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Important changes have been occurring in the clinical psychology literature that are relevant to how maladaptive personality characteristics are conceptualized, measured, and used in workplace applications. We aim to clarify distinctions among maladaptive personality traits, measures of maladaptive personality constructs, and their behavioral consequences at work. In pursuing a connection between the industrial–organizational (I–O) and clinical psychology literatures on maladaptive personality, we distinguish maladaptive constructs, maladaptive measures, and maladaptive work behaviors. Conceptual clarification and linguistic precision are essential, as their distinctions are not merely academic but have important consequences for workplace research and practice.

Maladaptive Traits Are Maladaptive Personality Constructs

  1. Top of page
  2. Maladaptive Traits Are Maladaptive Personality Constructs
  3. Maladaptive Traits Are Assessed Using Maladaptive Personality Measures
  4. Distinguishing Between Maladaptive Traits and Behaviors in Work Settings
  5. Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use
  6. References

The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA, 2013) includes a new section on emerging measures and models (Section III) that is intended to inform and advance its traditional categorical psychiatric diagnostic criteria and codes based on mounting research evidence.1 As Narrow et al. (2013, p. 80) noted, “the cross-cutting symptom measures tested in the DSM-5 Field Trials represent a first step in moving psychiatric diagnosis away from solely categorical descriptions toward assessments that recognize different levels of symptom frequency and intensity.” By indexing an individual's level of a given maladaptive tendency, this new dimensional approach aligns psychopathological diagnoses, previously conceptualized as categories, with psychometric assessment instruments tied to dimensional conceptualizations of personality variation.

Maladaptive traits reflect extremes of normal-range personality constructs (O'Connor & Dyce, 2001; Widiger & Costa, 1994). Personality constructs range between maladaptive positive and negative extremes, with the middle normal range representing typical (i.e., “normal”) traits. Current research shows that a similar organizational structure underlies normative and maladaptive personality constructs (Widiger & Simonsen, 2005). Empirical evidence supports a personality structure incorporating psychopathological variants of the Big Five factors (Markon, Krueger, & Watson, 2005; Wright & Simms, in press). Structural equation's modeling of maladaptive range traits yields the maladaptive Big Five (see Krueger, Derringer, Markon, Watson, & Skodol, 2012; Krueger & Markon, in press, for summaries and examples).

Similar to their normative counterparts, the maladaptive Big Five are hierarchically organized, ranging from relatively specific (e.g., anxiety proneness) to relatively broad (e.g., neuroticism/dispositional negative affect). Figure 1 provides an overview of personality structure in the maladaptive range. Wright et al. (2012) have presented evidence supporting this model using data on the structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012). The general factor at the apex of the hierarchy is even broader than the internalizing and externalizing maladaptive personality constructs (De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006; Krueger, 1999).2 Lower-order maladaptive range Big Five constructs emerge from higher-order constructs. Finally (not depicted in Figure 1), even more specific traits exist at lower levels of the personality hierarchy. These traits include both lower-order primary (pure) maladaptive facet markers and some compound (i.e., interstitial, blended) traits.3

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Figure 1. A hierarchical model of maladaptive personality. Note. Constructs are arranged hierarchically based on their breadth/specificity. Figure modified and adapted from Krueger and Markon (in press).

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Table 1 lists the DSM-5 maladaptive personality constructs, their definitions, and facet/compound indicators on the PID-5, as well as their Big Five linkages. Personality construct space is characterized by hierarchy, lack of simple structure (resulting in interstitiality [some primary traits indicating more than a single Big Five domain]), and bipolarity. The appearance of structure can be affected by differences in the range covered by specific measures (Krueger et al., 2011). Polarity and range distinguish maladaptive from normal personality constructs.

Table 1. DSM-5 Maladaptive Personality Constructs, Big Five Linkages, and Corresponding Indicators on PID-5
DSM-5 maladaptive personality constructsSubscales of PID-5DefinitionsBig Five linkages
  1. Note. For each maladaptive personality construct, subscales are listed in the order of their respective loading on the primary factor (based on Krueger et al., 2012; N = 1,128). For definitions of maladaptive personality constructs and PID-5 subscales: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013). American Psychiatric Association. All Rights Reserved.

