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Personality variation is increasingly thought to have an adaptive function. This is less clear for personality disorders (PDs)—extreme variants of personality that cause harm in most aspects of life. However, the possibility that PDs may be maintained in the population because of their advantages for fitness has been not convincingly tested. In a sample of 959 outpatients, we examined whether, and how, sexual selection acts on the seven main dimensions of personality pathology, taking into account mating success, reproductive success, and the mediating role of status. We find that, to varying extents, all personality dimensions are under sexual selection. Far from being predominantly purifying, selective forces push traits in diverging, often pathological, directions. These pressures differ moderately between the sexes. Sexual selection largely acts in males through the acquisition of wealth, and through the duration (rather than the number) of mates. This gives a reproductive advantage to males high in persistence–compulsivity. Conversely, because of the decoupling between the number of mates and offspring, the promiscuous strategy of psychopaths is not so successful. Negative emotionality, the most clinically detrimental trait, is slightly deleterious in males but is positively selected in females, which can help to preserve variation. The general picture is that at least some PDs form part of high-risk alternative strategies, although a sole evolutionary mechanism is unlikely to apply to all traits. An evolutionary perspective on PDs can provide a better understanding of their nature and causes than we have achieved to date by considering them as illnesses.

Extreme personality traits in humans often have detrimental life consequences, so they have long been supposed to be diseases. However, many other species display personality variants that are maintained due to their fitness advantages; in this case, they are construed as strategies. To examine the fitness costs and benefits of pathological personality traits in humans, we measured features of the A (socially odd, distrustful), B (incentive-seeking, selfish) and C (fearful, inhibited) clusters with the Personality Diagnostic Questionnaire-4 + (PDQ-4 +) in a sample of 738 outpatients. Fitness relevant parameters like mating success, reproductive output, self preservation, and access to status were assessed with the Life Outcome Questionnaire. No fitness advantages were found for high-A subjects. In contrast, high-B subjects tripled low-B subjects with regard to mating success and had 39% more offspring. Further, high-C subjects outperformed low-C subjects in attaining status and avoiding risks. These findings help explain the commonness of some extreme personality traits in humans, and suggest that they should be seen as evolutionary strategies rather than as diseases.