Skip to main content
SpringerLink
Log in
Book cover

Treatment of Personality Disorders pp 107–117Cite as

A Multidimensional Approach to Personality Disorders and Their Treatment

  • Chapter

  • 343 Accesses

Abstract

Personality disorders are, by definition, chronic. It is not surprising therefore, that they are often resistant to change in psychotherapy. Treatment planning requires an adequate etiological model. The therapy of complex pathology can not be based on simple models of causality. Instead, management must be rooted in a multidimensional model that takes into account the biological, psychological, and social factors in these disorders. In this chapter, an approach to the treatment of these disorders is suggested in which therapists work within the stability of personality, modifying the behavioral expression of traits sufficiently to help patients use their personality in more adaptive ways.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alexander, E. and French, T. (1946): Psychoanalytic Therapy. New York, Ronald.

    Google Scholar 

  • American Psychiatric Association (1994): Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Washington DC, American Psychiatric Press.

    Google Scholar 

  • Andreoli, A., Frances, A., Gex-Fabry, M., Aapro, N., Gerin, P., and Dazord, M. (1993): Crisis intervention in depressed patients with and without DSM-III-R personality disorders. J Nery Ment Dis 181: 732–736.

    Article  CAS  Google Scholar 

  • Arbel, N. and Stravynski, A. (1991): A retrospective study of separation in the development of adult avoidant personality disorder. Acta Psychiatr Scand 83: 174–178.

    Article  PubMed  CAS  Google Scholar 

  • Bandura, A., (1977): Social Learning Theory, Englewood Cliffs, Prentice Hall.

    Google Scholar 

  • Bardenstein, K.K. and McGlashan, T.H. (1989): The natural history of a residentially treated borderline sample: gender differences. J Personality Disorders 3: 69–83.

    Google Scholar 

  • Beck, A.T. and Freeman, A. (1990): Cognitive Therapy of Personality Disorder, New York, Guilford.

    Google Scholar 

  • Bergeman, C.S., Chipuer, H.M., Plomin, R., Pedersen, N.L., McClearn, G.E., Nesselroade, J.R., Costa, P.T., and McCrae, R.R. (1993): Genetic and environmental effects on openness to experience, agreeable-ness, and conscientiousness: an adoption/twin study. J Personality 61: 158–179.

    Article  Google Scholar 

  • Bond, M., Paris, J., and Zweig-Frank, H. (1994): Defense styles and borderline personality disorder. J Personality Disorders 8: 28–31.

    Article  Google Scholar 

  • Bond, M.P., Gardner, S., Christian, J., and Sigal, J.J. (1983): Empirical study of self-rated defense styles. Archives Gen Psychiatry 40: 33–338.

    Google Scholar 

  • Bornstein, R.F. (1992): The dependent personality: developmental, social, and clinical perspectives. Psychol Bull 112: 3–23.

    Article  PubMed  CAS  Google Scholar 

  • Carey, G. and DiLalla, D.L. (1994): Personality and psychopathology: genetic perspectives. J Abnormal Psychology 103: 32–43.

    Article  CAS  Google Scholar 

  • Chess, S. and Thomas, A. (1990): The New York Longitudinal Study: the young adult periods. Can J Psychiatry 35: 557–561.

    PubMed  CAS  Google Scholar 

  • Cloninger, C.R. (1987): A systematic method for clinical description and classification of personality variants. Arch Gen Psychiatry 44: 579–588.

    Article  Google Scholar 

  • Coccaro, E.F. (1993): Psychopharmacological studies in patients with personality disorders: review and perspective. J Personality Disorders 7:Supp 181–192.

    Google Scholar 

  • Coccaro, E.F., Siever, L.J., Klar, H.M., Maurer, G., Cochrane, K., Cooper, T.B., Mohs, R.C., and Davis K.L. (1989): Serotonergic studies in patients with affective and personality disorders, Arch Gen Psychiatry 46:587–599. Disorders, New York, Guilford.

    Google Scholar 

  • Eysenck, H.J. (1991): Genetic and environmental contributions to individual differences: the three major dimensions of personality. J Personality 58: 245–261.