Negative affect:Frequent and intense experiences of high levels of a wide range of negative emotions (e.g., anxiety, depression, guilt/shame, worry, anger) and their behavioral (e.g., self-harm) and interpersonal (e.g., dependency) manifestations.Emotional Lability“Instability of emotional experiences and mood; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.”ES−
Anxiousness“Feelings of nervousness, tenseness, or panic in reaction to diverse situations; frequent worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful and apprehensive about uncertainty; expecting the worst to happen.”ES−(weak secondary loading on detachment, EX−)
Restricted affectivity“Little reaction to emotionally arousing situations; constricted emotional experience and expression; indifference and aloofness in normatively engaging situations.”ES−(strong secondary loading on detachment, EX−)
Separation insecurity“Fears of being alone due to rejection by- and/or separation from- significant others, based in a lack of confidence in one's ability to care for oneself, both physically and emotionally.”ES−
Hostility“Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior.”ES−(similar loading on antagonism, A-; weaker secondary loadings on disinhibition, C− and detachment, EX−)
Perseveration“Persistence at tasks or in a particular way of doing things long after the behavior has ceased to be functional or effective; continuance of the same behavior despite repeated failures or clear reasons for stopping.”ES−(secondary loading on psychoticism)
Submissiveness“Adaptation of one's behavior to the actual or perceived interests and desires of others even when doing so is antithetical to one's own interests, needs, or desires.”ES−
Detachment: Avoidance of socioemotional experience, including both withdrawal from interpersonal interactions (ranging from casual, daily interactions to friendships to intimate relationships) and restricted affective experience and expression, particularly limited hedonic capacity.Withdrawal“Preference for being alone to being with others; reticence in social situations; avoidance of social contacts and activity; lack of initiation of social contact.”EX−
Anhedonia“Lack of enjoyment from, engagement in, or energy for life's experiences; deficits in the capacity to feel pleasure or take interest in things.”EX−(secondary loading on disinhibition, C−)
Depressivity“Feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame and/or guilt; feelings of inferior self-worth; thoughts of suicide and suicidal behavior.”EX−(secondary loadings on negative affect, ES− and disinhibition, C−)
Intimacy Avoidance“Avoidance of close or romantic relationships, interpersonal attachments, and intimate sexual relationships.”EX−
Suspiciousness“Expectations of—and sensitivity to—signs of interpersonal ill-intent or harm; doubts about loyalty and fidelity of others; feelings of being mistreated, used, and/or persecuted by others.”EX−(secondary loading on negative affect, ES−)

Antagonism:

Behaviors that put the individual at odds with other people, including an exaggerated sense of self-importance and a concomitant expectation of special treatment, as well as a callous antipathy toward others, encompassing both an unawareness of others' needs and feelings, and a readiness to use others in the service of self-enhancement.

Manipulativeness“Use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one's ends.”A−
Deceitfulness“Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events.”A−(secondary loading on disinhibition, C−)
Grandiosity“Believing that one is superior to others and deserves special treatment; self-centeredness; feelings of entitlement; condescension toward others.”A−
Attention Seeking“Engaging in behavior designed to attract notice and to make oneself the focus of others' attention and admiration.”A−
Callousness“Lack of concern for the feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one's actions on others.”A−(secondary loading on disinhibition, C−)

Disinhibition:

Orientation toward immediate gratification, leading to impulsive behavior driven by current thoughts, feelings, and external stimuli, without regard for past learning or consideration of future consequences.

