PERSONALITY THEORIES
Medical psychology seminar
Tamás Dömötör SZALAI
Semmelweis University, Institute of Behavioural Sciences
szalai.domotor@gmail.com
www.behsci.sote.hu
Structure of the seminar
Personality – definition and medical relevance
Personality theories
1 Trait theories
2 Type theories
3 Psychoanalytic theories
4 Behaviorist theories
5 Social cognitive theories
6 Humanistic theories
7 Biopsychological theories
8 Evolutionary theory
Assessment:
1 Interviews
2 Personality tests
Practice
1. Draw down your own personality
 Object, plant, human, symbols etc.
 What does this mean to you?
2. Discussion for 3-3 minutes with a partner:
 What is a personality?
 How would you describe your own
personality?
What is personality?
 Personality: a dynamic, but relatively stable and
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organized pattern of characteristics, thoughts, feelings
and behaviors behaviors that distinguishes one person
from another and that persists over time and
situations
The word "personality" originates from the latin word
of persona = mask
It was used to represent or typify the character.
„Essence of the person, psychological fingerprint”
Strongly influences one's perceptions, cognitions,
expectations, motivations, self-perceptions, values,
attitudes and whole life
Predicts reactions, problems, level of stress,
achivement, experineces and almost the wole life
Goals of studying the
personality
1. Describe – The first goal is to observe behavior
and describe as objectively as possible.
2. Explain – Why did the subject do what he or she
did?
3. Predict – “The best predictor of future behavior is
past behavior.”
4. Control – with understanding the patterns of
functioning, we can intervene to change negative
behaviors.
5. Improve – Not only controling behavior, but
improving a person’s life.
Main approaches to personaltiy
 To understand intrapsychic functioning and
interpersonal differences
 Gordon Allport (1937): two major ways to study
personality:
1. Nomothetic: seeks general laws, common
fetures that can be applied to many different
people (such as extraversion) - What is
common trait in us?
2. Idiographic psychology: attempt to
understand the unique aspects of a particular
individual – What is the difference between us?
Is there a healthy personality?
1. Adequate perception of reality
2. Self-knowledge and ability for reflection
3. Intentional control of behaviour
4. Self-esteem and acceptance
5. Ability to mak emotional relationships
6. Creativity / motivation
Practice
 3 groups
 Make a drawing/symbol of the personality with
the most important influencing factors and their
relevance in medical practice
 Which personality traits could increase the risk of
illnesses?
 What personality characteristics can be related to
sickness behaviour?
 Which personality characteristics can increase the
efficiency of medical care and make a better
compliance?
The relevance of personality in
medical practice
Personality plays a crucial role in:
 Coping with stress and diseases, tolerance of
treatment
 Maleficent or maladaptive behaviours
 Development of psychosomatic and mental
disorders
 Perception of symptomes
 doctor-patient relationship
 Acceptance of the patient status
Personality and diseases
 Psychosomatic studies: certain emotions, attitudes,
coping styles can in increase the risk of
psychophysiological disorders:
 Learned helplessness
 Constant anxiety or agitatedness, fury
 Repressed anger
 Submissive traits etc.
Vs. Sense of coherence, hardiness, optimism, self-efficacy,
internal locus of control
Personality types and
psychosomatic disorders
„A”-type personality
 Hostility, cynism
 Increased activity,
constant pressure for
accomplishment
 contention
 Will of control over
the environment
 Lack of time
 impatience
-> Higher risk for
cardiovascular
diseases
„C”-type personality
 Oversocialized: avoiding conflicts, patient, co-
operate, inhibited
 Unable to say no, alwas wnts to match the
others needs and expecttions
 Unable to express own demands and wishes,
but struggle for others
 Submissive, doesn’t fight with authority
 Can’t express engative emotions
 Absolute need for acceptance for self-esttem
 Unsatisfied biological and psychological needs
 Sense of hope- and helplessness
-> higher risk for tumors
Personality and diseaes
 C type personality: „C cancer proon” –
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submissive, dependent, anger-in tedencies
Hostility, anger and cardiovascular diseases
Anxiety, perfectionism and irritable bowel
syndrome
Trait anxiety, intensified internal body
monitoring and increased intensity of symptom
perceprion, hypochondria
Depression and lack of energy not only inreases
the risk of an oncological disease, but the are
often its first signals
The relevance of personality
in medical practice
 From the side of the doctor
 „The doctor as a medicine”
 Communicational skills, congruence,
trusworthyness
 Helper motivations
 Chances for burn-out
 With influencing the quality of compliance or
adherence, it has impact even on the
prognosis
The relevance of personality
in medical practice
The role of sympathy:
 To gain the patient’s sympathy, they need to
emotionally accept the doctor
 Regard him/her professionaly crecible and trustworty.
