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7 Core Pathological Personality Traits

New research examines emerging trait-based approaches to personality disorder.

Grant H Brenner MD DFAPA
6 min readNov 1, 2020

From Neighborhood Psychiatry, by Grant H. Brenner

Photo by Joshua Fuller on Unsplash

There is no unified consensus on how to evaluate and define personality, though there are many approaches. Models include the Five Factor Model (FFM or Big 5) consisting of Openness to New Experience, Conscientiousness, Extraversion, Agreeableness and Neuroticism (OCEAN). The HEXACO model has six factors, overlapping with the FFM: Honesty-Humility, Emotionality, eXtroversion, Agreeableness, Conscientiousness and Openness.

Some traits and clusters of traits are more problematic leading to difficulty with self-regulation, relationship issues, substance use disorders and mental illness. Others are associated with greater personal and professional success. Many are fine in moderation, and only become problematic in extremis.

Conscientiousness, agreeableness and lower neuroticism are associated with better average function (though there are downsides as well, for example being too agreeable may mean being insufficiently assertive). Openness and Extroversion are more characteristic of orientation to life experiences and relationships.

Another familiar model is the Jungian-based Meyers-Briggs, identifying 16 types based on four dimensions: Introversion-Extroversion, Sensing-Intuition, Thinking-Feeling, Judging-Perceiving. There are many others, often colorful or imaginative, used to try to predict and enhance performance, evaluate hires and promotions, and to help build effective teams.

Popular models tend to focus on strengths, and frame problematic traits in a positive way — or sidestep them altogether.

From adaptive to maladaptive

Personality is not the same as personality disorder, which is associated with profound, lifelong impairment in multiple domains (e.g. personal, professional, relationship), untold suffering and increased mortality and morbidity, affecting 6 to 10% of the population. A personality disorder diagnosis is not made lightly, but rather demands thoughtful and thorough evaluation.

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Grant H Brenner MD DFAPA
Grant H Brenner MD DFAPA

Written by Grant H Brenner MD DFAPA

Psychiatrist, Psychoanalyst, Entrepreneur, Writer, Speaker, Disaster Responder, Advocate, Photographer

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