Irresponsibility“Disregard for—and failure to honor—financial and other obligations or commitments; lack of respect for—and lack of follow-through on—agreements and promises; carelessness with others' property.”C−
Impulsivity“Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans; a sense of urgency and self-harming behavior under emotional distress.”C−
Rigid Perfectionism“Rigid insistence on everything being flawless, perfect, and without errors or faults, including one‘s own and others’ performance; sacrificing of timeliness to ensure correctness in every detail; believing that there is only one right way to do things; difficulty changing ideas and/or viewpoint; preoccupation with details, organization, and order.”C+(substantial loadings on negative affect, ES−; detachment, EX−; antagonism, A−; and psychoticism)
Distractibility“Difficulty concentrating and focusing on tasks; attention is easily diverted by extraneous stimuli; difficulty maintaining goal-focused behavior, including both planning and completing tasks.”C−(similar loadings on negative affect, ES−and psychoticism)
Risk Taking“Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences; lack of concern for one's limitations and denial of the reality of personal danger; reckless pursuit of goals regardless of the level of risk involved.”C−(similar loadings on psychoticism and low detachment (i.e., EX+)

Psychoticism:

Exhibiting a wide range of culturally incongruent odd, eccentric, or unusual behaviors and cognitions, including both process (e.g., perception, dissociation) and content (e.g., beliefs).

Unusual Beliefs and Experiences“Belief that one has unusual abilities, such as mind reading, telekinesis, thought-action fusion, unusual experiences of reality, including hallucination-like experiences.”OE+(high experiencing facet)
Eccentricity“Odd, unusual, or bizarre behavior, appearance; and/or speech; having strange and unpredictable thoughts; saying unusual or inappropriate things.”OE+(high experiencing facet)
Cognitive and perceptual dysregulation“Odd or unusual thought processes and experiences, including depersonalization, derealization, and dissociative experiences; mixed sleep-wake state experiences; thought-control experiences.”OE+(high experiencing facet)

Maladaptive Traits Are Assessed Using Maladaptive Personality Measures

  1. Top of page
  2. Maladaptive Traits Are Maladaptive Personality Constructs
  3. Maladaptive Traits Are Assessed Using Maladaptive Personality Measures
  4. Distinguishing Between Maladaptive Traits and Behaviors in Work Settings
  5. Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use
  6. References

Although normal and maladaptive personality traits are variants of the same Big Five constructs, most measures of the Big Five do not have the content or sensitivity to assess the entire range of each construct (e.g., Samuel, Simms, Clark, Livesley, & Widiger, 2010; Stepp et al., 2012; Walton, Roberts, Krueger, Blonigen, & Hicks, 2008). To measure the extreme (nonnormal) range and poles of the maladaptive Big Five, facets, and compounds, items designed to reflect their disordered and pathological content are necessary. Content is affected in terms of valence and extremity of the item indicators. First, item content of normal personality measures tends to be tilted to have greater positive valence, whereas maladaptive measures have item content tilted toward higher negative valence (Watson, Stasik, Ro, & Clark, 2013). Second, as extremity of the maladaptive range is increased, content of the personality measure necessarily becomes more extreme to capture the degree of impairment. For example, a maladaptive Neuroticism item on the PID-5 (item #178) inquires after the respondent's belief that he or she will eventually commit suicide. A maladaptive Openness item (item #150) explicitly indexes thought projection (influencing others with one's own thoughts). Items with such extreme content are not typically found (or desired) on normal adult personality measures.

There are measures that have been constructed or used to assess maladaptive personality constructs for workplace applications. Although the item content on such instrumentation falls somewhere between normal and maladaptive personality measures, these measures either are mostly tethered to DSM-IV's personality disorders in their entirety (e.g., the Hogan Development Survey [HDS], see Hogan & Hogan, 1997) or focus on specific personality disorders (e.g., psychopathy, narcissism, Machiavellianism; see O'Boyle, Forsyth, Banks, & McDaniel, 2012). Two observations are in order: the HDS omits substantial content from DSM-5's negative affect and psychoticism constructs as well as some specific detachment constructs. Second, both HDS scales and so-called “dark triad” indicators assess compound traits.