 Congruent in behaviour
We like people, if they:
 Have pleasant or admirable charachtersitics
 Interests, values similar to ours / emotionally similar
 Have good competences
 Like and understand us
 Physically attractive
PERSONALITY THEORIES
Major theories:
 Type approaches
 dispositional (trait) perspective
 Psychodynamic
 Humanistic
 Biological
 Behaviorist
 Evolutionary
 Social learning perspective.
Personality theories
1. Personality types
 Hippocrates 400 BC and Galen, 140/150 AD
classified 4 types of "humors" in people
 Each type was due to an excess of one of four
bodily fluids
 The personalities were termed "humors".
Somatotypes - William Sheldon
 William Sheldon (1940, 1942) classified
personality according to body type
-> Three main „somatotypes”:
Jungian Types: Myers-Briggs &
the Four Temperaments
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Jung's typology emerges from Jung's deep, holistic philosophy and psychology
about the person, not empirically-driven.
Ultimate psychological task as the process of individuation
Myers-Briggs developed the Myers-Briggs Type Indicator questionnaire for
better understanding one's own personality type and others with who the
individual interacts.
Four personality traits (functions):
Extroversion (E) --- Introversion (I)
Do you recharge your energy via external contact & activity (Extroversion) or
spending time in your inner space (Introversion)?
Intuition (N) --- Sensing (S)
Do you rely on your inner voice (Intuition) or observation (Sensing)?
Thinking (T) --- Feeling (F)
When making decisions, what do you rely on? Your thoughts or your feelings?
Judgement (J) --- Perception (P)
Do you tend to set schedules and organize your life (Judgement), or do you tend
to leave the options open and see what happens (Perception)?
Using the letters above, you have a unique 4 letter code to indicate one of the 16
Jungian personality types, e.g., I am an INTJ.
Meyers-Briggs typology
online test
 http://www.humanmetrics.com/cgi-
win/jtypes2.asp
2. Dispositional (trait)
theories
 Personality traits = enduring patterns of
perceiving, relating to, and thinking about the
environment and personal contexts
 They are used to help define people as a whole
 relatively stable over time
 differ among individuals
 influence behavior
 Traits are also bipolar - they vary along a
continuum (e.g. friendly vs. unfriendly)
 All trait theories incorporate at least two
dimensions: extraversion and emotional stability
Gordon Allport
Different traits / dispositions:
 Central traits: basic to an individual's
personality
 Secondary traits: more peripheral.
 Common traits: recognized within a culture
and thus may vary from culture to culture.
 Cardinal traits: by which an individual may be
strongly recognized.
Cattel and Eysenck
Raymond Cattel
 sixteen "primary personality factors" + five
"secondary factors."
 personality itself is defined in terms of
behavioral prediction
 Personality = which permits a prediction of what a
person will do in a given situation.
Hans Eysenck
 three traits are sufficient to describe human
personality: extraversion, neuroticism,
psychoticism
Goldberg and the Big Five
 Lewis Goldberg: five-dimension personality model
-> Big Five:
 Openness to Experience: the tendency to be imaginative,
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independent, and interested in variety vs. practical,
conforming, and interested in routine.
Conscientiousness: the tendency to be organized, careful,
and disciplined vs. disorganized, careless, and impulsive.
