Religion and Spirituality in Psychiatry

176 Ralph L. Piedmontits score. This parsing ability is perhaps the mostimportant feature of the FFM. It enables oneto avoid what Block (14) has referred to as the“jingle and jangle fallacies.” These terms refer to,respectively, the tendency to see scales as beingsimilar, or different, on the basis of their labelrather than on any empirical evidence. The formerterm sees convergence where none may exist,and the latter term allows useless redundancy todevelop. Perhaps the least useful place to lookfor a scale’s meaning is its name. Unfortunately,these “fallacies” too often characterize the field ofassessment.One case in point relates to research thatexamined the relationship between Type Apersonality styles and coronary heart disease(CAD). The Type A Behavior Pattern (TABP)was an identified aspect of personality that wasrelated to actual physical illness.(15) The timepressured,high-achieving, hyper-alert mentalcondition that characterized the TABP seemedto lead men to develop fatal heart problems.Although early research was supportive of thelink between TABP and CAD, later studies failedto find consistent relationships between the personalitystyle and health. What was identifiedas the “toxic component” to CAD was angerand hostility. Individuals having problems withexpressing anger in healthy ways seemed mostat-risk. But even here, the relationship was notalways observed; some measures of anger seemedto predict CAD, but others did not. It was notuntil various measures of anger were examinedwithin the context of the FFM that the puzzle wasfinally solved.It turned out that there are two types of anger.One type, characterized by emotional outburstsof screaming, yelling, and emotional upset isfrequently seen when someone gets frustrated oris provoked by another. The other type of angerdoes not show any type of negative emotionalarousal but rather reflects the malevolent attitude,“You hurt me and I will hurt you more.”One type of anger is affective in nature and theother more interpersonal and attitudinal. Whencorrelated with the FFM measures, the first typerelated strongly with neuroticism (reflecting thepresence of negative affect), while the secondtype correlated with low agreeableness (reflectinga very cynical, self-centered, mistrustful orientation).Surprisingly, it is the second type ofanger, related to low agreeableness that is relatedto CAD.(16) By mapping these measures of angeronto the dimensions of the FFM, we were ableto develop a more sophisticated and nuancedunderstanding of what is meant by anger .Although there are many scales that carry thelabel anger , they are not all measuring the sameconstructs. There are different types of anger,each with their own very different psychologicaland health-related implications. The FFM helpsus to clarify what our constructs measure andgives us a language for thinking more preciselyabout personality.3. THE FFM AND THE PERSONALITYDISORDERSBecause PDs represent enduring patterns thatcharacterize an individual’s long-term functioning,it seems reasonable to conclude that suchmaladaptive patterns would be related to one’sunderlying personality structure. Much has beenwritten concerning the linkages between the FFMand the PDs and the numerous conceptual issuesassociated with these comparisons (see Costa &Widiger (17) for an overview). Suffice it for ourpurposes to note that associations between theFFM and the PDs provide two points of interest.First, associations between these two sets of constructsdemonstrate that personality disordersrepresent more extreme variants of the normalpersonality dimensions. The FFM dimensionsrepresent a robust and economical set of personologicalqualities that are useful for understandingadaptive and nonadaptive aspects offunctioning. Second, the pattern of correlationsbetween the FFM domains and the PD dimensionscan, as noted above with anger, help toelaborate the kinds of temperaments underlyingthese disorders. Such information can facilitatedifferential diagnosis and enhance therapy byidentifying relevant etiological factors and anticipatingtreatment issues.