination of clinician ratings
and rational methods. Self-report scales were developed for each trait (Livesley, Jackson,
& Schroeder, 1989) and the structure underlying these scales was explored in general
population subjects and a sample of patients with personality disorder (Livesley et al.,
1992). Data from the two samples were examined in separate principal component
analyses. The important question for conceptualizing normal and disordered personality is
whether the two samples yielded important differences in the structure of their principal
component loadings. In each case, a 15 component solution was optimal. Examination of
the similarity of the component loadings in the two samples indicated considerable
congruence. These results were used to develop a self-report inventory—the Dimensional
Assessment of Personality Pathology—Basic Questionnaire (DAPP-BQ; Livesley &
Jackson, in press).
The similarity in primary factor structure in clinical and non-clinical samples is also
found in analyses of higher order structure. Livesley and colleagues (1998) compared the
factor structure underlying 18 dimensions of personality disorder assessed using the
DAPP-BQ in a general population sample, a clinical sample consisting of patients with a
primary diagnosis of personality disorder, and a general population twin sample.
Decomposition of the phenotypic correlation matrices for the three samples separately
yielded four components that were labelled Emotional Dysregulation, Dissocial,
Inhibition, and Compulsivity. Congruence coefficients among the phenotypic components
ranged from 0.94 to 0.99, indicating remarkable similarity in the clinical and general
population components. This structure is robust across cultures, being reported in studies
from North America (Livesley et al., 1998), Germany (Pukrop et al., 2001), Holland (van
Kampen, 2002), and China (Zheng et al., 2002).

Comparisons of normal and disordered personality traits

The similarity in the structure of personality disorder traits across samples differing with
respect to the presence of personality disorder and evidence that the same constructs may
be used to represent normal and disordered personality (Helmes & Jackson, 1994) raises
the question of whether personality disorder may be represented by models of normal
personality. This question has been examined in two ways: (1) evaluating the degree to
which DSM personality diagnoses can be accommodated within models of normal

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 Normal, abnormal, and disordered personality 261

personality and (2) exploring the relationship between descriptions of personality disorder
traits (as opposed to disorders) and models of normal personality.
Multiple studies suggest that several models of normal personality can accommodate
DSM personality disorder diagnoses, including the five-factor model, Eysenck’s three
component structure, and the interpersonal circumplex. The evidence suggests that the five
factor model provides a notably better fit than the interpersonal circumplex (Soldz, Budman,
Demby, & Merry, 1993). However, there seems little difference in fit between three and five
factor models. The relationship between the five factor approach and DSM diagnoses has,
however, received most attention. DSM personality disorders fit the five factor framework
well (Ball, Tennen, Poling, Krazler, & Rounsaville, 1997; Blais, 1997; Dyce & Connor,
1998; McCrae et al., 2000; Reynolds & Clark, 2001; Trull, Widiger, & Burr, 2001).
However, the results of these correlational studies are difficult to interpret. The global nature
of DSM diagnostic constructs—most disorders consist of multiple traits (Shea, 1995)—
makes it difficult to determine the constructs responsible for observed relationships. More
pertinent to the distinction between normal and disordered personality are studies that
explore the relationship between models of normal and disordered personality.
The four higher order or secondary factors of personality disorder closely resemble four
of the five factors assessed by the NEO-PI-R (Costa & McCrae, 1992). Emotional
Dysregulation, Dissocial, Inhibition, and Compulsivity resemble neuroticism, (dis)agree-
ableness, introversion, and conscientiousness, respectively (Widiger, 1998; Livesley,
1998). Consistent with other analyses of clinical scales, a factor resembling openness was
not obtained (Clark, 1993). The apparent convergence between the DAPP-BQ and the
Neuroticism, Extraversion, and Openness Personality Inventory (NEO-PI) was confirmed
when both measures were administered to a sample of 300 subjects (Schroeder et al.,
1992). Principal components analysis of the 18 scales and five NEO-PI domains yielded
five factors resembling the five factor structure.
The systematic relationships between the five factor model and personality disorder
diagnoses and traits led to the suggestion that the five factor model provides a suitable
framework for classifying personality disorder (Costa & Widiger, 1994, 2002). However,
the five factors do not appear to capture all aspects of personality pathology. Despite the
convergence between the five factor model and the DAPP-BQ, clinically important traits
such as DAPP-BQ insecure attachment and cognitive dysregulation are poorly represented
by the NEO-PI-R (Schroeder et al., 1992). The Schedule for Non-Adaptive and Adaptive
Personality (SNAP) also seems to capture clinically relevant behaviours not included in
the NEO-PI-R (Reynolds & Clark, 2001). This suggests caution in accepting the
suggestion that the five factor model might provide an integrating framework for
personality disorder. The five factor model as operationalized by the NEO-PI-R does not
appear to cover the range of traits relevant to assessment. The primary or facet structure in
particular needs further development before it captures clinical concepts (Livesley, 2001).

