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8 - Psychopharmacology and Personality Disorder

Treatment or Enhancement?

from Part II - Contemporary Approaches to Traditional Conceptual Perspectives

Published online by Cambridge University Press:  25 June 2025

By
Stefan Jerotic  and
Milutin Kostic
Edited by
Konrad Banicki  and
Peter Zachar
Konrad Banicki
Affiliation:
Jagiellonian University, Krakow
Peter Zachar
Affiliation:
Auburn University, Montgomery
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Summary

An in-depth examination into the application of psychopharmacology in the treatment of personality disorders highlights the multifaceted debates about using medication for personality enhancement. Proponents argue that underlying biological disturbances might be at the heart of behavioral anomalies and psychotropics could offer remedies. There’s a perspective that positions psychopharmaceuticals as means for self-creation, allowing individuals to align their identities with their aspirations. However, counter-views voice concerns about the potential erasure of one’s genuine self and the looming societal push toward medicinal conformity. Additionally, worries about the adverse impacts of medication, including potential long-term detriment, persist. The inclination of society to prioritize personality traits while underestimating situational factors adds another layer of complexity. Central to the discourse is the nuanced relationship between different layers of self – from the intrinsic, embodied experience to the externally influenced narrative identity. Ethical dilemmas, rooted in discussions around personal authenticity versus societal norms and the provocative proposition of perceiving certain personality disorders as moral rather than medical deficiencies, emerge. We emphasize the importance of an individualized, ethically balanced approach in employing psychotropics for personality disorders.

Keywords

psychopharmacologypersonality enhancementethical dilemmas

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Type
Chapter
Information
Conceptualizing Personality Disorder
Perspectives from Philosophy, Psychological Science, and Psychiatry
 , pp. 147 - 159
Publisher: Cambridge University Press
Print publication year: 2025

