Intro

Personality is an internal, psychological construct that determines how an individual views and ma
sense of events, interacts with others, and creates expectations as to how the world functions

This profile is designed to assist others in understanding an individual’s view of self and the w
and in predicting how an individual will respond when confronted with various situations and
stressors

Core surface structure of personality

The model identifies three levels:
1. Core beliefs: beliefs are theorized to be entrenched, or deep and influential, in how an
individual interprets,
appraises, and responds to situations
2. intermediate beliefs: beliefs that influence unspoken attitudes, rules, expectations, or
assumptions

3. automatic thoughts or images are at a “superficial” or top level, reflecting how the
individual verbally responds or thinks about a particular situation
core beliefs comprise the foundation
intermediate beliefs are at the second level
automatic thoughts images are the top, or surface, level

the contents of memory and a “motivated meaning system” that guides the individual’s
interpretations of situations, which impacts the person–situation interaction in one’s environm
these conceptualizations certainly help to explain how past experiences, thoughts, and cognit
appraisal or meaning influence how someone sees the self, others, and situations
and drive behavior, the critical component of emotions is left out.

emotions factor into the structure of personality at all levels and have thus been the subject o
much study in personality research.
the stability of emotions across environments and experiences, which adds to the understand
and predictability of a behavioral response.
The FFM (Five Factor Model), which includes:
openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism -
considered a universal method

Disordered personality
DSM 1
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Disordered personality
DSM 1
defined personality disorder as:
“a behavioral reaction that may be defined as one in which the personality, in its struggle for
adjustment to internal and external stresses,
utilizes primarily a pattern of action or behavior”
loosely identified the structural component of personality via “internal and external stresses,” b
without deeper definition, added complexity and confusion in its understanding and applicatio

DSM 2
personality disorders in the DSM- II:
“characterized by deeply ingrained maladaptive patterns of behavior that are perceptibly diffe
in quality from psychotic and neurotic symptoms”
Their own section was labeled as " Personality Disorders and Certain Other Non Psychotic
Mental Disorders"
and were defined as “ life- long patterns, often recognizable by the time of adolescence or ea

DSM 3
the DSM- III had a different approach and defined the concept of “dysfunction”, with the direct
of defining mental disorders, this approaches to diagnosis the multiaxial system:
• Axis I: Clinical Disorders
• Axis II: Personality Disorders or Mental Retardation
• Axis III: Medical or Physical Conditions
• Axis IV: Contributing Environmental or Psychosocial Factors
• Axis V: Global Assessment of Functioning.
every client would be assessed on the five axes, which would provide a greater understandin
and recognition of the pathology presented

“preexisting personality disturbance” increased the likelihood of developing

and exhibiting diagnoses identified on Axis I.
This edition separated this out from
other disorders (depression, anxiety, and schizophrenia.
the degree of actual separation of personality disorders between the “Axis I: Clinical Disorders

The DSM- III outlined a distinction between personality traits and personality disorders:
“Personality traits are enduring patterns, relating to, and thinking
about the environment and oneself, and are exhibited in a wide range
of important social and personal contexts. It is only when personality
traits are inflexible and maladaptive and cause either impairment in
social or occupational functioning or subjective distress that they
constitute Personality Disorders.”
This definition of personality from a trait perspective recognized that traits are
expressed outwardly while having internal workings.

DSM 3 R
the trait- based definition of personality disorders didn’t change,
The personality disorder clusters (A, B, and C) first appeared in the DSM- III-R to simplify
the eleven personality disorders recognized at the time

Cluster A - “odd or eccentric”:

• schizoid
• Schizotypal
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The personality disorder clusters (A, B, and C) first appeared in the DSM- III-R to simplify
the eleven personality disorders recognized at the time

Cluster A - “odd or eccentric”:

• schizoid
• Schizotypal
• paranoid

Cluster B - “dramatic, emotional, or erratic”:

• Antisocial
• Borderline
• Histrionic
• Narcissistic

Cluster C - “anxious or fearful”:

• Avoidant
• Dependent
• obsessive compulsive
• passive- aggressive

The three clusters was to allow for a dimensional model perspective, in

that the clusters, “may also be viewed as dimensions representing spectra of
personality dysfunction on a continuum with Axis I mental disorders”

DSM 4
attempt to understand trait related expressions and what motivates them

There is a constant change and understanding throughout the DSM editions illustrates the
complexity of these constructs and with the ongoing attempt to understand trait related
expressions and what motivated them

DSM 5
the removal of the multiaxial system:
1. the distinction between medical and psychiatric diagnosis was nebulous
2. the psychosocial and environmental problems listed on Axis IV were used inconsistentl
both clinicians and researchers
3. the Global Assessment of Functioning or Axis V had poor psychometric and clinical vali
The new approach was labeled the “Alternative DSM- 5 Model for Personality Disorders” and
placed in Section III,
“Emerging Measures and Models”, This change was because:
• a lack of substantial theoretical/ experimental reasoning for the identification of persona
disorder categories
• failures to support the categorical conceptualization of personality disorders with resear
findings
• lack of support for the structural organization of the diagnostic categories that exist with
the categorical model with statistical results
• the limitations to reliability and validity due to data collection methods and evidence tha
predicts external personality variables

The Alternative DSM-5 Model

The new “alternative” model differs from old the definition:
“impairments in personality functioning and pathological personality traits.”
The two central determinants to identify a personality disorder using the alternative model are
follows:
• elements of personality dysfunction, classified as “moderate or greater impairment in
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The Alternative DSM-5 Model
The new “alternative” model differs from old the definition:
“impairments in personality functioning and pathological personality traits.”
The two central determinants to identify a personality disorder using the alternative model are
follows:
• elements of personality dysfunction, classified as “moderate or greater impairment in
personality (self/interpersonal) functioning” (Criterion A)
• the presence of one or more pathological personality traits (Criterion B)

A “level of functioning” scale ranging from “Little to no impairment” to “Extreme impairment” is

also provided to help
identify the degree of personality dysfunction.

Elements of Personality Functioning

Criterion A: “disturbances in self and interpersonal functioning constitute the core of personali
psychopathology”
The core components of personality functioning are divided into four elements:
• Identity
• Self direction
• Empathy
• Intimacy

the self is composed of identity and self- direction:

Identity - how a person experiences themself as separate from
others with well defined boundaries, a belief in and accurate valuation of their
own worth and abilities, and control over a range of emotions
Self direction - the ability to pursue clear and important goals, to utilize constructive
and prosocial internal principles to manage behavior, and the possession of insight into one’s
own character, actions, and motives.
The interpersonal component of personality functioning is made up of empathy and intimacy:
empathy - understanding and feeling for another person’s experiences and drives, tolerating
alternative viewpoints, and
recognizing the impact one’s behavior has on others
intimacy - being able to emotionally connect to others for a period of time, wanting and being
to be close to another person, and behaving in a manner
that conveys consideration of others and sharing of his/her feelings.

Criterion A: does not include the potentially pathological nature of personality core content in
definition, as each specific personality disorder has a unique core content which contributes to
the dysfunctional expression of the specific disorder.
the deviation from an unimpaired or “normal” personality perspective to provide a baseline for
more self-destructive and interpersonally damaging personality disorder types.

The Level of Personality Functioning Scale

The four constructs that make up Criteria A are also used to make the Level of Personality
Functioning Scale (LPFS) to identify the personality dysfunction, an 80 item self- report meas
to assess the four interrelated core personality components that make up Criteria A in the
alternative model
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Pathological Personality Traits

Criterion B of the alternative model identifies 25 pathological personality trait facets got
organized into five general trait domains:
1. Negative affectivity
2. Detachment
3. Antagonism
4. Disinhibition
5. Psychoticism

Domains and facets: dimensional terms ranging from unimpaired and functional to impaired a
pathological, as opposed to categorical indicators of being either present or absent.
This new model requires an adjustment to previously held notions of personality pathology, as
is unique to the understanding, assessment, and treatment of personality disorders.
Criterion B of the alternative model identifies 25 pathological personality trait
facets got organized into five general trait domains:
1. Negative affectivity
2. Detachment
3. Antagonism
4. Disinhibition
5. Psychoticism

