Personality as a Mediating Variable in the Pathogenesis of Mood Disorders: Implications for Theory, Research, and Prevention

Abstract

It is widely believed that affective episodes arise from predisposing personality attributes. This position was most directly articulated by Kretschmer (1936), who believed that “the endogenous psychoses are nothing but accentuation of normal types of temperament.” While Kretschmer, as a faithful follower of the Kraepelinian tenets (1921), emphasized constitutionally determined temperamental contributions, much current theorizing has focused on learned characterologic attributes, believed to be the legacy of developmental vicissitudes (Chodoff 1972). Ideally, the study of personality in a given patient should precede the first affective episode as affective states may bias or even mask the patient’s personality profile. Even during euthymic periods, personality structure is altered by the illness episodes or the treatments provided for them. For these reasons, very few studies have succeeded in prospectively assessing the contribution of personality to mood disorders. However, despite the methodologic barriers, many interesting findings on the relevance of enduring personality characteristics to mood disorders have been recently reported.

Parts of this chapter previously appeared in Akiskal H (1984), Characterologic manifestations of affective disorders: toward a new conceptualization (Integr Psychiatry 2:83–88) and are reproduced here by permission of Elsevier Science Publishing Co., New York