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References

Aftab, A., & Ryznar, E. (2021). Conceptual and historical evolution of psychiatric nosology. International Review of Psychiatry, 33(5), 486–499.CrossRefGoogle ScholarPubMed
Bortolotti, L. (2020). Doctors without ‘disorders’. Aristotelian Society Supplementary Volume, 94, 163–184.CrossRefGoogle Scholar
Cameron, A. Y., Benz, M., & Reed, K. P. (2021). The role of guilt and shame in psychosocial functioning in a sample of women with borderline personality disorder. The Journal of Nervous and Mental Disease, 209(1), 13–16.CrossRefGoogle Scholar
Cartwright, C., Gibson, K., Read, J., Cowan, O., & Dehar, T. (2016). Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient Preference and Adherence, 10, 1401–1407.CrossRefGoogle ScholarPubMed
Charland, L. C. (2004). Personality disorders. In Radden, J. (ed.), The philosophy of psychiatry: A companion, pp. 64–77. Oxford University Press.Google Scholar
Charland, L. C. (2006). Moral nature of the DSM-IV Cluster B personality disorders. Journal of Personality Disorders, 20(2), 116–125.CrossRefGoogle ScholarPubMed
Chung, M. C. (2007). Conceptions of schizophrenia. In Chung, M. C., Fulford, K. W. M., & Graham, G. (eds.), Reconceiving schizophrenia, pp. 29–62. Oxford University Press.Google Scholar
Clark, L. A. (2005). Temperament as a unifying basis for personality and psychopathology. Journal of Abnormal Psychology, 114(4), 505.CrossRefGoogle ScholarPubMed
Cuijpers, P., Hollon, S. D., van Straten, A., Bockting, C., Berking, M., & Andersson, G. (2013). Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open, 3(4), e002542.CrossRefGoogle ScholarPubMed
d’Huart, D., Seker, S., Bürgin, D., … Schmeck, K. (2023). The stability of personality disorders and personality disorder criteria: A systematic review and meta-analysis. Clinical Psychology Review, 102, 102284.CrossRefGoogle ScholarPubMed
DeGrazia, D. (2005). Enhancement technologies and human identity. The Journal of Medicine and Philosophy, 30(3), 261–283.CrossRefGoogle ScholarPubMed
Elliott, C. (1998). The tyranny of happiness: Ethics and cosmetic psychopharmacology. In Parens, E. (ed.), Enhancing human traits: Ethical and social implications, pp. 177–188. Georgetown University Press.Google Scholar
Frances, A. (2014). Saving normal. Mariner Books.Google Scholar
Gallagher, S., & Zahavi, D. (2012). The phenomenological mind, 2nd ed. Routledge.Google Scholar
Hengartner, M. P., & Plöderl, M. (2021). Prophylactic effects or withdrawal reactions? An analysis of time-to-event data from antidepressant relapse prevention trials submitted to the FDA. Therapeutic Advances in Psychopharmacology, 11, 20451253211032052.CrossRefGoogle ScholarPubMed
Kass, L. (2003). Beyond therapy: Biotechnology and the pursuit of happiness. HarperCollins.Google Scholar
Kramer, P. D. (1994). Listening to Prozac. Fourth Estate London.Google Scholar
Kramer, P. D. (2016). Ordinarily well: The case for antidepressants. Farrar, Straus and Giroux.Google Scholar
Lebowitz, M. S. (2019). The implications of genetic and other biological explanations for thinking about mental disorders. Hastings Center Report, 49, S82–S87.CrossRefGoogle ScholarPubMed
Lebowitz, M. S., & Ahn, W. (2015). Emphasizing malleability in the biology of depression: Durable effects on perceived agency and prognostic pessimism. Behaviour Research and Therapy, 71, 125–130.CrossRefGoogle ScholarPubMed
Levy, N. (2011). Enhancing authenticity. Journal of Applied Philosophy, 28(3), 308–318.CrossRefGoogle Scholar
Moncrieff, J. (2018). Against the stream: antidepressants are not antidepressants – An alternative approach to drug action and implications for the use of antidepressants. Psychiatric Bulletin, 42(1), 42–44.Google Scholar
Munetz, M. R., & Schulz, S. C. (1986). Minimization and overreaction to tardive dyskinesia. Schizophrenia Bulletin, 12(2), 168–172.CrossRefGoogle ScholarPubMed
Neacsiu, A. D., Bohus, M., & Linehan, M. M. (2014). Dialectical behavior therapy: An intervention for emotion dysregulation. Handbook of Emotion Regulation, 2, 491–507.Google Scholar
Nisbett, R. E., & Wilson, T. D. (1977). Telling more than we can know: Verbal reports on mental processes. Psychological Review, 84(3), 231–259.CrossRefGoogle Scholar
Nosè, M., Cipriani, A., Biancosino, B., Grassi, L., & Barbui, C. (2006). Efficacy of pharmacotherapy against core traits of borderline personality disorder: Meta-analysis of randomized controlled trials. International Clinical Psychopharmacology, 21(6), 345–353.Google ScholarPubMed
Parens, E. (2013). On good and bad forms of medicalization. Bioethics, 27(1), 28–35.CrossRefGoogle ScholarPubMed
Pozzi, M., Ferrentino, R. I., Scrinzi, G., … Bravaccio, C. (2022). Weight and body mass index increase in children and adolescents exposed to antipsychotic drugs in non-interventional settings: A meta-analysis and meta-regression. European Child & Adolescent Psychiatry, 31, 21–37.CrossRefGoogle ScholarPubMed
Schermer, M. (2015). Ethics of pharmacological mood enhancement. In Clausen, J. & Levy, N. (eds.), Handbook of neuroethics, pp. 1177–1190. Springer.CrossRefGoogle Scholar
Skodol, A. E., Gunderson, J. G., McGlashan, T. H., … Morey, L. C. (2002). Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. American Journal of Psychiatry, 159(2), 276–283.CrossRefGoogle ScholarPubMed
Stein, D. J. (2008). Philosophy of psychopharmacology. Cambridge University Press.CrossRefGoogle Scholar
Stein, D. J. (2012). Psychopharmacological enhancement: A conceptual framework. Philosophy, Ethics, and Humanities in Medicine, 7(1), 5.CrossRefGoogle ScholarPubMed
Stone, M. B., Yaseen, Z. S., Miller, B. J., Richardville, K., Kalaria, S. N., & Kirsch, I. (2022). Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: Individual participant data analysis. BMJ, 378, e067606.CrossRefGoogle Scholar
Svenaeus, F. (2013). Psychopharmacology and the Self. In Fulford, K. W. M., Davies, M., Gipps, R. G. T., Graham, G., Sadler, J. Z., Stanghellini, G., & Thornton, T. (eds.), The Oxford handbook of philosophy and psychiatry, pp. 1171–1184. Oxford University Press.Google Scholar
Sylvia, T., Guy, K., Sarah, M., Julian, S., Neil, L., Miles, H., & Cowen, P. J. (2013). Beta adrenergic blockade reduces utilitarian judgement. Biological Psychology, 92(2), 323–328.CrossRefGoogle Scholar
Taylor, M. A., & Fink, M. (2006). Melancholia: The diagnosis, pathophysiology and treatment of depressive illness. Cambridge University Press.CrossRefGoogle Scholar
Tyrer, P. (2019). Nidotherapy: A cost‐effective systematic environmental intervention. World Psychiatry, 18(2), 144–145.CrossRefGoogle ScholarPubMed
World Health Organization. (2019). The ICD-11 classification of mental and behavioral disorders. https://icd.who.int/Google Scholar
Yang, M., Tyrer, H., Johnson, T., & Tyrer, P. (2022). Personality change in the Nottingham Study of Neurotic Disorder: 30-Year cohort study. Australian & New Zealand Journal of Psychiatry, 56(3), 260–269.CrossRefGoogle ScholarPubMed
Zachar, P. (2011). The clinical nature of personality disorders: Answering the neo-Szaszian critique. Philosophy, Psychiatry, & Psychology, 18(3), 191–202.CrossRefGoogle Scholar
Zachar, P. (2015). Personality disorder. Philosophical problems. In Schramme, T. & Edwards, S. (eds.), Handbook of the philosophy of medicine, pp. 1005–1024. Springer.Google Scholar

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