The extreme content of maladaptive trait measures has consequences for their psychometric properties. Indeed, there are more profound and consequential distinctions between adaptive (normal) and maladaptive (abnormal) measures than between constructs. Items on maladaptive measures tend to have high discriminations (item response function parameter a) around the more extreme ranges of traits being assessed (their maladaptive factor saturation is higher). In contrast, normal personality measure items are more strongly related to the normal ranges of the underlying constructs, with corresponding normal range factor saturation. In maladaptive personality measurement, item and test difficulty also appropriately shift to the targeted extreme of the latent trait distribution. Item difficulties (item locations—item response function parameter b) of maladaptive measures tend to be more extreme. In normal, working samples, some ceiling or floor effects (for positive/negative poles of the Big Five, respectively) can be anticipated. The result can be a nonnormal distribution of the manifest measure. Tall and narrow item/test information functions (i.e., high precision, low range) of typical maladaptive measures indicate lost information in the normal range of personality traits. Overall, then, item and test information functions (e.g., item and test measurement precision provided at all levels of the underlying construct) differ significantly between normal and maladaptive personality measures. The ability of these measures to differentiate among individuals is most sensitive at different portions of the trait continuum—with important implications for their applied usefulness in I–O psychology.

Use of static instrumentation of a manageable length may be a limiting factor in fully assessing the entire range of any given construct. Reliable assessment of personality traits over a broader range of the underlying constructs can be achieved through sophisticated test construction (see Krueger, Derringer, Markon, Watson, & Skodol, 2011). Computer adaptive personality testing may offer a dynamic solution (Simms et al., 2011). Measures built using latent trait models have the potential to encompass the entire range of constructs, blurring distinctions between normal and maladaptive measures.

Static maladaptive personality assessments developed without the benefits of latent trait models and with their typical tall and narrow item/test information functions (high precision, low range) have psychometric and predictive consequences. The following are some examples:

  1. Content of measures of the same latent trait may differ (e.g., being even-tempered vs. feeling depressed and anxious, reflecting the positive pole of Emotional Stability and high negative affect, respectively).
  2. Measurement errors of tests assessing different portions of the normal-maladaptive continuum differ. Normal measures have lower error in normal, whereas maladaptive measures have lower error in extreme, abnormal ranges of the trait.
  3. Convergent validity is higher among personality measures assessing the same portions of the trait continuum. Accordingly, maladaptive measures of the same trait will display higher convergence than maladaptive and normal measures of the same trait.
  4. Consequently, normal and maladaptive measures of the same trait will yield incremental validity over each other, even though they tap different ranges of the same trait.
  5. Predictive usefulness of traditionally developed maladaptive personality assessments among normal individuals may be hampered: Nonnormal maladaptive score distributions will achieve their maximal predictive validity when criteria are similarly nonnormally distributed.4

Distinguishing Between Maladaptive Traits and Behaviors in Work Settings

  1. Top of page
  2. Maladaptive Traits Are Maladaptive Personality Constructs
  3. Maladaptive Traits Are Assessed Using Maladaptive Personality Measures
  4. Distinguishing Between Maladaptive Traits and Behaviors in Work Settings
  5. Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use
  6. References

Broadly speaking, maladaptive behaviors in the context of work are those behaviors that inhibit normal occupational functioning. Such behaviors may be indicative of (a) psychological dysfunctions in work life and (b) detriments in global job performance or its facets (e.g., task performance, citizenship behaviors, counterproductive work behaviors [CWB]). They encompass individual-level behaviors that hinder employees from achieving their full employment potential. Although it may be tempting to equate maladaptive work behaviors with CWB, they are not synonymous. CWB are “scalable actions and behaviors that employees engage in that detract from organizational goals or well-being. They include behaviors that bring about undesirable consequences for the organization or its stakeholders” (Ones & Dilchert, 2013). Although most maladaptive behaviors detract from organizational goals and well-being, there are many that simply detract from the employee's personal goal achievement and adjustment. That is, maladaptive behavior may be either maladaptive only for the individual performing it or both personally and organizationally maladaptive (“counterproductive”). This conceptual distinction has implications for organizations' ethical and legal responsibilities related to personnel staffing.