    Article  Google Scholar 

  • Frances, A., Clarkin, J., and Perry, S. (1984): Differential Therapeutics in Psychiatry. New York, Brunner/Mazel.

    Google Scholar 

  • Frank, A.F. (1992): The therapeutic alliances of borderline patients, in J.F. Clarkin, E. Marziali, and H. Munroe-Blum, eds, Borderline Personality Disorder: Clinical and Empirical Perspectives. New York, Guilford pp. 220–247.

    Google Scholar 

  • Frank, J.D. and Frank, J.B. (1991): Persuasion and Healing, 3rd edition, Baltimore, Johns Hopkins.

    Google Scholar 

  • Glantz, K. and Pearce, J.K. (1989): Exiles from Eden: Psychotherapy from an Evolutionary Perspective. New York, Norton.

    Google Scholar 

  • Gunderson, J.G. (1985): Conceptual risks of the Axis I-II division, in Klar H. and Siever L.J., eds, Biological Response Styles: Clinical Implications. Washington DC, American Psychiatric Press, pp. 81–95.

    Google Scholar 

  • Gunderson, J.G., Frank, A.F., Ronningstam, E.F., Wahter, S., Lynch, V.J., and Wolf, P.J. (1989): Early discon-tinuance of borderline patients from psychotherapy. J Nery Ment Dis 177: 38–42.

    Article  CAS  Google Scholar 

  • Hoglend, D., Sorbye, O., Sorlie, T., Sorlie, W., Fossum, A., and Englestad, V. (1992): Some criteria for brief dynamic psychotherapy. Psychotherapy and Psychosomatic 57: 67–74.

    Article  CAS  Google Scholar 

  • Horwitz, L. (1974): Clinical Prediction in Psychotherapy, New York, Aronson.

    Google Scholar 

  • Kagan, J. (1994): Galen’s Prophecy. New York, Basic.

    Google Scholar 

  • Kernberg, O.F., Coyne, L., Appelbaum, A., Horwitz, L., and Voth, H. (1972): Final report of the Menninger Psychotherapy Research Project. Bull Menninger Clin 36: 1–275.

    PubMed  Google Scholar 

  • Kernberg, O.F. (1987): Severe Personality Disorders. New York, Basic.

    Google Scholar 

  • Kramer, P. (1993): Listening to Prozac, New York, Viking.

    Google Scholar 

  • Lewis, L. and Appleby, L. (1988): Personality disorder: the patients psychiatrists dislike. Brit J Psychiatry 153: 44–49.

    Article  CAS  Google Scholar 

  • Linehan, M.M., Armstrong, H.E., Suarez, A., Allmon, D., and Heard, H.L. (1991): Cognitive behavioral treat-ment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 48: 1060–1064.

    Article  PubMed  CAS  Google Scholar 

  • Linehan, M.M. (1993): Cognitive Behavioral Treatment of Borderline Personality Disorder. New York, Guilford.

    Google Scholar 

  • Linehan, M.M., Heard, H.L., and Armstrong, H.E. (1993): Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Arch Gen Psychiatry 50: 971–974.

    Article  PubMed  CAS  Google Scholar 

  • Livesley, W.J., Jang, K., Schroeder, M.L., and Jackson, D.N. (1993): Genetic and environmental factors in personality dimensions. Am J Psychiatry.

    Google Scholar 

  • Liveseley, W.J., Schroeder, M.L., Jackson, D.N., and Jang, K. (1994): Categorical distinctions in the study of personality disorder: implications for classification. J Abnormal Psychol 103: 6–17.

    Article  Google Scholar 

  • Luborsky, L., Crits-Christoph, P, Mintz, J., and Auerbach, A. (1988): Who will benefit from psychotherapy? Predicting therapeutic outcomes. New York. Basic.

    Google Scholar 

  • Lykken, D.T., McGue, M., Tellegen, A., and Bouchard, T.J. (1992): Emergenesis: genetic traits which may not run in families. Amer Psychologist 47: 1565–1577.

    Article  CAS  Google Scholar 

  • Masters, R.D. and McGuire, M.T. (1994): The Neurotransmitter Revolution: Serotonin, Social Behavior, and the Law. Carbondale IL, South Illinois Press.

