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Personality Disorders

Explore the definitions of personality traits and disorders, presentation in medical, family, and individual settings, comorbidity, diagnosis techniques, and treatment approaches including psychotherapy and pharmacotherapy.

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Personality Disorders

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  1. Personality Disorders

  2. Definitions • Personality trait • a stable, recurring pattern of human behavior • Personality type • a constellation of personality traits • recognizable as a frequent and familiar combination

  3. Definitions • Personality disorder • a constellation of personality traits that are • Inflexible • Maladaptive • lead to difficulties in work or interpersonal relations, subjective distress, and usually both. (Global Criteria)

  4. Approaches to describing personality 4

  5. Categorical versus Dimensional

  6. How Personality Disorders Present

  7. Presentation • In Medical Settings • doctor-patient relationship • Noncompliance • Difficulty coping • Hospitalization • Disability • medical restrictions

  8. Presentation • In the Family • Marital conflicts • Sexual dysfunction • Child rearing • Domestic violence

  9. Presentation • Within the individual • Anxiety • Depression • External problems/losses • resulting from maladaptive behavior • Divorce • job loss • legal troubles • poor outcome from a medical condition • When circumstances prevent living according to usual personality style

  10. Comorbidity

  11. Making a Personality Diagnosis • Collateral sources • Social and developmental history • Personality tests (ex. MMPI) • current strengths and weaknesses

  12. Speculations on Etiology

  13. DSM-IV Personality disorders PCategorical PArranged by clusters

  14. The Clusters • A: Odd • B: Dramatic • C: Anxious

  15. A: The Odd Cluster PParanoid PSchizoid PSchizotypal

  16. B: The Dramatic Cluster • Narcissistic • Antisocial • Borderline • Histrionic

  17. C: The Anxious Cluster • Avoidant • Obsessive-Compulsive • Dependent

  18. The Odd Cluster

  19. Paranoid Personality Disorder • Paranoid personality • mistrustful of everyone • but still able to test reality

  20. Schizoid personality • lacks intimate relationships • frightened by closeness • incapable of warmth • Anxious about any closeness

  21. Schizotypal personality • odd and eccentric ideas • influence daily behavior • but not psychotic

  22. Narcissistic personality • Exaggerated sense of self-importance, Unrealistic fantasies, Wants recognition for being special • Arrogant, Entitled, Requires admiration • Exploitative, Unempathic towards others • Envious of others • Unconcerned about effect on others

  23. Antisocial personality • the "psychopath“ • violates laws/social conventions • Dishonest • unconcerned about effect on others

  24. Borderline personality • emotionally intense • unstable • impulsive behavior • self-destructive • inner emptiness • intolerance of being alone

  25. Histrionic personality • Dramatic • attention-seeking • caricature of femininity/masculinity

  26. The Anxious Cluster

  27. Avoidant personality • Social inhibition • Feelings of inadequacy • Hypersensitivity to criticism

  28. Obsessive-Compulsive Personality • preoccupied w/ work/duty • not enjoying life • Often rigid and inflexible

  29. The Dependent Personality • clings to stronger person • Submissive • seeks help/advice • anxious when having to make decision

  30. Treatment 30

  31. Treatment: Psychotherapy • Acute symptom focused • Ex. Dialectic behavioral therapy • Fundamental • Focused on changing personality • Long term psychotherapy

  32. Treatment: Pharmacotherapy • Symptom Focused • Ex. • Depression • Anxiety • Psychosis • More fundamental treatment? • Forme frustre approach

  33. Treatment In Medical Settings • Identify and treat problems acute symptoms • Separate medical diagnosis from behaviors

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