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Why are Personality Theory and Personality Assessment Integral to Clinical Practice?

Insights from Millon's Evolutionary Theory

Seth Grossman, Psy.D.

Copyright © 2015. Pearson, Inc., and/or its affiliates. All rights reserved. 1

Why are Personal i ty Theory and Personal i ty

Assessment Integral to Cl in ical Pract ice?

Insights f rom Mi l lon 's Evolut ionary Theory


Topics

Why Focus on

Personality and

Personality Theory?

I. II.Millon’s Evolutionary

Theory

A. Overview

B. The Prototypes

C. Functional and

Structural Domains

D. Subtypes:

Admixtures of

Prototypes





Personality (General Definition)

“…individual differences in characteristic patterns of

thinking, feeling and behaving. The study of personality

focuses on two broad areas: One is understanding

individual differences in particular personality

characteristics, such as sociability or irritability. The other

is understanding how the various parts of a person come

together as a whole.”

Source: Adapted from Encyclopedia of Psychology (Ed. Kazdin, A. E., 2000)

Traditions in Personality Study

Biophysical Models Phenomenological Models

• Temperament &

Neurobiologic

• Mind-Body Connectedness

• Existential/Humanistic

• Cognitive/CBT, ACT,

Mindfulness

Behavioral Models

• Conditioning

• Social Learning

Sociocultural Models

• Ecological/Group

• Interpersonal/Narrative

Intrapsychic/Developmental Models

• Psychodynamic

• Structural/Objects





Purpose of Personality Study?

Personality Disorders

“Personality disorders represent the failure to develop a

sense of self-identity and the capacity for interpersonal

functioning that are adaptive in the context of the

individual’s cultural norms and expectations.” (DSM-5

Personality & Personality Disorders Work Group).

This definition aligns with Millon’s Evolutionary Model.





Personality Disorders

Adaptive failure is manifested in one or both of the following

areas:

1. Impaired sense of self-identify

i. Identity integration

ii. Integrity of self-concept

iii. Self-directedness

2. Failure to develop effective

interpersonal functioning

i. Empathy

ii. Intimacy

iii. Cooperativeness

iv. Complexity and integration of representations of others

Personality on a Continuum:

Adaptive to Maladaptive

Adaptive Maladaptive

Personality disorders are quantitative dimensions of severity

instead of qualitatively discrete categories.





Mil lon’s Evolut ionary Theory

A. Overview

Personality (Millon’s Evolutionary Theory)

“(Personalities) are the only organically integrated system

in the psychological domain… The intrinsic cohesion of

persons is not merely a rhetorical construction, but an

authentic substantive unity… segments of an inseparable

biopsychosocial entity, as well as a natural outgrowth of

Darwinian evolution’s progression.”

Source: Millon (2011) Disorders of Personality (3rd ed). Hoboken, NJ: Wiley.





Role of Personality

Clinical Symptomology

(Anxiety, Dysthymia

= Fever, Cough)

Role of Personality

Individual Wellness &

Psychosocial Context


(Anxiety, Dysthymia

= Fever, Cough)

(Marital, Economic, Health

= Infectious Agents)





Role of Personality

Individual Wellness &

Psychosocial Context

Personality Dynamics


(Anxiety, Dysthymia

= Fever, Cough)

(Personality Spectra

= Immune System)

(Marital, Economic, Health

= Infectious Agents)

Evolutionary Theory of Personality

Existence

Pleasure(Life Enhancing)

Pain(Life Sustaining)

Adaptation

Passive(Accommodating)

Active(Modifying)

Replication

Self(Independent)

Other(Dependent)

Three basic polarities (dimensions)





Mil lon’s Evolut ionary Theory

B. The Prototypes


Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)







Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)



Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)






2011: Millon Introduces a “Spectrum”

Each personality prototype is described through these three

levels:

Normal StyleAbnormal

Traits/Type

Clinical

Disorder

Millon Personality Patterns–SpectrumSpectrum Normal Style Abnormal Type Clinical Disorder