NORMAL, ABNORMAL, AND DISORDERED PERSONALITY

Evidence that personality disorder may be described by using graded continua that are
continuous with dimensions of normal personality promises to integrate the study of normal
and disordered personality and to bring coherence to the study of personality disorder—a
field that currently lacks an integrative framework. Unfortunately it also contributes to the
problem of differentiating normal and disordered personality variants—a conceptual

Copyright # 2005 John Wiley & Sons, Ltd. Eur. J. Pers. 19: 257–268 (2005)
262 W. J. Livesley and K. L. Jang

problem with considerable practical implications. The continuity observed between

normality and pathology suggests that the extreme variants that constitute personality
disorder can only be differentiated from normal personality variants using thresholds that
must to some extent be artifactual. This does not, however, mean that they must be
arbitrary—empirically determined thresholds could be established based on an under-
standing of liability or risk associated with different levels of trait expression. This raises
questions about what we mean by personality disorder, what it is about extreme variation
of adaptive traits that makes them disorders, and whether extreme variation alone is
sufficient to warrant a diagnosis of personality disorder.

Personality disorder as extreme trait variation

The simplest distinction between normal and disordered personality is quantitative—
personality disorder represents an extreme position on a trait dimension, that is, it involves
either too much or too little of a given characteristic (Eysenck, 1987; Kiesler, 1986;
Leary, 1957, Wiggins & Pincus, 1989). The justification for this approach is that
extremeness is assumed to indicate inflexibility in interpersonal behaviour and many
conceptions of personality disorder, including that adopted by the DSM-IV, consider
inflexibility to be a hallmark of personality disorder. Unfortunately, this idea confuses
extreme scores on a personality trait with disordered functioning (Parker & Barrett, 2000).
As Wakefield (1992) pointed out, statistical deviance alone is neither a necessary nor
sufficient criterion for disorder. With personality disorder, it is difficult to see how an
extreme score on dimensions such as conscientiousness, extraversion, or agreeableness is
necessarily pathological. Some additional factor needs be present to justify the diagnosis.
The DSM suggests two characteristics—inflexibility and subjective distress. Presumably
inflexibility is a function of extremeness (McCrae, 1994). However, an extreme position
on a trait dimension does not necessarily indicate inflexibility. One could imagine an
individual who acts in an extremely extraverted way most of the time but is able to refrain
from these behaviours at critical moments when they would be inappropriate. Extremeness
and inflexibility are probably highly correlated but they are not the same. Extremity
appears to be a necessary condition for personality disorder but it is not sufficient. Disorder
implies something else. But what is this something else?
At this point, it is useful to recall distinctions made by Kurt Schneider (1922/1950)
more than 80 years ago in his classical work on personality disorders, which he referred
to as psychopathic personalities. Schneider distinguished personality, abnormal
personality, and personality disorder. The term ‘abnormal personality’ was used in
the statistical sense to refer to extremes of normal variation. Schneider recognized,
however, that extremity alone was not sufficient to justify a clinical diagnosis. He
asserted that personality disorders were forms of abnormal personality that either cause
personal suffering or cause society to suffer. Although the conceptual distinction
between personality, abnormal personality, and personality disorder continues to be
useful, the criteria that Schneider proposed to differentiate abnormal and disordered
personality are less helpful. The problem is that both personal and community suffering
are continuous variables and it is unclear how much personal suffering is needed to
justify a diagnosis of personality disorder. Shyness may cause some discomfort in some
situations but clearly not all shy individuals have personality disorder: disorder implies
something more profound. Even more problematic is that both personal and community
suffering are dependent on social context. Traits such as being outspoken or highly

