Personality disorders occupy a contested space at the intersection of psychiatric science, moral responsibility, and theology. Contemporary psychiatric models describe enduring patterns of cognition, affect, and behaviour that shape relational and social functioning. These conceptions contrast with traditional theological understandings of the human person, which assume moral agency, freedom, and the capacity for virtue. This divergence raises pressing questions: if traits are persistent and resistant to change, how can theology address culpability, sin, and moral formation?
This paper argues that theology must engage psychiatric insights to develop a nuanced account of moral responsibility, recognising the role of psychological constitution and relational context. At the same time, theology offers frameworks for moral progress and sanctification, emphasising incremental transformation, the cultivation of virtue, and the work of grace. By dialoguing with psychiatry, this paper explores how contested understandings of personality illuminate ethical responsibility, pastoral care, and social inclusion.