AASchd Apathetic Asocial Schizoid

SRAvoid Shy Reticent Avoidant

DFMelan Dejected Forlorn Melancholic

DADepn Deferential Attached Dependent

SPHistr Sociable Pleasuring Histrionic

EETurbu Ebullient Exuberant Turbulent

CENarc Confident Egotistic Narcissistic

ADAntis Aggrandizing Devious Antisocial

ADSadis Assertive Denigrating Sadistic

RCComp Reliable Constricted Compulsive

DRNegat Discontented Resentful Negativistic

AAMasoc Abused Aggrieved Masochistic

ESSchizoph Eccentric Schizotypal Schizophrenic

UBCycloph Unstable Borderline Cyclophrenic

MPParaph Mistrustful Paranoid Paraphrenic

Millon, T. (2011). Disorders of personality: Introducing a DSM/ICD spectrum from normal to abnormal. Hoboken, NJ: Wiley.





Motivating Aims(Aberrations in Motivation)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)

Polarity Orientation

Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic

Personality Vulnerability: Four General Tendencies

Interpersonally Imbalanced

Spectra

Emotionally Extreme Spectra

Intrapsychically Conflicted Spectra

Structurally Compromised

Spectra





Interpersonally Imbalanced Spectra

Self-Other

Self (low)

Other (high)

Dependent

Personalities

Self (high)

Other (low)

Independent

Personalities

Passive

DADepn

Deferential Attached

Dependent

CENarc

Confident Egotistic

Narcissistic

Active

SPHistr

Sociable Pleasuring Histrionic

ADAntis

Aggrandizing Devious

Antisocial

CENarc (Narcissistic) Spectrum(MCMI-IV Scale 5)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic





Emotionally Extreme Spectra

Pleasure-Pain

Passive

Low Pleasure

Low Pain

Low Pleasure

High Pain

AASchd

Apathetic

Asocial

Schizoid

DFMelan

Dejected

Forlorn

Melancholic

Active

High Pleasure

Low Pain

Low Pleasure

High Pain

EETurbu

Ebullient

Exuberant

Turbulent

SRAvoid

Shy

Reticent

Avoidant

SRAvoid (Avoidant) Spectrum(MCMI-IV Scale 2A)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic





Intrapsychically Conflicted Spectra

Pleasure-Pain Reversal

Self-Other Discordance

Passive

AAMasoc

Abused

Aggrieved

Masochistic

RCComp

Reliable

Constricted

Compulsive

Active

ADSadis

Sociable

Pleasuring

Sadistic

DRNegat

Discontented

Resentful

Negativistic

RCComp (Compulsive) Spectrum(MCMI-IV Scale 7)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic





Structurally Compromised Spectra

Spectrum Style Type Disorder

ESSchizoph Eccentric Schizotypal Schizophrenic

UBCycloph Unstable Borderline Cyclophrenic

MPParaph Mistrustful Paranoid Paraphrenic

UBCycloph (Borderline) Spectrum(MCMI-IV Scale C)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic





Mil lon’s Evolut ionary Theory:

C. Functional and Structural Domains

Pleasure Pain

Active Passive

Self Other

Evolutionary Polarities

Functional/Structural Domains

Domain/Facet Level of Personality

Level Functional Domains Structural Domains

BehavioralEmotional ExpressionInterpersonal Conduct

Phenomenological Cognitive Style Self-Image

IntrapsychicIntrapsychic Dynamics Intrapsychic Content

Intrapsychic Architecture

Biophysical Mood/Temperament





Characterizing the Personality Prototypes

Functional Domain

Emotional

Expression

Interpersonal

Conduct

Cognitive Style

Intrapsychic

Dynamics

Self-Image

Intrapsychic

Content

Intrapsychic

Architecture

Mood/

Temperament

Structural Domain

EETurbu (Turbulent) Spectrum(MCMI-IV Scale 4B)

Existence



Adaptation


Active(Modifying)

Replication

Self(Independent)

Other(Dependent)


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic





ImpetuousExpressive Emotion

MercurialMood/Temperament

ExaltedSelf-Image

High-Spirited

Interpersonal Conduct

ScatteredCognitive Style

PiecemealIntrapsychic Content

UnsteadyIntrapsychic Architecture

MagnificationIntrapsychic Dynamics

Personologic Domains: EETurbu Spectrum

Millon, T., Grossman, S., & Millon, C. (2015). Millon Clinical Multiaxial Inventory, Fourth Edition: Manual. Minneapolis, MN: Pearson.