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 Normal, abnormal, and disordered personality 263

independent may cause problems for the community in some contexts but one would not
consider them an indication of disorder. For good reasons, psychiatric classifications are
cautious about including disorders that are culturally bound or found only in certain
cultures. Despite these problems, little conceptual progress has been made beyond
Schneider’s formulation. The DSM-IV definition of personality disorder as maladaptive
and inflexible traits that are associated with functional impairment or distress is not an
improvement —it merely restates the definition in a different form.
An extension of the extreme trait definition of personality disorder is Widiger’s (1994)
proposal, based on the five-factor model, that personality disorders could be diagnosed at
that point along the continuum of personality functioning that is associated with clinically
significant impairment involving ‘dyscontrolled impairment’ or ‘maladaptivity’ in
psychological functioning (Widiger & Trull, 1991; Widiger & Sankis, 2000). The idea
is interesting but it creates the problem of the criteria that could be used to diagnose
‘dyscontrolled maladapativity’ reliably. Without a general definition, one would have to
catalogue the various maladaptive manifestations of each trait. The proposal also seems to
embody an ideal concept of normality since, as Widiger (1994) noted, everyone shows
some degree of maladaptive expressions of basic traits.
Perhaps the difficulty in arriving at a definition of personality disorder that relies largely
on trait expression occurs because the construct of trait does not readily lend itself to this
task. Trait constructs represent proclivities—tendencies to act in certain ways and exhibit
a particular class of behaviours. They do not describe competencies. Thus extreme levels
of a trait may increase the risk of psychopathology but they are not necessarily
maladaptive. A definition of personality disorder needs to incorporate features of disorder
that are separate from, although possibly correlated with, extreme trait variation.
Such an approach is also needed because traits are not all there is to personality, and the
clinical concept of personality disorder refers to more than maladaptive traits (Livesley &
Jang, 2000). It is useful in this context to think of personality as a system of interrelated
structures and processes (Costa & McCrae, 1994; Mischel, 1999; Vernon, 1964) that
includes dispositional traits, personal concerns including motives, roles, goals, and coping
strategies, and the life narrative and self system that provides an integrated account of past,
present, and future (McAdams, 1994). The psychopathology of personality disorder covers
all components of this system: symptoms, problems with affect and impulse regulation,
maladaptive expressions of traits, interpersonal problems, and self-pathology (Livesley,
2003). Disorder is seen not only in the contents of the system but also in its structure and
functioning. Indeed, the notion of disorder implies a disturbance of functioning. As
Wakefield (1992) suggested, mental disorders generally could be defined as ‘harmful
dysfunctions’. That is, they involve a harmful failure of internal mechanisms to perform
their naturally selected functions. By extension, personality disorder involves a harmful
dysfunction in the normal adaptive functions of the personality system.

Personality disorder as adaptive failure

Some years ago, Cantor (1990) recalled Allport’s comment that ‘personality is something
and personality does something’ to draw attention to how personality psychology (and
psychiatric nosology) has focused largely on what personality is—that is, on the
description of individual differences in normal and disordered personality. In the process,
they neglected what personality does and how personality functioning is disturbed in
personality disorder. Cantor described the functions of personality in terms of the personal

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264 W. J. Livesley and K. L. Jang

tasks that individuals face and set for themselves, the schemata used to construe these
tasks, the self, and life situations, and the strategies used to achieve personal tasks. This
functional analysis provides the beginnings of a definition of personality disorder. The
functions described, however, involve mechanisms that differ in breadth and scope. Some
involve dysfunctions in specific adaptive mechanisms. Although a description of these
dysfunctions would contribute to our understanding of psychopathology, the concept of
personality disorder implies something more pervasive than circumscribed dysfunction.
This suggests that a definition of personality disorder should be focused on the more
abstract level of life task.
Life tasks are the problems individuals face as a consequence of cultural expectations of
social living and underlying biology. Tasks vary with culture and stage of development.
Especially important for understanding personality disorder are universal life tasks that
have evolutionary significance. Personality may be viewed as the product of adaptive
mechanisms that evolved to solve problems of survival and reproduction that confronted
our remote ancestors in the ancestral environment of hunter-gatherers on the African
savanna. Universal tasks were common problems to be solved for effective functioning
and survival in the ancestral environment. The problem of course is to establish an agreed
set of universal tasks. Plutchik (1980) suggested one approach that has the merit of being
similar to clinical concepts of personality disorder. He identified four universal challenges:
the development of identity; the solution to the problems of dominance and
submissiveness created by hierarchy that is characteristic of primate social hierarchies;
development of a sense of territoriality or belongingness; and solution to the problems of
temporality, that is, problems of loss and separation.
These ideas lead to the suggestion that personality disorder occurs when ‘the structure
of personality prevents the person from achieving adaptive solutions to universal life tasks’
(Livesley, 1998, p. 141). This is a deficit definition, which considers personality disorder to
be a ‘harmful dysfunction’ involving the failure to acquire the structures required for
adaptive functioning. The life tasks involved could be expressed in traditional clinical
language while still retaining an evolutionary perspective by defining personality disorder
as the failure to achieve one or more of the following: (1) stable and integrated
representations of self and others; (2) the capacity for intimacy, to function adaptively as
an attachment figure, and/or to establish affiliative relationships; and (3) adaptive
functioning in the social group as indicated by the failure to develop the capacity for
prosocial behaviour and/or cooperative relationships. To differentiate personality disorder
from other mental disorders, one or more of these failures should be enduring and
traceable to adolescence or at least early adulthood and they should be due to extreme
personality variation rather than another pervasive and chronic mental disorder such as a
cognitive or schizophrenic disorder.
Failure to achieve adaptive solutions to these tasks was probably maladaptive in an
evolutionary sense. A cohesive sense of self or identity would help to ensure the
adaptive social behaviour needed to gain access to the resources needed for
reproduction and survival. It would also contribute to the establishment and attainment
of the longer term goals that are part of effective adaptation. The ability to function
effectively in close familial relationships would contribute to effective reproduction and
child-rearing that would help to guarantee that genes were passed on. Finally,
cooperative and prosocial behaviour would facilitate access to resources and the
protection of the social group. These tasks are probably equally pertinent to effective
adaptation in the contemporary situation. In a continually changing world, a coherent

