Personality Disorders in Modern Life

1. Personality Disorders in Modern Life Introduction and Perspectives

2. What is personality? • Personality – three definitions • 1) Persona – mask • 2) Outer appearance • 3) Inner characteristics

3. Defined • Personality: Characteristic ways of thinking, feeling and behaving • Personality Disorder: personality that is not necessarily disorganized, but a way of being that is maladaptive in a variety of ways

4. Areas affected (2/4) • Cognition • Interpersonal relationships • Impulse control • Affect • 2/4 areas affected at minimum

5. Personality and Psychiatry Personality Disorders Abnormal Psychology Personality Psychology Personology Psychiatry

6. Characteristics of PDs • Inflexible traits • Maladaptive behavior • Long-standing • Pervasive • Difficult to treat • Ego syntonic

7. DSM • 1952 • 2000 • Diagnostic Criteria

8. DSM • Polythetic, MonotheticFormat • Personality Disorders • 7, 8, or 9 criteria

9. Types of Personality Disorders • schizoid, paranoid, schizotypal • narcissistic, histrionic, borderline, antisocial • avoidant, compulsive, dependent • self-defeating, sadistic (1987 – cut 1994) • depressive, negativistic (1994)

10. Schizoid • Apathetic, remote solitary, indifferent • Little need for attachment • Not aware of feelings • Few drives or ambitions Click here

11. Schizoid withdrawn, emotional suppression, spouses complain of lack of intimacy Develop anxiety, somatoform reactions, brief reactive psychosis Check for alcohol abuse or PTSD Click here

12. Avoidant • Hesitant, self-conscious, embarrassed • Fears rejection, anxious • Inept, inferior, unappealing, lonely Click here

13. Avoidant • Hypersensitive to evaluation • Profound feelings of inadequacy • Sensitive to signs of disapproval • Use fantasy as defense (if only…) • Risk for developing social phobia

14. Depressive • Somber, pessimistic, fatalistic, brooding • Valueless, guilty, impotent • Worthy of criticism and contempt

15. Depressive • New scale, not a lot of validity • Gloomy, passive, quiet, pessimistic • Down, hard to please, defeatist • Difficulty expressing anger • High scores could be due to major depression or dysthymia

16. Dependent • Helpless, incompetent, submissive • Irresponsible, Weak, fragile What about Bob?

17. Dependent Click here • Submissive, acquiescent, concerns about being abandoned, fears of rejection, self-blame, insecure • Co-morbid with depression and anxiety

18. Histrionic Vivian Leigh • Dramatic, seductive, shallow • Attention seeking, exhibitionistic • “attractive”, “charming” • Colourful A Street Car Named Desire

19. Histrionic • Center of attention • Shallow emotions • Might be a style… • More common with substance abusers Gone with the Wind Vivian Leigh

20. Narcissistic • Egotistical, arrogant, entitled, grandiose • “Admirable”, “superior” A Few Good Men Jack Nicholson Click here

21. Narcissistic • Egocentricity, independence, grandiosity, feelings of superiority • Self-centered, entitled, constant praise • Bubble bursts… prone to depression, paranoia, substance abuse • Might be a style

22. A Few Good Men Jack Tom

23. Antisocial Cape Fear • Impulsive, irresponsible, deviant, unruly • Non-reflective, self-serving • Disrespectful, free, independent Robert DeNiro

24. Antisocial • Motivated to avoid control and domination • Competitive, blunt, intimidating • Prone to legal, vocation and marital difficulties

25. Antisocial

26. Sadistic Vincent D'Onofrio Law and Order • Hostile, abrasive, cruel, dogmatic • Explosive, intimidating, dominating • opinionated and close-minded

27. Sadistic • Top Dog persona • Publicly “ok” – successful • Private “monster” • Type A personalities • Not official PD, diagnosis – PD NOS Warning Very violent

28. Compulsive • Restrained, conscientious, respectful • Rigid, conventional, regulated • “Reliable, efficient, productive”

29. Compulsive • Organized, perfectionistic, impatient, good morals, obedient behavior, suppression of emotions • Fears disapproval • Might be a style

30. Negativistic • Resentful, skeptical, discontented • Resisting, inefficient • Angry, moody, irritable, sullen

31. Negativistic • twisted, conflicted • irritable, hostile, negativistic • complaining, disgruntled • feel unappreciated, pout • disillusioned • vacillate • Not official, PD NOS

32. Masochistic • effacing, servile, blameful • defeatist, self-condemning

33. Self-defeating PD • Self-sacrificing, deserve to suffer • Martyr-like, endures abuse • Look for victimization • Not a well-validated scale • Not official anymore – PD NOS

34. Paranoid • Guarded, defensive, distrustful • “persecuted”

35. Paranoid PD • Hypervigilance • Sensitive • Rigid and argumentative • Annoyance with others • Grandiosity • Edgy defensiveness • Secretive

36. Schizotypal • Eccentric, bizarre, absent • Peculiar, odd, disconnected Warning Foul Language Click here

37. Schizotypal PD • Cognitive impairments • Self-absorbed in own thoughts • Ideas of reference • Detachment, social isolation • Self-conscious and anxious

38. Types of PDs • Borderline • Unpredictable, manipulative, unstable • Fears abandonment • Moody, contrary Warning Foul Language Click here

39. Theron

40. Borderline PD • Unstable mood, anger, guilt, dependency seeking, Impulsive, self-damaging • Suicidal • Constantly seek approval • Prone to brief psychotic reactions • Poor sense of self and boundaries

41. Misery • Rent or click on following • Next slide to view this movie… • Do a Character Analysis of Annie. • What PD(s) does she have?

42. Misery (warning, violent) • Part IPart IIPart III • Part IVPart VPart VI • Part VIIPart VIIIPart IX • Part XPart XI