Extraversion: the tendency to be sociable, fun-loving, and
affectionate vs. retiring, somber, and reserved.
Agreeableness: the tendency to be softhearted, trusting,
and helpful vs. ruthless, suspicious, and uncooperative.
Neuroticism: the tendency to be anxious, insecure, and
self-pitying vs. calm, secure, and self-satisfied
 Big Five – 10 questionnaire
Critics of the trait models
 Purely descriptive and offers little
explanation of the underlying causes of
personality.
 They may lead some people to accept
oversimplified classifications based on a
superficial analysis of personality
 Trait models often underestimate the effect
of specific situations on people's behavior.
3. Psychoanalytic theories
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Psychic energy is needed to make the mind go & the energy (motivation)
cannot be destroyed, it must be expressed
Psychic Determinism:
Humans have base instincts (unconscious urges):
Topography of the psyche (unconscious, pre-conscious, conscious):
Structure of Mind: The mind has an internal structure: its three parts has
separate motivations: Id (emtional part); the Ego (rational part); and the
Superego (the moral part).
The resolution of psychic conflicts shapes personality: Personality is very
strongly influenced by early experiences. The quality of a person's mental
health is determined by the way in which a person learns to resolve
unconscious conflicts , amongst the Id, Ego & Superego.
Personality is viewed as a dynamic set of process which are always in motion
psychodynamic.
We Use Defense Mechanisms to Shield Our Psyche's from the Pain
Unconscious Leaks Into Conscious Awareness via dreams, slips of the
tongue, psychosomatic symptoms.
Therapeutic Relief Can be Achieved Through Insight into the Unconscious:
Freud
 Freud video
 He and his psychoanalytic theory (from the 1900s)
formed the foundation of modern psychology
 the early years of development make a critical
contribution to the adult psyche, depending on
various psycho-sexual stages are resolved, the
power of ego and defense mechanisms
 urges, passions, repressed ideas and feelings in the
unconscious control over the conscious thoughts
Psychosexual development
 The focal objects for the developing child's
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energy serves to define five main stages of
psychological development:
oral (0-18 months)
anal (18 months - 3 1/2 years)
phallic (3 1/2 years - 6 years)
latency (6 years - puberty)
genital (puberty - adulthood)
The topographical model
 Iceberg metaphore: represents the configuration of
the mind - three levels of consciousness:
 Conscious: what you re aware of, you can verbalize
your conscious experience and you can think about it
in a logical fashion.
 Preconscious: ordinary memory. Things stored here
are not in the conscious, but can be readily brought
into conscious.
 Unconscious: not directly accessible to awareness.
Urges, feelings and ideas that are tied to anxiety,
conflict and pain. They influence our actions and our
conscious awareness. „Dream is the royal way to the
unconsious.”
 10% is visible whereas, 90% is beneath the water;
preconscious is 10% -15%, unconscious is 75%-80%.
The structural model of the
personality
3 basic perosonality components:
1. ID (instincts)
 Inherited, inctinctive part of the personality, strong
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relationship with biological needs
A source of all psychic energy, based on the princile of
pleasure
Basic insincts:
Life (Eros): survival, giving birth, pleasure; energy: libido
Death (Tanatos): destructive instincts, anger, aggression
Freud – stuctural model
2. Ego
 Main task is to control the ID
 Mediates between ones desires, the roles of the
Superego and the external world
 Executive functions in the personality functioning
 „reality principle” - rational behaviour: consider the
consequencies of the fulfilment of needs
 Conscious or preconscious
2. Superego
 Values, norms, differentiating at the age of 3-5-6-years
 Two parts: idea of the ego and the conscience
Anxiety
 Healthy personality functioning is determined by
the balance od the 3 components
 When there is no balance between the mor the
external world -> anxiety
1. Realistic anxiety: threat from the external world
(avoidance or coping)
2. Moral anxiety: because the offence against
internalized moral normes and values, source is the
superego
3. Neurotic: fear from the loss of the Ego’s control
over the ID and its impulses
4. Traumatic
Defense mechanisms
 Forms of defences and deflections developed
by the Ego to cope with anxiety
 They function unconsciously, but remain parts
of the eveyday life with influencing the
personality functionin
 What is the function of defense mechanisms?