Mil lon’s Evolut ionary Theory:

D. Subtypes: Admixtures of Prototypes

Multiple Elevations: Narcissistic (CENarc Scale 5) and Avoidant (SRAvoid Scale 2A)

Pleasure Pain


Strong

Average

Weak

Unaffected

Conflicted

Reversal

Wavering

Immovable

Polarity Dynamic

Passive Active

Self Other

CENARC (5)

Pleasure Pain

Passive Active

Self Other

SRAVOID (2A)





AASchd

SRAvoid

DFMelan

DADepn

SPHistr

CENarc

ADAntis

ADSadis

RCComp

DRNegat

AAMasoc

ESSchizoph

UBCycloph

MPParaph

ExpressiveEmotion

InterpersonalConduct

CognitiveStyle

Content

Self-Image

Dynamics Architecture

Mood/Temperament

Abstinent Acquiescent Diffident Undeserving

Impassive Unengaged Impoverished Complacent Meager IntellectualizationUndifferentiated Apathetic

FretfulAversive

Distracted Alienated Vexatious Fantasy Fragile Anguished

Disconsolate Defenseless Fatalistic Worthless Forsaken Asceticism Depleted Woeful

Puerile Submissive Naive Inept Immature Introjection Inchoate Pacific

Dramatic Flighty Gregarious ShallowAttention-Seeking Dissociation Disjointed Fickle

Haughty Exploitive Expansive Admirable Contrived Rationalization Spurious Insouciant

Impulsive Irresponsible Nonconforming Autonomous Debased Acting-Out Unruly Callous

Precipitate Abrasive Dogmatic Combative Pernicious Isolation Eruptive Hostile

Disciplined Courteous Constricted Reliable ConcealedReaction

Formation Compartmentalized Solemn

Embittered Contrary Cynical Discontented Fluctuating Displacement Divergent Irritable

Discredited Exaggeration Inverted Dysphoric

Peculiar Secretive Circumstantial Estranged Chaotic Undoing FragmentedDistraught

or Insentient

Spasmodic Paradoxical Vacillating Uncertain Incompatible Regression Split Labile

Defensive Provocative

Mistrustful Inviolable Unalterable Projection Inelastic Irascible

EETurbu

IntrapsychicTraitDomains

SpectrumDisorders

ImpetuousHigh-

SpiritedScattered Exalted Piecemeal Magnification Unsteady Mercurial

Grossman Facet Scales Highlighted

Clinical Presentation

(Anxiety, Dysthymia

= Fever, Cough)

Questions





References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of

Mental Disorders, 5th Edition (DSM-5). Washington, DC: Author.

Choca, J. P. (2004). Interpretive guide to the Millon Clinical Multiaxial Inventory,

Third Edition. Washington, DC: American Psychological Association.

Grossman, S. & Amendolace, B. (2017). Essentials of Millon Inventory

assessment. Hoboken, NJ: Wiley.

Kazdin, A. E. (2000). Encyclopedia of psychology. Oxford, UK: Oxford University

Press.

Millon, T. (2011). Disorders of personality: Introducing a DSM/ICD spectrum from

normal to abnormal. Hoboken, NJ: Wiley.

Millon, T., Grossman, S., & Millon, C. (2015). Millon Clinical Multiaxial Inventory,

Fourth Edition. Minneapolis, MN: Pearson.

PearsonClinical.com/MCMI-IV

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