Impulsive phenomena, the impulsive character (der Triebhafte Charakter) and DSM personality disorders

Abstract

Impulsive phenomena have frequently been associated with personality disorders, beginning with Reich's description of the impulsive-character (Reich, 1925/1975). However, questions remain regarding the cooccurrence of a wide variety of impulsive phenomena and whether an underlying structure influences the differential association of impulses to individual personality disorders. Adults entering residential treatment for treatment-refractory disorders were interviewed about their lifetime histories of 33 impulse items, following independent diagnostic interviews. Factor analysis suggested 12 underlying dimensions of impulsive phenomena, explaining 68% of the variance. Borderline and antisocial PDs had the highest impulse scores, followed by self-defeating, narcissistic, depressive, and passive-aggressive PDs. Schizoid, avoidant, obsessive-compulsive, and dependent types were negatively associated with impulsive phenomena. Individuals with the highest impulse scores showed higher levels of borderline, antisocial and either self-defeating or passive-aggressive personality pathology, and were characterized by high Neuroticism and Openness and low Agreeableness on the NEO-FFI. Personality disorders and the NEO-FFI personality traits both predicted unique variance in impulsive phenomena, with the former predominating. Our findings bear striking similarities to Reich's (1925/1975) descriptions of the impulsive character.