The development and maintenance of personality disorders: A behavioral perspective.

The current review is concerned with the development and maintenance of personality disorders from a behavior analytic approach. At first glance, a discussion of the concept of personality in general from a behavior analytic perspective appears somewhat contradictory. Below, however, we consider personality and extreme variants of it that result in disordered (i.e., maladaptive) behavior from such a perspective. Specifically, following a review of basic behavioral principles and an attempt to integrate personality concepts within these principles, we review development and maintenance factors associated with personality disorders as defined within the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR, American Psychiatric Association [APA], 2000). Following, we provide examples of our model for avoidant and borderline personality disorders to demonstrate its utility. First, however, we must define what we consider behavior. What Is Behavior? We define behavior as anything a person does, which includes overt and covert forms. Overt behaviors refer to behaviors that are publicly observable, such as verbal (e.g., speaking) or physical (e.g., muscle movement) output. Thus, overt behaviors are public events that can be reported by one or more observers. Covert behaviors, conversely, refer to behaviors that are privately observable and occur within the person, such as feeling, thinking, and physical sensations. Thus, covert behaviors are sometimes referred to as private events. Covert behaviors are observable only to the person him or herself (e.g., experiencing a thought such as "I'll never be good at this") and are not subject to public observation. This distinction between overt and covert forms of behavior (i.e., whether or not the behavior is subject to public observation), however, is of little importance from a behavior analytic perspective as overt and covert behaviors are affected by reinforcement and punishment processes in the same way (Baum, 2005). Indeed, as cited in Baum (2005), Skinner (1969) supported the experience of covert behaviors as behavior in stating that "The skin is not all that important as a boundary" (p. 228). Another example of behavioral definitions that are inclusive of thoughts and feelings as behavior includes Lang's (1968) conceptual division of anxiety. Lang divided anxious behavioral responses into three types: motor, psycho-physiological, and cognitive-verbal. First, motor behaviors involve behaviors characterized by activation of skeletal muscle systems. Second, psycho-physiological behaviors involve hormonal activity or automatic nervous system activity. Finally, cognitive-verbal behaviors involve thoughts, attitudes, or beliefs. Whereas the motor and psycho-physiological arousal behavioral responses are overt behaviors that are subject to public observation, cognitive-verbal responses and emotional responses can include covert behaviors as well. Thus, despite making a distinction between types of responses, much like covert and overt behaviors, Lang considered all of these responses to be behavior. These forms of behavior are the building blocks of personality. Personality as a Composite of Complex Behavioral Repertoires Personality can be conceived as consisting of several complex behavioral repertoires. These repertoires include: instrumental or motor behaviors, emotional-motivational behaviors, and language-cognitive behaviors (Staats, 1975, 2003). Instrumental or motor behaviors include athletic skills, social skills, occupational activities, and house keeping skills, to name a few. Emotional-motivational behaviors include experienced emotion (such as love, hate, anxiety), as well as physiological correlates of emotion. According to Staats (1975), these emotional-motivational behaviors serve three purposes: they contribute to the person's attitude, determine reinforcers or punishers for the individual, and direct the person's behavior toward or away from certain consequences. …