Behaviors should be considered maladaptive when they hinder positive personal occupational behavior such as job performance, as well as extrinsic success (e.g., achievements in career progression, compensation growth) or intrinsic success (e.g., personal growth, satisfaction). For example, maladaptive behaviors such as self-injurious behaviors (e.g., self-biting, cutting, hair pulling), ritualistic behaviors (e.g., obsessive hand washing), and aberrant behaviors can affect personal success and well-being at work but cannot reasonably be included among CWB. When such behaviors do not prevent the employee from fulfilling essential functions of their job, screening for traits at the root of these behaviors becomes problematic (see below). On the other hand, inappropriate interpersonal behaviors (e.g., swearing, screaming), property destruction, and aggression (e.g., hitting others) are both maladaptive and counterproductive at work, and organizations have legitimate reasons for predicting and preventing them.

Maladaptive traits can be expected to predict appropriately matched maladaptive behaviors in the workplace. Maladaptive traits can also relate to job performance at the global and facet levels (see Guenole, 2014, for an overview). The DSM-5 maladaptive personality constructs antagonism and disinhibition predict CWB. Some maladaptive range traits (e.g., risk taking, distractibility) can give rise to poor task performance. Others can impact employability (Hogan, Chamorro-Premuzic, & Kaiser, 2013) as in the case of psychotic incapacitation (e.g., due to cognitive and perceptual dysregulation) or severe interpersonal problems (e.g., due to withdrawal; see Table 1).

Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use

  1. Top of page
  2. Maladaptive Traits Are Maladaptive Personality Constructs
  3. Maladaptive Traits Are Assessed Using Maladaptive Personality Measures
  4. Distinguishing Between Maladaptive Traits and Behaviors in Work Settings
  5. Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use
  6. References

Several important issues need to be addressed regarding the use of maladaptive personality measures in employment contexts, including operational appropriateness, utility, and legality. First, from an organization's point of view, should possessing a maladaptive trait disqualify an individual from employment? This is a question of personnel screening rather than selection. The answer depends on the work to be performed. Staffing decisions must be based on work-relevant characteristics. It is possible to use job analytic approaches to identify maladaptive traits relevant to specific jobs. They can be linked to job competencies, to behavior that disrupts workplace functioning, as well as to job performance and its facets. The maladaptive personality constructs from the DSM-5 emerging model can serve as a starting point for such job analytic investigations. Yet, we expect few maladaptive traits to be universally applicable as disqualifiers (one exception may be the externalizing traits of irresponsibility and deceitfulness).

The second question is one of utility. Most individuals seeking jobs score in the normal range of most personality constructs. Utility of employee selection systems is maximized when measures have high predictive validity and large numbers of individuals can be distinguished from one another with good precision. Thus, the ability of measures to reliably assess differences among individuals in the normative range is essential, something that normal range personality measures do well. Maladaptive constructs can be measured by normal range personality measures (e.g., Wille, De Fruyt, & De Clercq, 2013). However, maladaptive measures provide unique value in cases where an extreme range of the trait needs to be evaluated with good reliability and therefore precision. Screening applications (i.e., eliminating job applicants who pose a risk due to their extreme trait level) call for precision at extreme poles of constructs.

The third question is one of legality. In the United States, the Americans with Disabilities Act (ADA) prohibits the use of medical examinations in preemployment settings. The EEOC ADA Enforcement Guidance clarifies when a test is considered a “medical examination” and the conditions under which it can be used. Medical examinations include tests that seek “information about an individual's physical or mental impairments or health.” Based on EEOC guidance, maladaptive measures can be considered medical examinations, especially when they are designed to reveal mental health and are normally given in medical settings. Even though high standing on any maladaptive trait, as revealed by scores on normal or maladaptive measures, is not sufficient to make a specific psychiatric diagnosis per the DSM-5, trained professionals (i.e., clinical psychologists and psychiatrists) can discern patterns of psychological dysfunction from scores on maladaptive personality inventories. These legal aspects might limit the use of some maladaptive measures in preemployment settings in the United States, even if such measures are not scored or considered until later in the hiring process.5 However, employers may require medical examinations under certain circumstances following a conditional job offer: At that stage, maladaptive measures administered to all applicants in a given job category are legitimate if they result in screenings that are job-related and consistent with business necessity.

