Depressive Personality Disorder
Personality disorder is a matter of false judgments of value. Listed below are the false value judgments that are at the root of Depressive Personality Disorder.
||to see current circumstances, themselves, and the future as worse than they are
||usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, and unhappiness
||to have a negative view of themselves
||self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem
||to see themselves as bad
||is critical, blaming, and derogatory toward self
||bad things happening in the future
||is brooding and give to worry
||to see others and their behavior as bad
||is negativistic, critical, and judgmental toward others
||bad things happening in the future
||to see things that they have done in the past as bad
||is prone to feeling guilty or remorseful||
The Disease Perspective
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 733), for research purposes, describes Depressive Personality Disorder as a pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- usual mood is dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness;
- self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem;
- is critical, blaming, and derogatory toward self;
- is brooding and given to worry;
- is negativistic, critical, and judgmental toward others;
- is pessimistic;
- is prone to feeling guilty or remorseful.
The disorder does not occur exclusively during Major Depressive Episodes and is not better accounted for by Dysthymic Disorder.
The Dimensional Perspective
Here is a hypothetical profile, in terms of the five-factor model of personality, for Depressive Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):
- High Neuroticism
- Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.
- Low Extraversion
- Social isolation, interpersonal detachment, and lack of support networks; flattened affect; lack of joy and zest for life; reluctance to assert self or assume leadership roles, even when qualified; social inhibition and shyness.
- Low Openness
- Difficulty adapting to social or personal change; low tolerance or understanding of different points of view or lifestyles; emotional blandness and inability to understand and verbalize own feelings; alexythymia; constricted range of interests; insensitivity to art and beauty; excessive conformity to authority.
- Low Agreeableness
- Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.
- High Conscientiousness
- Overachievement: workaholic absorption in job or cause to the exclusion of family, social, and personal interests; compulsiveness, including excessive cleanliness, tidiness, and attention to detail; rigid self-discipline and an inability to set tasks aside and relax; lack of spontaneity; overscrupulousness in moral behavior.
The Behavior Perspective
The Life Story Perspective
Basic Belief: I am bad; nothing is pleasurable; there is no hope. Strategy: Withdrawal.
The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).
Compulsive beliefs and attitudes are idols, too.
John M. Oldham has defined the Serious Personality Style in The New Personality Self-Portrait. I have rephrased many of his ideas in terms of extreme, rigid, and imperative beliefs and attitudes. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." These are the typical beliefs that I associate with Depressive Personality Disorder:
- I am always disappointed with myself and cynical about others and the future (Oldham, 369).
- I do not consider the spreading of good cheer to be among my responsibilities (369).
- I am not eager for authority (369).
- I expect those under me to take on a great deal of work (369).
- When I'm in charge, the work atmosphere need not be upbeat, personally encouraging, or even supportive (369).
- I can be quite critical of those who work under me (369).
- I never expect things to go right (369).
- I don't get much pleasure from anything outside of work (370).
- What's the use of looking at life from the bright side (370)?
- Life is just work, pain, and loss (370).
- I'll believe it when I see it (371).
- Life is depressing; I have a right to always be pessimistic (371).
- I believe that my dark view of things is just being realistic (371).
- Bad news is interesting and reassuring because it represents reality (372).
- A person should remain faithful to their spouse, even if their spouse does not (372).
- I expect the worse from others (372).
- I am very critical of my mate (372).
- Other people expect too much of me (373).
- Parents should teach their children not to expect too much from life (374).
- Parents should inculcate the value of work; activities outside of homework and chores should be restricted (374).
- I am severely limited as a person; if only I'd been born with a different temperament (374).
- My life has been a series of failures and I am helpless in the face of forces beyond my control (374).
- I should continually prepare for the worst (374).
- I must keep my nose to the grindstone, adhere to routine, and remain undistracted by impulses and passion (375).
- I should always think everything through before acting, not take risks or challenge fate, and never try to escape into pleasure (375).
- There is no hope, now or ever (378).
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.
Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.
McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.
Oldham, John M., and Lois B. Morris (1995).
The New Personality Self-Portrait: Why You Think, Work, Love, and Act the Way You Do.
Rev. ed. New York: Bantam.
Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.
Is it appropriate to medically diagnose personality?
The medical model of mental illness really founders when used to classify personality problems, or particular types of problems in living. Schwartz et al. (1995), quote Kurt Schneider (1923), an early and seminal theorist of what we now call personality disorders, on the inappropriateness of applying symptomology to personality.
Psychopathic [i.e., personality] types look like diagnoses but the analogy is a false one. A depressive psychopath is simply a "certain sort of person." People or personalities cannot be labeled diagnostically like illness or like the psychic effects of illness. At most, we are simply emphasizing and indicating a set of individual peculiarities which distinguish these people and in which there is nothing comparable to symptoms of illness....In any detailed portrayal the type is soon lost and other traits not necessarily linked to the special characteristic in question creep in to form a concrete portrait (429).
Schwartz, M. A., Wiggins, O. P. & Norko, M. A., (1995). Prototypes, ideal types, and personality disorders: the return to classical phenomenology. In Livesley, W. John, (Ed.), The DSM-IV Personality Disorders (pp. 417-432). New York: Guilford.