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 Normal, abnormal, and disordered personality 265

sense of self provides a stable frame of reference that gives stability to relationships,
provides direction and purpose to action, and contributes to self-regulation. The
capacity for intimacy, attachment and cooperative behaviour are no less important now
than for our remote ancestors.
Although this definition is derived from normal personality theory and evolutionary
psychology, it incorporates clinical concepts of personality disorder. Most clinical
conceptions of disordered personality reference either chronic interpersonal difficulties or
problems with self or identity. Rutter (1987), for example, concluded that personality
disorder is ‘characterized by a persistent, pervasive abnormality in social relationships and
social functioning generally’ (p. 454). In contrast, psychoanalytic thinkers such as Kohut
and Kernberg tend to emphasize self pathology. Kohut (1971), for example, considered
narcissistic personality in terms of the failure to develop a cohesive sense of self. Similarly,
Kernberg (1984) considered identity diffusion to be a central feature of borderline
personality organization. Identity diffusion was said to involve ‘a poorly integrated
concept of the self and of significant others . . . reflected in the subjective experience of
chronic emptiness, contradictory self-perceptions, contradictory behavior that cannot be
integrated in an emotionally meaningful way, and shallow, flat, impoverished perceptions
of others’ (1984, p. 12).
Several advantages accrue from defining personality as the failure to achieve adaptive
solutions to universal life tasks. First, it separates the diagnosis of personality disorder
from the assessment of individual differences in personality dimensions such as traits,
thereby avoiding the problems created by defining disorder only in terms of extreme levels
of a given characteristic. Second, it emphasizes the severity of personality disorder and
clarifies the distinction between disordered personality and dysfunctions in relatively
discrete aspects of personality such as an isolated trait. Such dysfunctions may cause
distress but they do not always lead to the level of difficulties usually seen in patients
considered to have personality disorder. Finally, the definition of disorder is based on an
understanding of the functions of normal personality rather than an arbitrary set of
characteristics.

CONCLUDING COMMENTS

Ideas about the nature of personality disorder and its relationship to normal personality
have changed considerably in recent years. Far from being the separate domains assumed
by contemporary psychiatric nosologies, they are merely seen to reflect different levels of
the same continua. We are only just beginning the task of describing and explaining the
various ways in which personality pathology is manifested and there are major challenges,
both conceptual and empirical, in understanding disordered personality and its relationship
to normal personality structure and functioning. Nevertheless, we think that there is
considerable merit in differentiating the assessment of extreme levels of individual
differences in personality characteristics from the evaluation and diagnosis of disorder.
The distinction brings a measure of clarity to the assessment process and places emphasis
on dysfunction at the overall level of the organization and functioning of the personality
system. We also think that it is apparent from the progress that has been made in
understanding the similarity in trait structure across clinical and non-clinical groups that
much is likely to be gained from integrating personality disorder with theories of
personality and its development.

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266 W. J. Livesley and K. L. Jang

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