 Which mechanims do yo know or experience from
your own lives?
Defense mechanisms
Jung – structure of personality
Jung – personality types
 8 personality types
 Main orientation: Introversion – extraversion
 Their combionation with four styles
School of Budapest
 Szondi
 Bálint
 Hermann
 Ferenczi
4. Behaviourist theories
 John B. Watson, USA, 1920’s Learning theories believes that individual
differences essentially arose from the learning experiences: patterns of
behaviour are shaped by experience.
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Stimulus – Organism – Response
 Classical conditioning
 Nexus of the unconditional and conditional stimuluses
 Eg. Anxiety from illness is associated with the smell of the hospital or white
colak
 Habituation
 Generalization
 Discrimination
5. Cognitive theories (70’s)
 The human mind processes information. Experience is our information.
 We store and organise experiences into patterns called schemas , which
help us to interpret new experiences
 Self-schemas organise information about how we see ourselves – are we
optimistic or pessimistic, what we are motivated by, what our likes or
dislikes are, etc.?
 Attributions are characteristic ways of explaining events.
 Self-schemas, attributions and memory activations are cognitive
explanations for individual differences in personality.
 Self-regulation assumes that behaviour is directed from within the
person
 Self-regulation emphasises the importance of goals and the process of
feedback control
Practice
 The relationship or situations, their
interpretations (automatic thoughts,
cognitive distortions), with feelings and
behaviours is highly important
 Typical cognitive distortions
How to use cognitions to
help yourself?
6. Humanistic theories
 Humanism is a philosophical movement that emphasises the personal
worth of the individual and the centrality of human values.
 Carl Rogers (1902-1987)
 all people have a constant tendency toward growth = self-actualization
 Self congruence + empathy + congruence
 Ideal self: the person you’d like to be
 The actual self is what you are now or even what you THINK you are
because remember from this perspective it’s all about subjective
perceptions.
 When you are self-actualized then there is congruence (i.e. harmony or
agreement) between the real and the actual selves.
 There’s a second kind of congruence and that is between the actual self and
experience. That is the experiences in life should fit with the type of person
you think you are.
 Incongruence is bad and means there is a breakdown in your unitary sense
of self.
Practice
Interpersonal inventory
 You + most important people in your life
 Peole who influenced your personal
development and the person who you are
 How did they? – talk it over with a partner
 Important relationships and emotions
 What would you change?
7. Biological theories
 Major assumptions
 Many personality characteristics are
genetically determined
 Behavioural tendencies derive from our
evolutionary history
 Human behaviour produced is by a complex
biological system (e.g. hormones,
neurotransmitters)
Neurotransmitters and
personality
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Norepinephrine for example is likely to be involved in both anxiety and
anger.
High levels of norepinephrine have for example been associated with
anxiety-proneness, dependency and sociability. On the other hand, low
levels of norepinephrine are associated with disinhibition & impulsivity
(Zuckerman).
Criminals have been found to have low levels of epinephrine and
norepinephrine.
Lack of dopamine is associated with Parkinson’s disease (l-dopa and Sacks).
The enzyme MAO which I mentioned early and which regulates the
breakdown of the neurotransmitters serotonin, norepinephrine and
dopamine has been found to be implicated in aggression, extraversion,
sensation seeking, such that low levels of this enzyme lead to increased
levels of aggression, extraversion, and sensation seeking.
Serotonin has a role in the inhibition of behavioural & emotional impulses.
Low serotonin levels are implicated with obsessive worry, depression,
irrational anger, higher aggression and chronic pessimism.
High serotonin levels are associated with compulsive behaviours and
obsessive tidiness.
Behavioral genetics
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It studies the way inherited biological material i.e. genes, can influence
patterns of behaviour.
„Trait genetics”: examines the way our genes influence our personality traits.
