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03-10 How personality affects mental health

How personality affects mental health

All people have a characteristic style of thinking, feeling and behaving that makes them unique. The set of distinct traits, behavioral and relational styles, and thought processes that influence who we are, and how we perceive ourselves and the world around us all comprise our personalities, which develop when we are young and persist throughout our lives. It has become increasingly clear that certain personality traits can make people more prone to developing certain mental health outcomes such as anxiety and depression.

Personality disorders are mental disorders characterized by the presence of stable and consistent pathological personality traits that lead to significant impairments in self and interpersonal functioning. There are several distinct types of personality disorders that can affect how a person functions in several aspects of life. For example, people with paranoid personality disorder may be overly suspicious or distrustful of others, while people with narcissistic personality disorder hold beliefs that they are more special or important than others.

There are different types of personality disorders grouped into three main clusters based on their similarities in symptoms and characteristics:

  • Cluster A: odd, eccentric thinking or behavior (i.e., paranoid, schizotypal and schizoid personality disorders)
  • Cluster B: overly dramatic, emotional or unpredictable (i.e., antisocial, borderline, histrionic and narcissistic personality disorders)
  • Cluster C: anxious or fearful (i.e., avoidant, dependent and obsessive-compulsive personality disorders)

What causes personality disorders?

As with mental illness, an individual’s distinct personality traits and vulnerability for developing personality disorders both appear to be influenced by genetic and environmental factors. For example, parents may pass down to their children certain personality traits that can increase their vulnerability for developing personality disorders.

Although it is still unclear how personality disorders develop, genetics research has been helpful for identifying some of the biological factors that may influence the development of personality disorders. Recent research has found evidence for the role of certain gene variations, or differences, in regulating social behaviors through changes in sex hormones including oxytocin and testosterone.

Personality disorders are more likely to occur when a person has certain risk factors present:

  • Family history of mental illness
  • Low socioeconomic status and education level
  • Childhood verbal, physical or sexual abuse or neglect
  • Childhood diagnosis of conduct disorder
  • Sexual trauma (during childhood or adulthood)
  • Variations in brain chemistry and structure

Early in life, certain environmental factors, including our surroundings, certain life situations and relationships with others, can impact our personalities and contribute to the development of certain mental health conditions, including personality disorders. While genes are considered to increase a person’s vulnerability for personality disorders, these environmental factors are important for triggering their actual development.

Among all the risk factors, childhood trauma is most often linked to personality disorders. One study found that sexual trauma during childhood or adulthood increased participants’ vulnerability for developing borderline personality disorder. Another study found that participants who had experienced verbal abuse during childhood were three times more likely to have borderline, narcissistic, obsessive-compulsive and paranoid personality disorders during adolescence or early adulthood, compared to those who did not experience verbal abuse.

Impact of personality traits on mental health

The “Big Five” or the Five-Factor model of personality includes five major dimensions that describe individual differences in personality. In the “Handbook of Personality,” third edition, Oliver P. John, Ph.D., professor at University of California, Berkeley, and his colleagues described the five major personality dimensions (Page 120):

  • Openness to experience — describes an individual’s mental and experiential life and the tendency to be imaginative, creative and original
  • Conscientiousness — describes socially prescribed impulse control (i.e., thinking before acting, delaying gratification, following the rules, etc.) and the tendency to be organized, persistent and reliable
  • Extraversion — tendency to be warm, sociable, active, emotionally positive and cheerful
  • Agreeableness — the energetic approach toward the social and material world and includes traits of interpersonal relatedness (e.g., altruism, trust, modesty, cooperativeness)
  • Neuroticism — contrasts emotional stability with negative emotionality and the tendency to experience negative emotions (i.e., feeling anxious, sad and tense)

Neuroticism is a specific personality trait that has been associated with an increased vulnerability for mental health problems. This is because individuals who are high in neuroticism often tend to feel anxious, nervous, sad and tense, and are emotionally sensitive and highly self-critical, and exhibit heightened needs for approval and achievement. For example, studies have found that young people who are high on neuroticism are more likely to develop anxiety, substance use and depressive disorders.

Certain personality traits have also been associated with substance use. A study conducted by Antonio Terracciano and colleagues from the National Institute on Aging at the National Institutes of Health (NIH) and Johns Hopkins Bloomberg School of Public Health found that people who used tobacco, cocaine and heroin exhibited lower scores on conscientiousness and higher scores on neuroticism, while those who used marijuana scored high on openness to experience, average on neuroticism, but low on agreeableness and conscientiousness.

This study highlighted the importance of certain personality traits on drug use, especially the association between high levels of negative affect and impulsive traits, and low conscientiousness and agreeableness. In general, patients with personality disorders tend to exhibit low frustration tolerance, externalize blame for psychological distress and have impaired impulse control, which makes them more prone to high-risk behaviors and mental health problems.

Treating personality disorders

Pathological personality traits become largely ingrained in an individual’s personality, making these disorders very difficult to treat. Furthermore, many people with personality disorders do not seek treatment unless they are aware that their personality is dysfunctional. The treatment options available to people with personality disorders usually depend on the type of personality disorder and whether there are any comorbid disorders present.

In general, treatment of personality disorders often includes long-term (i.e., 6 months or longer) psychotherapy, cognitive behavior therapy (CBT), interpersonal therapy and group therapy. Dialectical behavior therapy (DBT) is a type of cognitive behavioral treatment that helps to reduce self-harm behaviors and improve coping with emotional instability, and has been very successful for treating patients with borderline personality disorder (BPD). While there are no medications available for treating patients with personality disorders, certain medications may be prescribed to treat co-occurring mental health problems, such as antidepressants for comorbid depression.

Personality plays an important role in our mental health, and certain personality traits can contribute to the development of certain behavioral disorders such as anxiety, substance abuse and depression. Untreated personality disorders can lead to considerable distress for patients. The Sovereign Health Group offers evidence-based treatments, including CBT and DBT, for mental health problems such as personality disorders.

Sovereign Health’s Rancho San Diego facility provides comprehensive behavioral health treatment programs that are individualized to meet the specific needs of adolescents with emotional and behavioral problems. If you or a loved one is affected by a personality disorder and/or a co-occurring disorder, or for more information about the programs offered at our Rancho San Diego facility, please contact our 24/7 helpline for further assistance.

About the author

Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at

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