Domains and facets: dimensional terms ranging from unimpaired and functional to
impaired and pathological, as opposed to categorical indicators of being either
present or absent.
This new model requires an adjustment to previously held notions of personality
pathology, as it is unique to the understanding, assessment, and treatment of
personality disorders.
The Application of the Alternative Model
Using the alternative model to diagnose Borderline Personality Disorder (BPD)
requires 2+ difficulties from Criteria A (i.e., identity, self- direction, empathy, and
intimacy) that are present to a moderate, severe, or extreme level of impairment.
The four elements of the self and interpersonal functioning - core content :
• uncertainty of self-image and self- concept
• being highly self- critical
• feelings of emptiness
• uncertainty as to career and personal goals
• feelings of unworthiness
• tendency to see the world as ostensibly biased

These core elements/ core content, make up the surface expression (surface
content) which are evident through the pathological personality traits as identified in
Criterion B, including:
• unstable emotions
• frequent mood changes
• being highly emotionally reactive
• experiencing intense and overwhelming anxiety and panic to stress
• being fearful of past negative experiences
• possessing intense worry about negative possibilities

To meet criteria for BPD;

the individual would need to exhibit: 4+ seven pathological personality traits- surface
content, and one of those must include impulsivity, risk taking, or hostility
The Confusion and Complexity of
Personality Disorders
Most individuals will not fall into a specific personality disorder category, like NPD but are more likely to be
diagnosed with Unspecified Personality Disorder.
Using the model in Section II for the DSM- 5 or “Personality Disorder – Trait Specified”,
one of the inherent issues related to the complexity and confusion of personality disorder research and
treatment was that the conceptualization was categorical.
A categorical approach leads to errors in diagnosis and conceptualization by the assumption that an individual
with a particular personality disorder will process/ react to/ interact with the world in a specific, diagnostically
limited, and predictable manner.
The alternative model was developed out of the recognition that personality disorders do overlap, are
complex, and are constructs that are best understood using a dimensional perspective that increases
reliability and validity.

The Criteria Overlap and Diagnosis Perplexity

The alternative model is attempting to reduce the complexity and confusion by not only reducing the
number of personality disorders from 10 to 6 but also increasing the threshold that must be met, resulting in
a more stringent basis for specific personality disorder diagnosis.
most individuals do not fit the criteria for a specific disorder, due to the presence and expression of sub
threshold features of the disorder or multiple features of multiple disorders most individuals with personality
disorders are unlikely to meet criteria for one specific personality disorder.
individuals are better diagnosed using a broader diagnostic identifier, as is included in the alternative
model.
“Personality Disorder Trait Specified” (PD TS),
which can be used in those disorder cases that do not fall into one of the six specified personality disorder
categories - antisocial, avoidant, borderline, narcissistic, obsessive- compulsive, and schizotypal
personality disorders. the individual must still possess moderate - greater impairment in at least two of the four
Elements of Personality Functioning: identity, self direction, empathy, and intimacy.
For example, in the DSM- 5, the diagnosis of Other Specified Personality Disorder seemingly encourages
greater specificity but this actually asks the diagnostician to use other general terms, such as “mixed
personality features” or “cluster B traits.”

The Interrelated Structure of Personality Disorders

Personality Disorders are made up of a unique interrelated structure not seen in other types of mental
illnesses.
This structure is made up of core elements of personality - Criterion A
that drive surface structure expressions/ pathological personality traits - Criterion B

In treatment and research settings, the goal is to examine and better understand how core content influences
personality features” or “cluster B traits.”

