The purpose of this chapter is to summarize and discuss the complex relationship between Five Factor Model (FFM) personality traits and clinical (Axis I) psychopathology, including depressive, bipolar, anxiety, obsessive–compulsive, eating, schizophrenia and psychotic, trauma and stress-related, and substance use disorders. Considered herein will be the alternative forms of relationship, including vulnerability, common cause, pathoplasty, complication/scar, and spectrum. This chapter will highlight the necessity for well-designed, longitudinal studies aimed at elucidating the complex relationships between the FFM and clinical disorders. Consistent research supports Neuroticism as a vulnerability factor to certain disorders, even sharing genetic etiology. However, there are also important contributions for each of the other four domains. The majority of this research is in the area of mood and anxiety disorders. Expanding these studies to include other forms of psychopathology could help identify common personality vulnerabilities to psychopathology, as well as unique predictors of certain constellations of symptoms.