Clinical psychology is the psychological specialty that provides mental and behavioral health care for individuals and families, seeking to improve persons’ mental health, physical health and quality of life. Clinical psychology integrates science, theory and clinical experience as a means to understand, prevent and relieve distress and dysfunction and promote wellbeing and personal development. Personality is inherently intertwined with outcomes related to health and quality of life; therefore, an understanding of personality is of fundamental importance to the goals of clinical psychology. There was a time when the importance of personality – if not its very existence – were called into question. Some contended that behaviors were merely situationally specific responses to environmental stimuli rather than the result of any stable dispositions (Mischel, 1968). This period of doubt and skepticism has long since passed, as it has become undeniably evident that personality traits are not only real but are of clinical significance. The purpose of the current chapter is to present the predominant model of personality (the Five-Factor Model [FFM]), and indicate its importance to the development of psychopathology, including in particular the personality disorders. The implications of the particular importance of personality to the development of psychopathology are then discussed (e.g., perhaps treatment should begin early and focus on personality itself).

De Fruyt and De Clercq (this volume) and Sellbom (this volume) raise important issues surrounding the use of a five-factor model (FFM) of personality to conceptualize, assess, and diagnose personality disorder including how one includes a measure of impairment, the level of abstraction that is optimal (domains vs. facets), and the need for the development of formal test manuals, normative data, and means for identifying non-credible responding. In this response, the authors note their agreement with De Fruyt and De Clercq regarding the importance of assessing impairment but note that (a) it is already included to a large degree in the assessment of pathological FFM traits and (b) that they would prefer an approach that focuses explicitly on difficulties in occupational and social functioning. As to Sellbom’s comments suggesting that further work is necessary with regard to the development of test manuals, normative databases, and measures of valid responding – the authors agree and note some of the obstacles including the need for funding for the collection of normative data (and what consensus as to the kind – clinical only; community only; both) and development of test manuals.  As to measures of credible responding, they note that many of these exist already for the family of FFM PD scales that they helped create and are aware of similar efforts for other popular measures of pathological traits.

The use of dimensional personality traits with explicit ties to general or normative personality has gone mainstream with instantiation in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the soon to be released 11th revision of the International Classification of Diseases (ICD-11). Much of the theoretical and empirical work that supports the transition to dimensional trait-based models of personality disorder has used the prominent five-factor model of personality to do so, which suggests that five basic dimensions capture much of the important and reliable personality variance: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. This chapter reviews this literature and demonstrates how general and pathological five-factor models of personality are parsimonious, valid, and useful. The authors believe that the use of such models for the diagnosis of personality disorder represents a much needed and empirically supported movement to integrate normative and pathological personality.

Everybody has a personality, or a characteristic manner of thinking, feeling, behaving, and relating to others. Some persons are typically introverted and withdrawn; others are more extraverted and outgoing. Some persons are characteristically agreeable, cooperative, and even altruistic, whereas others might be consistently argumentative, self-centered, and exploitative. The personality traits that distinguish one person from another have been shown to have substantial temporal stability, heritability, cross-situational consistency, and functional relevance to a wide variety of important life outcomes, including (but not limited to) career success, well-being, marital stability, and physical health (Pervin & John, 1999).

Personality traits are important to consider when attempting to explain gender differences in depression for two fundamental reasons. First, there is a considerable amount of research indicating that some personality traits do provide a vulnerability to the occurrence of mood disorders, and, second, these personality traits have been shown to obtain consistent gender differences.

DEPENDENCY, DEPRESSION, AND WOMEN

One of the more heavily researched personality dispositions for the development of depressive episodes is the personality trait of dependency (Clark, Watson, & Mineka, 1994). Dependency has been studied extensively within general personality research, assessed typically by the Depressive Experience Questionnaire (Blatt & Zuroff, 1992; Santor, Zuroff, & Fielding, 1997), the Sociotropy-Autonomy Scale (SAS; Robins, Hayes, Block, Kramer, & Villena, 1995), the Personality Style Inventory (Robins et al., 1995), or the Interpersonal Dependency Inventory (IDI; Hirschfield et al., 1977).