The Interrelated Structure of Personality Disorders

Personality Disorders are made up of a unique interrelated structure not seen in other types of mental
illnesses.
This structure is made up of core elements of personality - Criterion A
that drive surface structure expressions/ pathological personality traits - Criterion B

In treatment and research settings, the goal is to examine and better understand how core content influences
particular surface content expression, resulting in the dysfunctional pathology that constitutes the particular
personality disorder. (Criteria A-B)

The Cognitive-Affective Processing System (CAPS)

The model provides a framework in which to conceptualize the behavior, in certain situations, for a given
individual.
This model outlines a network of mental representations that when activated:
• lead to thoughts
• Feelings
• Memories
• Other internal experiences that drive subsequent behavior

The goal is to provide a means to conceptualize clinical cases and form treatment planning options to promote
research and clinical practice that best for understand the intersection of personality and behavior

The CAPS model is founded on two basic tenets (outlined by Shoda and colleagues, 2014):
1. individual’s varying stream of thoughts, feelings, and behaviors reflect changes in
cognitive affective units (CAUs). CAUs are made up of:
○ Thoughts
○ Feelings
○ the ideas of self and others
○ expectations and beliefs
○ goals and values
○ self regulatory strategies that an individual can potentially access and experience
2. Individual’s vary in their unique behavioral responses to different internal and external factors, influenced
by the systemic organization and interaction of their CAUs. This organization forms the stable foundation
of their personality system and drives the distinctive ways they respond to stimuli or stressors. The
interplay of an individual’s CAUs results in a high likelihood of consistent behavioral patterns.

The CAPS Model and Personality

The CAPS model is ideal to understand the interrelated structure of personality, both impaired and
unimpaired, as it provides a way to explain the stability in core content and surface structure.

The model starts with the presence and impact of external stressors- experienced and interpreted with an
individualized basis and is characterized as one of the five stressor types:
1. Time- limited
2. Environmental
3. Blended
4. Continuous
5. Historical
Perception and response to stressors are individualized based upon:
• past experience
• current assessment of stressor
• number of stressors present at the time
• the individual’s degree of mental health (ranging from no impairment to extreme impairment)

These + other factors should be taken into account when exploring and assessing stressors of an individual and
the impact they have on core/surface structures

Stressors trigger the core content elements of personality resulting in an outward/ behavioral expression of
personality traits and facets
The core content elements can be explained as: surface structure expression of the individual’s personality traits
and facets.
The CAPS describes the intera personal cognitive affective and motivational process:
Activated by stressors that contributed to a particular behavioral expression.

The CAU network consistent of five components:

1. Encodings
categories or constructs of the self, others, and situations.
“People are selfish; I’m ignorant”

2. Expectations and Beliefs

pertain to the social world and to related to specific behavior/ competencies in various situations.
“I know I’m going to fail; I’m doomed to be lonely”

3. Affects
feelings, emotions, and affective responses and physiological reactions.
“I’m so angry right now my heart is beating a mile a minute; I’m frozen with fear”

4. Goals and Values

desirable and aversive outcomes and affective states that impact organization and motivation of
behavior over time.
“I will seek treatment because I want to have control over my life; I want a better job to have a
better life, so I’m going to school”

5. Competencies and Self - Regulatory Plans (coping skills)

behaviors and scripts about what someone can do, plans and strategies to organize action to
impact one’s internal state, behavior, and outcome.
“In therapy I’m learning to control my anger though using relaxation exercises and cognitive
processing; I’m going to leave him when I have enough money to be away from this pain”

If … then …
the affective evaluative reactions to initial stressors is mediated through CAUs to produce predictable and
stable responses using “if… then…” profiles
These are based upon the individual’s response to stressors, that activate the mental processing of
acquiring information and understanding it using thoughts, images, memory (cognitions) and emotions
(affects)
If… then… profiles posit that:
○ if the individual experiences situation A (composed of a stimulus or stressor),
○ they will respond with B (thoughts, emotions, or observable behaviors).

The CAPS model and the person

“…[the] CAPS model offers a comprehensive,
integrative framework on which many theories of personality and pathology can
be placed at the conceptual level.”
“those models of personality dis-
orders that have the most interest to personality disorder researchers and
clinicians
(e.g., psychoanalytic and psychodynamic, interpersonal, social- cognitive,
trait,
neurobiological) can be readily mapped into this framework.”