 35. Personality and Psychopathology  745
ner, & Wilson, 2012; Mullins-  Sweatt et al., 
2019; Tackett, Daoud, et al., 2013; Tackett 
et al., 2014). Associations with extraversion 
and openness to experience, and externaliz -
ing psychopathology, tend to be more mixed 
(Kotov et al., 2010; Tackett, Daoud, et al., 
2013).
Finally, thought disorder, or psychosis, has 
been less extensively investigated relative to 
normal-  range personality traits, in part be -
cause these symptoms are much less common 
in the larger population. However, this do -
main of psychopathology has been the cen -
ter of some debate around whether psycho -
sis is dimensionally related to normal-  range 
openness to experience or a fully distinctive 
component from openness to experience 
(e.g., Chmielewski, Bagby, Markon, Ring, 
& Ryder, 2014; De  Young, Grazioplene, 
& Peterson, 2012; Tackett, Silberschmidt, 
Krueger, & Sponheim, 2008). Beyond the 
extensive discussions around associations 
between psychosis and openness to experi -
ence, psychosis appears to be associated with 
higher levels of neuroticism and lower levels 
of extraversion (Dinzeo & Docherty, 2007).
Why Is Personality Related 
to Psychopathology?
There are four major models of the etiology, 
nature, and implications of the relation -
ship between personality and psychopa -
thology: scar–  complication, vulnerability–  
risk, pathoplasty,  and spectrum–  continuum  
models (Krueger & Tackett, 2003; South, 
Eaton, & Krueger, 2011; Tackett, 2006; Wi -
diger & Smith, 2008). Each of these mod -
els is discussed in more detail, but it should 
be noted that there is no consensus about 
which model provides the best explanation 
for these relationships, and the models are 
not mutually exclusive (Clark, 2005).
Scar–Complication
The scar and complication models suggest 
that the experience of psychopathology 
leads to change in premorbid personality 
functioning; that is, the psychopathology 
experience essentially “scars” the underly -
ing personality. For example, premorbid traits of dependency, introversion, and neu -
roticism might be increased following the 
occurrence of multiple major depressive epi -
sodes (Shea & Yen, 2005; Tackett, 2006). 
Unfortunately, there are very few empirical 
studies of this model.
Vulnerability–Risk
The vulnerability or risk model hypothesizes 
that preexisting personality traits predispose 
an individual to develop particular mental 
disorders. For example, individuals high in 
neuroticism and low in extraversion are more 
likely to experience anxiety disorders, major 
depressive disorder, and attempted suicide, 
while individuals low in conscientiousness 
are more likely to engage in antisocial be -
haviors and have substance use problems 
(Tackett, 2006). Similarly, neuroticism may 
be a predisposing vulnerability that contrib -
utes to the development and presentation of 
borderline personality disorder (BPD) symp -
toms in adulthood (Barlow, Sauer-  Zavala, 
Carl, Bullis, & Ellard, 2014; Skodol et al., 
2002; Widiger, 2005). In fact, neuroticism 
has been demonstrated to be an early vulner -
ability factor for many disorders—  notably, 
for not only major depression (e.g., Fanous, 
Neale, Aggen, & Kendler, 2007; Kendler, 
Neale, Kessler, Heath, & Eaves, 1993) but 
also for schizophrenia (van Os & Jones, 
2001). A key aspect of the vulnerability–  risk 
model is that the earlier personality traits are 
conceptualized as qualitatively distinct from 
the later psychopathology they predispose 
an individual to develop. Thus, the “pres -
ence” of the earlier personality trait places 
an individual at elevated risk for developing 
the disorder later in life.
Pathoplasty
In contrast to the vulnerability model, the 
pathoplasty model does not assume that per -
sonality traits predict the onset of psycho -
pathology. Instead, the pathoplasty model 
suggests that once psychopathology occurs, 
personality traits impact the presentation, 
course, and severity of the disorder (Widiger 
& Smith, 2008). An example might be the 
increased suicide risk in an individual with 
major depressive disorder who also has high 