Assessment of maladaptiveness: a core issue in the diagnosing of personality disorders

Although an operationalized and commonly accepted definition of maladaptiveness is lacking, the delineation of personality traits as being adaptive or maladaptive is essential in diagnosing personality disorders (PDs). A way to explore the meaning of maladaptiveness is to compare how patients from all DSM-III-R PDs relate to different traits and dimensions of various dimensional models of personality. In the present study, the Karolinska Scales of Personality (KSP) were used in a sample of 94 psychiatric outpatients who were assessed according to severity of maladaption and according to type of predominant cluster type of deviant traits. Only one of four factors of the scores of the KSP subscales, "Interpersonal Aversiveness," was related to degree of maladaption, indicating high detachment, suspicion, irritability, dysphoria, and low socialization as core features of maladaptiveness. Three subscales of the KSP Socialization were all associated with maladaptiveness. However, one subscale, "Childhood Adjustment," was also related to the predominant cluster type of personality pathology.