Personality Disorders

1. Personality Disorders

2. I pulled up near a gas station. I told the service station guy to give me all of his money. I then took him to the bathroom and told him to kneel down and then I shot him in the head twice. The guy didn’t give me any trouble but I just felt like I had to do it. [The next morning, I left my car at another service station] I went in and told the guy to give me the money…Then I shot him.

3. Definition • Personality disorder = psychological disorder characterized by inflexible and enduring behavior patterns that impair social functioning. • Dysfunctional behavior patterns that impair people’s social functioning without depression or delusions.

4. Symptoms • Personality disorders symptoms • Ego syntonic = feels like a normal part of oneself • Most have interpersonal problems • Can be difficult to diagnose in initial session • Difficult to treat & can affect treatment of other disorders

5. Cluster Organization in DSM-IV • Personality disorders are classified within clusters defined by common features • Cluster A • Main feature is odd or eccentric in nature • Within this cluster: • Paranoid PD – distrust and suspiciousness • Schizoid PD – detachment from social relationships (does not want them) • Schizotypal PD – feels intense discomfort in close relationships; has distorted thinking and eccentric behavior.

6. Clusters (cont.) 2) Cluster B • Main feature is dramatic, emotional, or erratic • Within this cluster: • Antisocial PD – disregard for social norms and rights of others • Borderline PD – instability in relationships, self-image, and mood; impulsive • Histrionic PD – excessive emotionality and attention seeking • Narcissistic PD – elaborate, need for admiration, self-centered

7. Clusters (cont.) 3) Cluster C • Main feature involves anxiety or fearfulness • Within this cluster: • Dependent PD – submissive, need to be taken care of • Avoidant PD – social inhibition and inadequacy • Obsessive-Compulsive PD – orderliness, perfectionism, need to control things

8. Antisocial Personality Disorder • Formerly called a sociopath or psychopath • Usually male • Lack of conscience becomes plain before age 15 • Common characteristics: • Superficial charm • Absence of delusions and irrational thinking • Absence of “nervousness” • Unreliability • Untruthfulness and insincerity • Lack of remorse or shame • Poor judgment and failure to learn by experience • Incapable of love • Unresponsiveness in general interpersonal relations • Sex life impersonal and trivial • Failure to follow any life plan

9. Antisocial vs. Criminal Behavior • “Criminal” is a legal term denoting conviction for breaking a law: • Not all people with ASPD are criminals (or in jail) • Not all people in jail or considered criminals have ASPD • Many criminals do show responsible concern for their family and friends. • Antisocial personalities feel and fear little.

10. Serial Killers • Jeffrey Dahmer • Killing spree 1978-1991 of 17 known men & boys. • Murders involved rape, dismemberment, cannibalism, & necrophilia. • Henry Lee Lucas • 32 years of crime • Confessed to killing 360 women, men, and children. • Murders involved beating, suffocation, shooting, and stabbing

11. Nature vs. Nurture Biological -Twin, family, and adoption data show strong genetic influence - Show little autonomic nervous system arousal is stressful situations -Violent repeat offenders have 11% less frontal lobe tissue than normal. Neither “bad” genes alone nor a “bad” environment alone predispose later antisocial behavior. -Nature vs. Nurture interact • Antisocial behavior seems to age out after 40 - could still show ASPD features (lying; poor work habits)

12. Treatment • Most don’t seek treatment for ASPD • No treatment shown to be effective • More likely to end up in jail than in treatment • Focus is on prevention – • Target antisocial children & channel characteristics (fearfulness, low anxiety) into positive roles • athletics, adventure, military