Where is the boundary between normal and abnormal?
Temperament is a normal phenomenon. Temperament-environment conflict can be resolved through taking steps to improve 'goodness of fit.'
When temperament-related behavior looks like a symptom, the distinction is whether the behavior is serious enough to reduce the person's adjustment, or seems to be present independent of the context in which it occurs.
On the extremes, or in situations with high demand, there may be conflict between the person's temperament and environment
The distinction between the two, temperament and psychopathology is based on qualitative differences in the behavior and impact on adjustment. Difficult temperament characteristics, in conjunction with a clinical disorder, may create complications in the treatment of individuals for psychiatric conditions. Ross Greene's work on The Explosive Child, has demonstrated how therapy goals are limited and may take extended time to treat based on inflexible, explosive patterns of temperament.
Further information for clinicians can be obtained from the 2016 upadate of the book: Child Behavioral Assessment and Management in Primary Care, Second Edition. Click here for CBAM2 page