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Personality Disorders

Personality Disorders. Odd/Eccentric Cluster Dramatic/Erratic Cluster Anxious/Fearful Cluster. Defining features. Long lasting, pervasive, inflexible patterns of behavior and inner experience Deviate from the person’s culture Impair social and occupational functioning

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Personality Disorders

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  1. Personality Disorders Odd/Eccentric Cluster Dramatic/Erratic Cluster Anxious/Fearful Cluster

  2. Defining features • Long lasting, pervasive, inflexible patterns of behavior and inner experience • Deviate from the person’s culture • Impair social and occupational functioning • May cause emotional distress

  3. Additional characteristics • Features are found in normal folks • Beware 1st-year medical school syndrome • Characteristics begin in adolescence or early adulthood • Be careful with diagnosis if the symptoms have persisted for less than 10 years • Axis II disorders • High degree of comorbidity with Axis I disorders

  4. Reliability of diagnoses of personality disorders • Interrater reliabilities are good • Test-retest reliabilities are often poor: • Schizotypal .11; Dependent .15; • Narcissistic .32; Histrionic .40; • Avoidant .41

  5. Problems with diagnosis • Actual symptoms of people may fit more than one personality disorder • Personality traits may be on a continuum, making categorical diagnosis inappropriate • The characteristics listed as symptoms are features which diagnosticians find particularly difficult to deal with

  6. Odd/Eccentric Cluster: Loners • Paranoid Personality Disorder • Distrust, suspicion, see malevolent motives • Need to be autonomous and in control • Schizoid Personality Disorder • Detached relationships; do not seek intimacy • Limited variability of emotional expression • Schizotypal Personality Disorder • Sharp discomfort with close relationships • Mental distortions and behavioral oddities

  7. Dramatic/Erratic Cluster: Annoying • Borderline Personality Disorder • Unstable relationships, self-image, mood • Impulsiveness • Histrionic Personality Disorder • Intense affect and attention-seeking • Narcissistic Personality Disorder • Grandiose, needs admiration • Lacks empathy

  8. Antisocial Personality Disorder • Ignores and overrules rights of others • At least three of: • Repeated violations of legal social norms • Repeated deceitfulness • Impulsiveness or lack of planning • Repeated fights or assaults • Reckless disregard for safety: Self or others • Repeated failure to meet obligations • Lack of remorse: Indifference or rationalizing • Had conduct disorder before age 15

  9. Cleckley’s criteria • Interpersonal: Charming, poised, calm • Unreliable, irresponsible, impulsive • Ungrateful, vulgar, rude • Cognitive: Average to above-average IQ • No delusions or irrational thinking • Poor judgment, lack of insight and planning • Manie sans delire

  10. More Cleckley... • Emotional: No anxiety, incapable of love • No deep, lasting emotions; quick shifts • Moral: Untruthful and insincere • Lacking in remorse and shame • Impersonal and trivial sex life • No real suicide attempts • Natural Born Killers

  11. Lykken’s Apparatus

  12. Anxious/Fearful Cluster • Avoidant Personality Disorder • Socially inhibited, feels inadequate • Very sensitive to criticism • Dependent Personality Disorder • Overly submissive, clinging, “Care for me.” • Obsessive-Compulsive Personality Disorder • Neatness, perfectionism, control systems

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