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Personality Disorders

Personality Disorders. Chapter 11. An Overview of Personality Disorders. Personality disorders

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Personality Disorders

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  1. Personality Disorders Chapter 11

  2. An Overview of Personality Disorders • Personality disorders • Enduring maladaptive patterns of perceiving, relating to, and thinking about the environment and oneself, exhibited in a wide range of contexts that cause significant functional impairment or subjective distress (some individuals do not feel distressed) • Not well responsive to treatment • 0.5% to 2.5% of general population • Originate in childhood and continue into the adult years • High comorbidity

  3. An Overview of Personality Disorders • Cluster A – The “odd” or “eccentric” • Paranoid • Schizoid • Schizotypal • Cluster B – The “dramatic”, “emotional” or “erratic” • Antisocial • Borderline • Histrionic • Narcissistic • Cluster C – The “anxious” or “fearful” • Avoidant • Dependent • Obsessive-compulsive

  4. Paranoid Personality Disorder • Involves pervasive distrust and suspiciousness of others (extends to people close to them, very sensitive to criticism) • Combination of biological (more common among relatives of people suffering with schizophrenia), psychosocial (parents) and cultural (prisoners, refugees, people with hearing impairments, elderly) factors • Unlikely to seek professional help

  5. Schizoid Personality Disorder • Pervasive pattern of detachment from social relationships and limited range of emotions in interpersonal situations • Possibly caused by lower density of dopamine receptors in combination with psychological factors • Treatment involves social skills training but very few would seek help

  6. Schizotypal Personality Disorder • Socially isolated but also behave in unusual ways, tend to be suspicious and have odd beliefs (small proportion develops schizophrenia) • Possibly phenotype of schizophrenia genome (milder form) • Caution – different cultural beliefs can lead to a mistaken diagnosis • Almost a half suffers also from depression • Treatment often involves social skills training and medication

  7. Antisocial Personality Disorder • Pervasive pattern of disregard for and violation of the rights of others, deceitful, irresponsible, impulsive, lack of empathy  Y-Antisocial • Psychopathy partially overlaps with APD but is defined in terms of personality traits (superficial charm, manipulative etc.) rather than overt behavior • Not all people with psychopathy or APD are criminals (only about 15% predominantly low IQ) • Interaction between genes and environmental influence • Neurobiological theories • The Underarousal Hypothesis • The Fearlessness Hypothesis (conditioning) • Treatment is not very successful but prevention programs (parenting skills, family support programs) are promissing

  8. Borderline Personality Disorder • Pervasive pattern of instability of interpersonal relationships, self-image, affects, lack of control over impulses (75% are women) • Possible contribution of early trauma (abuse) – similar to PTSD in some individuals • Treatment • Dialectical behavior therapy (learning to cope with stressors)

  9. Histrionic Personality Disorder • Pervasive pattern of excessive emotional and attention seeking behavior • Histrionic personality and antisocial personality may be sex-typed alternative expressions of the same underlying condition • Treatment • Modification of the attention-seeking behavior and improving relationships

  10. Narcissistic Personality Disorder • Pervasive pattern of grandiosity in fantasy or behavior, need for admiration, and lack of empathy • Possible cause • Parent’s failure of empathic “mirroring” in development • Increasing prevalence in Western cultures (emphasis of short-term hedonism, individualism, competitiveness, and success) • Therapy focuses on grandiosity, hypersensitivity to evaluation, lack of empathy, relaxation

  11. Avoidant Personality Disorder • Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism (fear of rejection) • Difficult temperament combined with parental rejection (problem with retrospective studies) • Treatment involves systematic desensitization and behavioral rehearsal

  12. Dependent Personality Disorder • Pervasive and excessive need to be taken care of (submissive and clinging behavior, fear of separation, need for reassurance etc.) • Possible cause • Interruption of early bonding can cause people to be anxious that they will lose people close to them • Therapy focuses on learning to make decisions independently and developing confidence

  13. Obsessive-Compulsive Personality Disorder • Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency (leads to procrastination) • Many serial killers have obsessive-compulsive personality disorder (controlling all aspects of the crime) • Weak genetic contribution, parental reinforcement

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