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Lecture

PSYCH257 Lecture Notes - Phenotype, Etiology, Comorbidity


Department
Psychology
Course Code
PSYCH257
Professor
Allison Kelly

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LECTURE 16
PERSONALITY DISORDERS PART 1 OF 2
CHAPTER 12 OF TEXTBOOK
Today’s Questions
1. How do we know when a personality is “disordered”?
2. Are people with personality disorders aware of, and motivated to change, their
personality problems?
3. Does it make sense to “treat” a personality disorder?
Outline
The nature of personality disorders
Cluster A PDs
Cluster C PDs
Summary game name that PD
The nature of personality disorders
DSM-IV Axes Review
Axis I Acute psychological problems
AXIS II PERSONALITY DISORDERS
Axis III Physical health
Axis IV Psychosocial issues
Axis V Global Assessment of Function
General Criteria for a Personality Disorder (DSM-IV-TR)
Enduring pattern of inner experience and behavior that deviates markedly from
cultural expectations. Manifested in
2 or more
of the following areas:
o Cognition
o Affectivity
Emotional reactions to people or in situations
o Interpersonal functioning
Goals they have for themselves, types of relationships they have
o Impulse control
Ability to regulate impulses

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Pattern is inflexible and pervasive across a broad range of personal and social
situations
Pattern leads to clinically significant impairment or distress
o People around individual are usually the ones who are distressed
Pattern is stable and of long duration; onset can be traced to adolescence /
early childhood
Pattern not better accounted for as a manifestation of another disorder
Not due to substance or medical condition

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Other Common Features
Little insight: into the fact that they are different or the problems it is causing
them have it their whole life, don’t know anything different
Ego syntonic : Their way of seeing things fit with their goals, values and
interests.
Interpersonal problems
Initially difficult to diagnose: People usually present with AXIS I Disorder: not on
the clinicians mind to look for personality disorder person doesn’t realize it
Intractable, difficult to treat person doesn’t think anything is wrong
Personality Disorder Clusters
Cluster A: Odd or eccentric
o Paranoid, Schizoid, Schizotypal
Cluster B: Dramatic, emotional, or erratic
o Histrionic, Narcissistic, Antisocial, Borderline
Cluster C: Fearful or anxious
o Avoidant, Dependent, Obsessive-Compulsive
Controversies in Diagnosis of PDs
Dimensional versus categorical
o Generally studied dimensionally: levels. But PD grouped categorically
Reliability and validity
o Reliability: A different person assessing the same client should make same
diagnosis high in relation to having a disorder, but agreement on which
PD is not consistent.
o Most common diagnosis: PDNOS
o Comorbidity: 50% - 90%
Gender bias
o Certain personality disorders are more prevalent in females (histrionic)
o Antisocial: highly diagnosed in males
o Were criteria written more for one gender than another
o Do clinicians look for disorder in specific gender
Label that sticks
o Making a conclusion about a person that will follow them throughout
their lives.
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