Humans are highly similar to each other genetically. About 90% of human
genes are identical from one individual to another. Behavioural genetics
concentrates on the approximately 10% of the human genome that does
vary.
The inheritance of species-specific traits or traits that all humans share is
examined later in evolutionary psychology.
The basic assumption of behavioural genetics is that if a trait is influenced by
genes then it ought to be more highly correlated across pairs of identical
(monozygotic:MZ) twins than across pairs of fraternal (dyzygotic:DZ) twins,
and more highly correlated across closer genetic relatives than across more
distant genetic relatives.
Across many personality traits the average correlation across MZ twins is .50
and across DZ twins is .30
According to twin studies average heritability of most personality traits is
.40 -> behavioural variance that can be explained by genetic variance is 40%
8. Evolutionary psychology
 Aspects of human psychology which attract much of the focus of
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those interested in evolutionary psychology:
human intellectual capacity - overall brain size, large frontal
cortex, more convolutions, etc. all imply that a greater capacity
to process information have been arguably the most dominant
psychological characteristic selected for during the evolution of
the human species
the sophisticated use of language - interestingly, humans seem
to come pre-wired to learn language, but not with a pre-set
language. During the remarkable period of neural plasticity
during a child's early years, the child has a greater capacity for
acquiring language that at any other period of his/her life.
capacity for emotion and affect - humans are fundamentally
emotional animals, experiencing great heights of ecstasy and
depths of depression.
complex courting & sexual behaviors
Personality assessment
Aim: to predict the behaviour
Methods:
1. Observation
2. Physiological eaminations
3. Experiments
4. Interviews
5. Tests
INTERVIEW
structured / semi – or unstructured
Argerlander’s first interview for
psychotheraptists and clinicians
(unstructured)
3 types of information:
1. Objective informations (data, biographical
details)
2. Subjective: meaning attached by the patient
3. Scenic / situational: what the patient does
under the investigation
4 types of clients
1./ Delegated client (owner of the problem
remains in the background)
2./ Complaining / demandnig) client Követelőző
kliens (strong needs and high expectations)
3./ undemanding / helpless client (no one can
help me)
4./ informed client (seeks for self-justification)
Case Study
What type of a personality disorder could it be? Signals?
 Patient starts the second session with a female
therapist:
P: I don’t really know, why I am here again to meet you.
You’re not quit a Sigmund Freud, are you? No, you1re
rather primitive, you do not even have a normal idea.
T: What did actually hurt you so much last time?
P:
You just always doubted and questiones all of my
interpretations and perspective in the situations, which
have lead me to loose my job. Do you see any other
valid explanations beside mine?
T: These situations could have hurt you indeed, specially
because the were so unexpected.
Thechniques in the interview
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Mirroring
Reflecting emotions (with questions)
Summarizing
Reframing (meaning or sitution)
Repeat
Highlighting thoughts / emotions
Questions to clarify the meaning, or for exploration
Conretizing
Paraphrasing
Asking for example
Practice - interview
1. Make a short (15 minutes) interview with
about the personality and determining
motivations of a chosen patner
2. Use interview tehchniques, objective,
subjective and scenic informations
Assesment of symptoms –
structured interview and tests
 If you experience symptoms might be related to
clinically significant diseases
-> You are going to investigate the further symptoms
by asking or by certain questionnaires
Aims:
 Confirming the diagnosis (fulfilment of all criteria)
 Differential diagnosis
 To assess the severity of symptoms with a
determined focus
-> Eg. Beck Depression Inventory or Spielberger State
Anxiety Scale
PERSONALITY TESTS
= Standardized instrument designed to reveal
aspects of an individual's character or
psychological makeup
 Most tests assess according to certain traits or the
combination of some characteristics
 Types of psychological tests:
1. Personality tests
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Questionnaires
Projective methods
2. Achivement or IQ tests
3. Tests for symptom assessment
Personality questionnaires
 The most common type is the self-report inventory, also
commonly referred to as objective personality tests.
