Does your culture create your personality?
Personality is as much a part of human biology as a liver, yet it is understood and evaluated through society, culture, and emotions. Personality is an individual’s unique patterns of thinking, feeling, and behaving. Unlike the liver, personality is difficult to dissect and is often studied through observation of the thoughts, behaviors, and feelings reported by individuals.
Personality has been studied and characterized in many different ways but one of the most common ways to describe it is through the Five Factor Model, also known as “The Big Five.” These Five Factors of Personality are Neuroticism, Extraversion, Openness, Conscientiousness, and Agreeableness. Neuroticism is another way of describing a person’s emotional stability. Extraversion is how outgoing an individual is while Agreeableness describes someone’s ability to cooperate with others. Conscientiousness can be vaguely described as self-discipline whereas Openness refers to openness to experience. The Five Factors are used as categories with high and low values that correspond to individual personality traits. Being very extraverted, open, consciousness, and agreeable with no neuroticism is not an ideal personality state that individuals are to aspire for. The presence or absence of these factors do not indicate a disorder or a psychological problem as many agree that all humans have a personality with these characteristics in different intensities.
The Diagnostic and Statistical Manual of Mental Illness 5th (DSM 5) Edition describes a disorder of personality as problems in self-direction or identity and empathy or intimacy for a long time in many situations without the influence of a mental illness. Though there is some debate as to whether a Personality Disorder is a mental illness due to its pervasive style and inability to treat or manage like many other mental illnesses, certain types of Personality Disorders such as Borderline Personality Disorder are less impairing with appropriate management.
The International Classification of Diseases 10th Edition (ICD-10), an international compilation of illness and disease which also includes mental illnesses has a similar way of looking at Personality Disorders as the DSM 5 but it notes that disharmonious attitudes and behavior with problems in emotion control, sensitivity, impulse control, ways of relating to others, and ways of perceiving and thinking have traits that begin in childhood or adolescence and remain until adulthood. The ICD-10 also notes that “For different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations.” This is because culture is a personality made from a person’s learned, accumulated experience which is socially transmitted, or more briefly, behavior through social learning. This overlap of thoughts, behaviors, and actions on a personal and societal level has often made it complicated for mental health professionals to discern between a personality disorder and a culturally appropriate personality, particularly when they are evaluating individuals who come from a different culture.
A good way for psychiatrists to determine if someone of a different culture has a personality disorder is to look at the domains of their personality and coping through the DSM-5 Cultural Formulation Interview (CFI). The CFI is a tool intended to help health professionals gather and organize culturally relevant clinical information to determine the presence of a disorder. Understanding the culture in which someone’s personality has formed and operates as well as normal behaviors when people try to communicate to someone of a different background creates improved sensitivity for physicians and therefore, improved treatment.
Suni Jani1, MD, MPH and Raja Jani2, MHA
1 Harvard Medical School
2Touro College of Medicine
Educating Residents on Diagnosing Personality Disorders Across Cultures
Jani S, Johnson RS
Acad Psychiatry. 2015 Oct 27