Although not a means of circumventing ADA-related requirements regarding disability-related inquiries, one innovative way to assess maladaptive personality traits is through the use of others' ratings on these constructs. Connelly and Ones (2010) have shown that others' ratings of personality yield higher predictive validity for job performance than self-report measures. They also have incremental validity over self-reports. The DSM-5 maladaptive personality measure (PID-5) has an informant's form. In work settings, such forms can be completed by different individuals for different applications (e.g., background investigators, reference providers, and recruiters/interviewers for screening; coworkers for coaching interventions).

Some fundamental changes have been occurring in ways that clinical psychologists view and measure personality disorders. I–O psychologists—researchers and practitioners alike—can benefit from these developments as they can enhance the capabilities to predict, understand, and modify employee behavior in organizations. We are in agreement with Guenole that researchers can benefit from incorporating maladaptive personality constructs and measures into their theories involving personality variables at work. Practitioners with foresight and vision can build on emerging knowledge around maladaptive personality constructs in designing individual assessment approaches, employee focused interventions, and in making personnel decisions. Aligning such research and applications with the DSM-5 trait framework can only strengthen the scientific base of our field. At the same time, responsible use of such tools requires psychological, psychometric, and legal awareness as well as operational and ethical sensitivity.

References

  1. Top of page
  2. Maladaptive Traits Are Maladaptive Personality Constructs
  3. Maladaptive Traits Are Assessed Using Maladaptive Personality Measures
  4. Distinguishing Between Maladaptive Traits and Behaviors in Work Settings
  5. Maladaptive Traits and Measures in I–O Practice: Thoughts on Responsible Use
  6. References
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  1. 1

    The third author (R.F.K.) of this commentary was involved in the DSM-5 development process as a member of the Personality and Personality Disorders Work Group. However, his service on the Work Group ended in December 2012. Thus, this commentary reflects only the positions and opinions of its three authors as independent scholars.

  2. 2

    Interestingly, higher-order maladaptive range personality constructs do not mimic the higher-order structure found for normal range personality constructs—Factor Alpha (the higher-order source trait for Conscientiousness, Agreeableness, and Emotional Stability) and Factor Beta (the higher-order source trait for Extraversion and Openness; DeYoung, 2006; Digman, 1997). Although low Agreeableness (Antagonism) and low Conscientiousness (Disinhibition) still factor together as externalizing, low Emotional Stability (Negative Affect) and low Extraversion (Detachment) factor together as internalizing. This two-factor internalizing–externalizing structure of psychopathology is highly replicable when the indicators are mental disorders that are common in the general population (i.e., mood, anxiety, substance use, and antisocial behavior disorders; Krueger & Markon, 2006). Watson, Stasik, Ro, and Clark (2013) suggested that greater negatively valenced content of maladaptive low Extraversion (as opposed to positively valenced content of normal range Extraversion) may be responsible for this finding.

  3. 3

    Compound personality traits may reflect multiple different traits from the same or different levels of the personality hierarchy. Hence, they occupy interstitial areas in the lumpy personality trait space. For maladaptive traits, cross loadings on maladaptive Big Five factors indicate interstitiality (Krueger & Markon, in press). Interstitiality is the consequence of lack of simple structure in personality dispositions. Guenole (2014) suggests that the maladaptive traits included in the DSM-5 trait framework are pure (i.e., not blends of primary traits), but this does not seem compatible with the evidence that many primary or facet-level traits are interstitial and not pure markers of factors.

  4. 4

    Distributional mismatch between the maladaptive predictor measure and criterion (e.g., non-normally distributed predictor marginal distribution and normally distributed criterion marginal distribution) may result in nonlinear associations between the two.

  5. 5

    One point articulated by the EEOC is that “not all impairments [are] disabilities; an impairment is a disability only if it substantially limits a major life activity” (EEOC, p. 8). It would seem that extreme standing on some maladaptive traits revealed by maladaptive measures (e.g., perseveration, manipulativeness, deceitfulness; see definitions provided in Table 1) could be considered psychological impairments, but not disabilities, and thus could legitimately be assessed in preemployment contexts even before a conditional job offer is made.