 They consist of items: typically statements of
aracteristics of psychological constructs that allow
respondents to indicate level of agreement (Likert-type
scale)
 a personality test is expected to demonstrate reliability
and validity.
 One problem with self-report measures of personality is
that respondents are often able to distort their
responses, or just rate according to subjective notions
about theirselves which leads to distortions
Multifactorial personality
questionnaires
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The 16PF Questionnaire (16PF) was developed by Raymond Cattell and his colleagues
in the 1940s and 1950s in a search to try to discover the basic traits of human
personality using scientific methodology. The test was first published in 1949, and is
now in its 5th edition, published in 1994. It is used in a wide variety of settings for
individual and marital counseling, career counseling and employee development, in
educational settings, and for basic research.
The DISC assessment is based on the research of William Moulton Marston and later
work by John Grier, and identifies four personality types: Dominance; Influence;
Steadiness and Conscientiousness. It is used widely in Fortune 500 companies, for-profit
and non-profit organizations.
The HEXACO Personality Inventory – Revised (HEXACO PI-R) is based on the HEXACO
model of personality structure, which consists of six domains, the five domains of the
Big Five model, as well as the domain of Honesty-Humility.[27]
The Personality Inventory for DSM-5 (PID-5) was developed in September 2012 by the
DSM-5 Personality and Personality Disorders Workgroup with regard to a personality
trait model proposed for DSM-5. The PID-5 includes 25 maladaptive personality traits as
determined by Krueger, Derringer, Markon, Watson, and Skodol.[29]
The NEO PI-R, or the Revised NEO Personality Inventory, is one of the most significant
measures of the Five Factor Model (FFM). The measure was created by Costa and
McCrae and contains 240 items in the forms of sentences. Costa and McCrae had
divided each of the five domains into six facets each, 30 facets total, and changed the
way the FFM is measured.[34]
MMPI – case study
 Minnesota Multiphasic Personality
Inventory (MMPI)
 The most widely used standardized
psychometric test of adult personality and for
the assessment of psychopathologies in
clinical settings
 Different forms: MMPI, MMPI-2, MMPI-A,
MMPI-2RF
 Contains the 10 important scales :personality
featues + psychopatoligical sympotmes
The MMPI scales
MMPI profile
Projective personality
assessment
E.g. Rorschach, Szondi, TAT, PFT, drawing
 To assess the unconscious functioning and deep
level of the personality
 Frank: semi-structured or dubious, ambigious
stimuluses are need to be structured or worded
 Personal motivations, emotions, thoughts,
perspective are going to be involved ->
projcetion
 The test can reflect, how we see the world and
how we function
 Not valid nad reliable enough BUT it works
The Rorschach test
 Evaluation of a subjects response to ambiguous ink blots
 Published in 1921 by Hermann Rorschach, psychiatrist in Switzerland.
 The interpretation of people's responses to the Rorschach Inkblot Test was
originally based on psychoanalytical theory
 10 standard pictures, 18x24 cm in size, bilateral symmetry.
 Five inkblots are of black ink, two are of black and red ink and three are
multicolored, on a white background
Rorschach
 The interpretation of the Rorschach test is not based primarily on
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the contents of the response, i.e., what the individual sees in the
inkblot (the content).
In fact, the contents of the response are only a comparatively
small portion of a broader cluster of variables that are used to
interpret the Rorschach data: for instance, information is
provided by the time taken before providing a response for a card
can be significant (taking a long time can indicate "shock" on the
card).[as well as by any comments the subject may make in
addition to providing a direct response.
In particular, information about determinants (the aspects of the
inkblots that triggered the response, such as form and color)
location (which details of the inkblots triggered the response) is
often considered more important than content, although there is
contrasting evidence.
"Popularity" and "originality" of responses can also be
considered as basic dimensions in the analysis
Szondi test
Practice with a
projective method
TAT
Rosenzweig Picture
Frustration Test
 24 situations to check how do you
handle frustration
Prctice
Draw a person in the rain
Or draw a tree
Talk about the impressions with a chosen partner
Thank you for your kind attention!