Chapter 12

1. Chapter 12 Personality Disorders (Clusters B and C)

2. Cluster B: Histrionic Personality Disorder Pervasive pattern of excessive emotionality and attention seeking indicated by five or more of the following: • Uncomfortable in situations in which he/she is not the center of attention. • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior. • Displays rapidly shifting and shallow expressions of emotion. • Uses physical appearance to draw attention to self. • Has a style of speech that is impressionistic and lacking in detail. • Shows self-dramatization, theatricality, and exaggerated expression of emotion. • Is suggestible (easily influenced by others) • Considers relationships to be more intimate than they actually are.

3. Cluster B: Narcissistic Personality Disorder Pervasive pattern of grandiosity, need for admiration, and lack of empathy, as indicated by five or more of the following: • Has a grandiose sense of self-importance • Is pre-occupied with fantasies of unlimited success, power, beauty, ideal love, etc. • Believes he/she is special and unique and only can be understood by high-status people. • Requires excessive admiration. • Sense of entitlement. • Interpersonally exploitive. • Lacks empathy. • Is envious of others. • Shows arrogant, haughty behaviors or attitudes.

4. Theories of Narcissistic PD • Psychoanalytic: • Fixation at an early psychosocial stage • Psychodynamic/Object Relations: • Reaction formation to underlying feelings of low self-esteem and low self-worth • Cognitive • Have assumptions about self-worth that are extremely positive as a result of an early childhood of over-indulgence and overvaluation.

5. Cluster C: Avoidant Personality Disorder • Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Indicated by four of the following: • Avoids occupational activities that involve interactions with others because of fears of disapproval, criticism, etc. • Unwilling to get involved with people unless certain of being liked. • Shows restraint within intimate relationships due to fears of being shamed. • Preoccupied with being criticized or rejected in social situations. • Inhibited in new interpersonal situations because of feelings of inadequacy. • Views self as socially inept, personally unappealing, or inferior to others. • Reluctant to take personal risks or engage in new activities

6. Dependent Personality Disorder • Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. Indicated by five of the following: • Difficulty making everyday decisions without excessive advice • Needs others to assume responsibility for major areas of life • Difficulty expressing disagreement • Difficulty initiating projects on his/her own • Goes to excessive lengths to obtain nurturance and support from others, even to the extent of doing unpleasant things • Feels uncomfortable or helpless when alone due to fears of being unable to care for oneself • Urgently seeks another relationship as a source of care when another one ends • Unrealistically preoccupied with fears of being left to take care of oneself

7. Obsessive-Compulsive Personality Disorder • Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Indicated by four of the following: • Preoccupied with details, rules, lists, order, etc. • Shows perfectionism that interferes with task completion. • Excessively devoted to work and productivity to the exclusion of leisure activities. • Overconscientious and inflexible about matters of morality, ethics, or values. • Unable to discard worn-out or worthless objects. • Reluctant to delegate tasks. • Adopts a miserly spending style both towards self and others • Shows rigidity and stubbornness.