    Google Scholar 

  • Maziade, M., Caron, C., Coté, R., Boutin, P., and Thivierge, J. (1990): Extreme temperament and diagnosis: a study in a psychiatric sample of consecutive children. Arch Gen Psychiatry 47: 477–484.

    Article  PubMed  CAS  Google Scholar 

  • McCrae, R.R. and Costa, P.T. (1990): Personality in Adulthood. New York, Guilford.

    Google Scholar 

  • McGlashan, T.H. (1993): Implications of outcome research for the treatment of borderline personality disorder, in Paris J., ed, Borderline Personality Disorder: Etiology and Treatment. Washington DC, American Psychiatric Press, pp. 235–260.

    Google Scholar 

  • Millon, T. (1987): On the genesis and prevalence of borderline personality disorder: a social learning thesis. Journal of Personality Disorders 1: 354–372.

    Article  Google Scholar 

  • Millon, T. (1993): Borderline personality disorder: a psychosocial epidemic, in J. Paris, ed, Borderline Personality Disorder: Etiology and Treatment, Washington DC. American Psychiatric Press, pp. 197–210.

    Google Scholar 

  • Nakao, K., Gunderson, J.G., Phillips, K.A., Tanaka, N., Yorifuji, K., Takaishi, J., and Nishimura, T. (1992): Functional impairment in personality disorders. J Personality Disorders 6: 24–33.

    Article  Google Scholar 

  • Nigg, J.T. and Goldsmith, H.H. (1994): Genetics of personality disorders: perspectives from personality and psychopathology research. Psychol Bull 115: 346–380.

    Article  PubMed  CAS  Google Scholar 

  • Paris, J. (1988): Long-term outcome of borderline personality disorder: A critical review. J Personality Disorders 2: 189–197.

    Google Scholar 

  • Paris, J. (1990): Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry 147: 711–718.

    Google Scholar 

  • Paris, J. (1993): Treatment of borderline personality disorder in the light of the research on its long-term outcome. Can J Psychiat 38: S28 — S34.

    Google Scholar 

  • Paris, J. (1996): Social Factors in the Personality Disorders, New York, Cambrige University Press. Paris, J. ( 1998 ): Working with Traits. Northvale, NJ, Aronson.

    Book  Google Scholar 

  • Paris, J. (1993): Personality disorders: a biopsychosocial model. J Personality Disorders 7: 255–264.

    Article  Google Scholar 

  • Paris, J. (1994): Borderline Personality Disorder: A Multidimensional Approach. Washington DC, American Psychiatric Press.

    Google Scholar 

  • Paris, J., Frank, H., Buonvino, M., and Bond, M. (1991): Recollections of parental behavior and Axis II cluster diagnosis. J Personality Disorders 5: 102–106.

    Article  Google Scholar 

  • Perry, J.C. (1993): Longitudinal studies of personality disorders. J Personality Disorders, Supp 63–85.

    Google Scholar 

  • Perry, J.C. and Cooper, S.H. (1989): An empirical study of defense mechanisms. Arch Gen Psychiatry 46: 44–452.

    Article  Google Scholar 

  • Plomin, R., DeFries J.C., and McClearn G.E. (1990): Behavioral Genetics: A Primer. New York, W.H. Freeman.

    Google Scholar 

  • Propst, A., Paris, J., and Rosberger, Z. (1994): Do therapist experience, diagnosis and functional level predict outcome in short-term psychotherapy? Can J Psychiatry 39: 178–183.

    Google Scholar 

  • Robins, L.N. (1966): Deviant Children Grown Up. Baltimore, Williams and Wilkins.

    Google Scholar 

  • Rothbart, M.K. and Ahadi, S.A. (1994): Temperament and the development of personality. J Abnormal Psychology 103: 55–66.

    Article  CAS  Google Scholar 

  • Rutter, M. (1987) Temperament, Personality, and Personality Development, Brit J Psychiatry 150: 443–448.

    Google Scholar 

  • Rutter, M. and Quinton, D. (1984): Long-term follow-up of women institutionalized in childhood. Brit J Developmental Psychol 18: 225–234.

    CAS  Google Scholar 

  • Rutter, M. and Rutter, M. (1993): Developing Minds: Challenge and Continuity Across the Life Span. New York, Basic.

