By: THEODORE MILLON
et al.
The obstacles
confronting investigators engaged either in the design, execution, or interpretation
of studies of personality disorders are formidable. Numerous questions have been raised about both the methodological
adequacy of earlier research and the likelihood that these studies will prove more fruitful
in the future.
Since it is
impossible to design an experiment in which relevant variables can
systematically be controlled or manipulated, it is impossible to establish
unequivocal cause-effect relationships
among these variables and personality pathology. Investigators cannot arrange, no
less subvert and abuse, an individual or a social group for purposes of
scientific study; research in this field must, therefore, continue to be of a
naturalistic and
correlational nature. The problem that arises with naturalistic studies is
the difficulty of
inferring causality; correlations do not give us a secure base for determining
which factors were cause and which were effect. For example, correlations
between socioeconomic class and personality disorders may signify both that
deteriorated social
conditions produce mental disorders and that mental disorders result in
deteriorated social conditions.
Throughout the literature
were comments indicating the lack of definitive research to support assertions about the role of pathogenic
factors in personality pathology. That pathogenic factors of both a psychosocial and biologic
nature are significantly involved seems axiomatic to most theorists, but science
progresses not by supposition and belief but by hard facts gained through well-designed and
well-executed research. This paucity of evidence does not signify neglect on the part of
researchers; rather, it indicates the awesome difficulties involved in unraveling the
intricate interplay of influences productive of personality pathology. Despite
these apologetics, there is reason for caution in accepting the contentions of
pathogenic theorists.
We have no choice
but to continue to pursue the suggestive leads provided us both by plausible speculation and exploratory research;
difficulties notwithstanding, we must caution against
inclinations to revert to past simplifications or to abandon efforts out of dismay or cynicism. Our
increasing knowledge of the multi-determinant and circular character of
pathogenesis, as well as the inextricable developmental sequences through which it proceeds,
should prevent us from falling prey to simplifications that led early theorists to attribute
personality pathology to single factors. Innumerable pathogenic roots are possible; the
causal elements are so intermeshed that we must plan our research strategies to
disentangle not isolated determinants but their convergencies, their interactions,
and their continuities.
References
Personality Disorders in Modern Life,
second edition, 2000, 2004 by John Wiley & Sons, Inc.
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