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Chapter 13.docx

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PSYC 2740
Andrew Robinson

Chapter 13: Personality, Mental Health, and Psychopathology  Most people with personality disorders are unaware of the negative aspects of their personality and how it causes distresses, not only for themselves but also to the people around them  Ways that personality variables may be important to mental health and psychopathy. 1. Personality factors may serve as vulnerability factors that are involved in the etiology of psychopathology  Personality also plays a role in the persistence or long-term stability of psychopathology  Personality factors may predict symptom profile differences and help explain some of the heterogeneity among people who share the same diagnosis yet differ in the symptoms they express  Personality may have a direct role in determining how a person responds to their dysfunction by influencing such things as the willingness to seek help ABNORMALITY DEFINED  Behaviour that is highly atypical  Characteristics that cause significant distress to self or to other people  The pattern of the behaviour is associated with significant impairment or disability  Important to remember cultural differences when determining whether a behaviour is abnormal Conceptualizations of Personality Disorders  self- reports of personality disorders should be supplemented by observer rating because people with personality disorders often lack self-insight and may be unaware of their problems and the impact they have on other people  personality disorders are difficult to treat, and people with personality disorders often do not respond well to psychologically based interventions  Livesley focused on 3 criteria’s for establishing personality disorder 1) to form stable, integrated, and coherent representations of self and others 2) to form intimate and positive affiliations with other people 3) to be a useful member of society in that the person can engage in pro-social and co-operative activities  The ability to form intimate and positive affiliations is important because personality disorders are often identified based on extreme, aberrant interpersonal behaviour  Anti-social and narcissistic personality disorder reflects extreme dominance, while avoidance personality disorder reflects submissiveness  Million identified 3 key criteria that help distinguish normal vs. disordered personality 1) The person is being rigid and inflexible in his or her tendencies 2) The person is habitually engaging in self-defeating behaviours. Self- defeating behaviour moves us further from our goals rather than closer to them 3) The person has a structural instability to the self so that he or she find it hard to withstand stress and novel situations The Psychiatric Approach to Personality Disorders  The American Psychiatric Association defines personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible”  Devitions are reflected in 2 or more ways: (1) cognition (ways of interpreting and perceiving the self, others, and the world); (2) affect (the range, intensity, lability, and appropriateness o the emotional response); (3) interpersonal functioning; and (4) impulse control  10 personality disorders in the DSM-IV - Personalities are grouped into 3 categories: odd-eccentric, dramatic- emotional, and anxious- fearful  Comorbidity: when 2 or more diagnosis apply to an individual Personality Disorder Dimensions  Empirical tests of the categorical vs. dimensional view have provided extensive support for a dimensional conceptualization of personality disorders  Personality disorders can be construed as the extremes of characteristics we possess  The categorical approach reflects the psychiatric approach to classification and diagnosis. Several pieces of evidence argue against the categorical approach including the great comorbidity that exists with more severe dysfunction involving multiple diagnoses  The categorical approach is marred by subjective and ill-defines personality disorder categories  The empirical evidence strongly favors the dimensional approach. The main exception is psychopathy, which seems to reflect a category variable PERSONALITY DISORDER CLUSTERS Cluster A  Reflects odd, eccentric behavior  3 personality disorders in this category: paranoid personality disorder, schizpid personality disorder, and schizotypal personality disorder Cluster B  Reflects dramatic and erratic behavior  Anti-social personality disorder - more extreme people often has a condition called psychopathy: a highly anti-social personality style that involves no sense of shame or remorse when someone engages in extremely anti- social acts. Have a glib sense of charm and a superior ability to manipulate people - Psychopathy is assessed with the Psychopathy checklist- revised, which was developed by Robert Hare  Borderline personality disorder  The histrionic personality disorder  The narcissistic personality disorder - Multidimensional construct with maladaptive and adaptive components (e.g. leadership) - Likely to lack self-awareness - Narcissism scores tend to be lower among older people, females, and people from collectivistic cultures Cluster C  Reflects fearful behavior  Avoidant personality disorder  Dependent personality disorder - Rely excessively on other people - Prone to feelings of separation anxiety - Robery Bornstein, the most prominent theorist and researcher of the study on dependent personality disorder  The obsessive- compulsive personality disorder *** ALL disorders are summarized on pg. 545, table 13.1** DIMENSIONAL MODELS AND PERSONALITY DYSFUNCTION Cloninger’s Tridimensional Model  This model combines temperament- based factors with 3 character factors: novelty seeking, harm avoidance, and reward dependence  Harm avoidance has four facets: anticipatory worry, fear of uncertainty, shyness, and fatigability  Harm avoidance is associated with levels of serotonin  Novelty seeking is highly related to addiction  Novelty seeking has four facets: explanatory excitablility, impulsiveness, extravafance, and disorderliness  Novelty seeking associated with levels of dopamine  Reward dependence reflects a sensitivity to punishment and reinforcement  Reward dependence involves the 3 elements of dependence, attachment, and sentimentality  Reward dependence is associated with noreponephrine  Cluster A disorders are linked to low reward dependence  Cluster B disorders are linked to novelty seeking  Cluster C disorders are linked to high harm avoidance th  Recently a 4 dimension has been added to the model: persistence The Five- Factor Model in Personality Dysfunction  The facets associated with each of the five factors are displayed in table 13.2, p.g 555  Costa and McCrae have argued th
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