traits have always been of interest to people. We often hear
others described in terms of their personality characteristics.
Although the combination of these characteristics is unique to the
individual, the basic descriptors have evolved to be understandable to
all. The early Greeks employed a literary form begun by
Aristotle, which exaggerated 'good' and 'bad' traits to communicate an
individual's personality, often with humorous effect (Millon and Davis
pp.3-4). The word personality
has its origins in Latin; persona
originally meant the mask worn by actors in a drama.
term mask connotes "pretense and illusion" it has evolved to represent
a person's observable qualities and characteristics (ibid,
p. 2). Conceptions of personality and its related pathology have
continued to evolve since the ancient Greeks and Romans first began
their attempts to describe the complexities of human character and
Evolution of the DSM Conceptions of Personality Disorders
By the mid 19th century, psychiatrists began to
believe that "one could be insane without a confusion of mind" (Millon
and Davis in Livesley,1995, p.6). This was perhaps the first time
traits were pathologized. In 1952 with the publication of the
first Diagnostic and Statistical
Manual of Mental Disorders the term "personality disorders"
included five broad categories each with several smaller
subclasses. These personality disturbances were considered to be
unaffected by therapy and included things we do not currently consider
to be related to personality such as learning disabilities and
post-traumatic stress disorder (Millon and Davis in Livesley,1995, pp.
A major change in the conceptualization of
personality disorders occurred in the DSM-II (APA,1968), which
"stipulated that these disorders must involve both impaired functioning
and personally experienced distress." Further, personality
disorders should not overlap with other neurotic and psychotic
disorders (Millon and Davis in Livesley,1995, p.16). Another
occurred with the publication of the DSM III (APA, 1980), and the
development of the multiaxial model. Personality disorders were
hence separated from clinical disorders and placed on a separate
axis. This shift in conceptualization and structure recognized
that "lifelong coping styles and emotional vulnerabilities comprising
personality can provide a context within which the more salient and
usually transient clinical states are likely to arise and be
understood" (Millon and Davis in Livesley, pp.16-17).
The current edition of the DSM (IV-TR), defines
personality disorders as "an enduring pattern of inner experience and
behavior that deviates markedly from the expectations of the
individual's culture, is pervasive and inflexible, has an onset in
adolescence or early adulthood, is stable over time, and leads to
distress or impairment." The ten currently recognized personality
disorders are grouped into three clusters based on "descriptive
similarities" (APA, p. 685).