D. Von Zerssen, Variants of premorbid personality and personality disorder: a taxonomic model of their relationships, EUR ARCH PS, 250(5), 2000, pp. 234-248
From a biographical analysis of approximately 500 case records of patients
with various kinds of mental state tin particular mood, anxiety and schizop
hrenic) disorders, a typology of premorbid personality variants was derived
. It comprises three "affective types" dominating in patients with major af
fective disorders and three "neurotoid types" prevailing in other, above al
l anxiety and schizophrenic, disorders. These types were operationalized so
that they could be assessed by means of a diagnostically "blind" rating of
biographical case reports or of interview protocols concerning the premorb
id development of clinically remitted patients. The material for the presen
t analysis consisted of ratings regarding 120 subjects (100 patients and 20
healthy controls) who had been interviewed within a project primarily aimi
ng at the development of a novel assessment tool, the Biographical Personal
ity Interview (BPI). This data was used for constructing a comprehensive ta
xonomic model of premorbid personality variants and their relationships to
personality disorders.
The intercorrelation of type-scores representing the six premorbid personal
ity types suggests a circular order of these types, opposing the "neurotoid
types" on one side to the "affective types" on the other side of the circl
e (circumplex) along a dimension of mental abnormality vs. normality. Two t
ypes, the ("neurotoid") nervous, tense type, and the ("affective") manic ty
pe are contrasted with the ("affective") melancholic and the ("neurotoid")
anxious, insecure types along an orthogonal dimension of rather changeable
vs, rather constant habitual behaviour. This order is confirmed by the corr
elation of type-scores with factor scores of the two main dimensions of BPI
-item scores. It is also concordant with the correlation of type-scores and
scores on questionnaire scales of personality. Personality disorders as ma
ladapted extreme variants of personality can be located outside the circle
according to their similarity or dissimilarity with the six premorbid perso
nality types. They are necessarily distributed almost exclusively along the
"neurotoid" side of the circumplex. This two-dimensional model of variants
of premorbid personality and personality disorders is in basic agreement w
ith models derived from dimensions of personality in mentally healthy subje
cts and with findings concerning the comorbidity among personality disorder
s. Further empirical studies are required for choosing or developing the mo
st appropriate model of the relationships between personality variants and
personality disorders.