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Personality Disorders

Personality Disorders. Definitions . Personality trait a stable, recurring pattern of human behavior Personality type a constellation of personality traits recognizable as a frequent and familiar combination. Definitions. Personality disorder a constellation of personality traits that are

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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. Why Should We Care? …as doctors

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

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

  7. 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

  8. Comorbidity

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

  10. Speculations on Etiology

  11. DSM-IV Personality disorders PCategorical PArranged by clusters

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

  13. A: The Odd Cluster PParanoid PSchizoid PSchizotypal

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

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

  16. The Odd Cluster

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

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

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

  20. The Anxious Cluster

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

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

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

  24. The Dramatic Cluster • Narcissistic • Antisocial • Borderline • Histrionic 24

  25. 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

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

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

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

  29. Treatment 29

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

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

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

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