    Google Scholar 

  • Scarr, S. and McCartney, K. (1983): How people make their own environments: a theory of genotype-environment effects, Child Development 54: 424–435.

    PubMed  CAS  Google Scholar 

  • Shea, M.T., Pilkonis, P.A., Beckham, E., Collins, J.F., Elikin, E., Sotsky S.M., and Docherty, J.R (1990): Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry 147: 711–718.

    PubMed  CAS  Google Scholar 

  • Shea, M.T., Widiger, T.A., and Klein, M.H. (1992): Comorbidity of personality disorders and depression: implications for treatment. J Consulting Clinical Psychol 60: 857–868.

    Article  CAS  Google Scholar 

  • Siever, L.J. and Davis, L. (1991): A psychobiological perspective on the personality disorders. Am J Psychiatry 148: 1647–1658.

    PubMed  CAS  Google Scholar 

  • Skodol, A.E., Buckley, P, and Charles, E. (1983) Is there a characteristic pattern in the treatment history of clinic outpatients with borderline personality? J Nerv Ment Disease 171: 405–410.

    Article  CAS  Google Scholar 

  • Soloff, P.H. (1993): Psychopharmacological intervention in borderline personality disorder, in Paris J., ed, Borderline Personality Disorder: Etiology and Treatment. Washington DC, American Psychiatric Press, pp. 319–348.

    Google Scholar 

  • Storr, A. (1988): Solitude. New York, Free Press.

    Google Scholar 

  • Tellegen, A., Lykken, D.T., Bouchard, T.J., Wilcox, K.J., Segal, N.L., and Rich, S. (1988): Personality similarity in twins reared apart and together. J Pers Soc Psychol 54: 1031–1039.

    Article  PubMed  CAS  Google Scholar 

  • Tyrer, P (1988): Personality Disorders, London, Wright.

    Google Scholar 

  • van Reekum, R., Links, PS., and Boiago, I. (1993): Constitutional factors in borderline personality disorder, in Paris J., ed, Borderline Personality Disorder: Etiology and Treatment. Washington DC, American Psychiatric Press, pp. 13–38.

    Google Scholar 

  • Wachtel, EL. (1994): Cyclical processes in personality and psychopathology. J Abnormal Psychology 103: 51–54.

    Article  CAS  Google Scholar 

  • Wachtel, P.L. (1977): Psychoanalysis and Behavior Therapy. New York, Basic.

    Google Scholar 

  • Waldinger, R.J. and Gunderson, J.G. (1984): Completed psychotherapies with borderline patients. Am J Psychother 38: 190–201.

    PubMed  CAS  Google Scholar 

  • Wallerstein, R. (1986): Forty-two Lives in Treatment. New York, Guilford.

    Google Scholar 

  • Westen, D. (1985): Self and Society: Narcissism, Collectivism and the Development of Morals. New York, Cambridge University Press.

    Chapter  Google Scholar 

  • Winston, A., Laikin, M., Pollack, J., Wallner Samstag, L., McCullough, L., and Muran, J.C. (1994): Short-term psychotherapy of personality disorders. Am J Psychiatry 151: 190–194.

    PubMed  CAS  Google Scholar 

  • Yochelson, S. and Samenow, S. (1976): The Criminal Personality. New York, Jason Aronson.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Community and Family Psychiatry Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 4333 Chemin de la Cote Ste. Catherine, Montreal, QC, H3T1E4, Canada

    Joel Paris (Professor of Psychiatry)

Authors
  1. Joel Paris
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Nijmegen, Nijmegen, The Netherlands

    Jan Derksen

  2. Free University of Brussels, Brussels, Belgium

    Jan Derksen

  3. Vita-Salute San Raffaele University and Scientific Institute San Raffaele, Milan, Italy

    Cesare Maffei

  4. Forensic Psychiatric Institute “Oldenkotte”, Rekker, The Netherlands

    Herman Groen

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Paris, J. (1999). A Multidimensional Approach to Personality Disorders and Their Treatment. In: Derksen, J., Maffei, C., Groen, H. (eds) Treatment of Personality Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6876-3_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-6876-3_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-3326-3

  • Online ISBN: 978-1-4757-6876-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation