How Personality Disorder Became an Independent Domain in Psychopathology: A History

In this chapter I describe the introduction of a new concept, “personality,” into the language of psychology and psychopathology of the late 19th century. Personality was introduced in a clinical-pathological context but was transferred to a psychometric context by American psychologists. In medicine, in the middle part of the 20th century, although several types of ‘psychopathic personalities’ were described, most of psychopathology was considered personality-related. ‘Personality disorders’ came to be seen as treatment-resistant and conceptualized as lying in a borderline region between neurosis and psychosis. In the DSM-III, personality disorders were more thoroughly segregated from the rest of psychopathology. After the publication of the DSM-IV (and ICD-10), psychological scientists began to assert themselves, re-invigorating the old the contrast between a clinical-pathological method and a psychometric, factor analytic approach as a “categorical” versus “dimensional” debate. More recently, the aspiration to apply factor-analytic psychometrics to psychopathology in general has the potential to reverse the separation introduced in the DSM-III and re-nest psychopathology under personality.