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Lecture 8

PSY240 Lecture 8

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University of Toronto St. George
M.Mc Kay

PSY240 Lecture 8 June 18: Personality and Personality Disorders Lecture Outline Introduction to personality DSM-IV-TR Personality Disorder Criteria Assessment techniques Causes Treatments Criticisms Proposed changes for DSM-5 Definitions Personality: all the ways we have of acting, thinking, believing, and feeling that make each of us unique Personality trait: a complex pattern of behaviour, thought, and feeling that is stable across time and across many situations o Trait psychologists believe that all people can be measured along dimensions Five factor model of personality Neuroticism: (adjustment/emotional stability) o Individuals high on neuroticisms have these problems: chronically anxious, hostile, depressed, self-conscious, impulsive, poor coping skills Extraversion: o Individuals high in extraversion (vs. those high in introversion): sociable, active, talkative, interpersonally oriented, optimistic, fun-loving, affectionate o Low extraversion: reserved, sober, aloof, independent, quiet Openness-to-experience: o Actively seek experience, curious, imaginative, open to new ideas o Low openness: conventional, conservative, dogmatic, rigid, emotionally insensitive Agreeableness o Softhearted, good-natured, trusting, helpful, forgiving, altruistic o Low in agreeableness: cynical, rude, suspicious, uncooperative, irritable, manipulative, ruthless Conscientiousness o Organized, reliable, hard-working, self-directed, punctual, ambitious, persevering o Low in conscientiousness: aimless, unreliable, lazy, careless, negligent, hedonistic DSM-IV-TR Criteria: Personality Disorders An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. DSM-IV-TR: General criteria This maladaptiveness has to manifest in one of these four areas Cognition: Affectivity: Interpersonal functioning: Impulsive control: DSM-IV-TR: general criteria for personality disorder Inflexible and pervasive across a variety of situations Stable and long in duration (it has to be present by early adolescence/adulthood) Clinically significant distress/impairment Rule out other disorders (this might vary across the different personality disorders) Rule out substance, medical condition 68 DSM-IV-TR Axis II Clusters A: Odd-eccentric (paranoid, schizoid) May look like schizophrenia o Inappropriate or flat affect o Odd thought and speech patterns o Paranoia But maintains grasp on reality, so this sets them apart from psychotic disorders Paranoid personality disorder Distrustful and suspicious of others (4) 1. Reluctance to confide 2. Suspicious of others 3. Doubts loyalty of friends 4. Suspicions of infidelity 5. Demeaning/threatening interpretations 6. Persistent grudges 7. Counterattacks Schizoid personality disorder Detachment from relationships, emotional coldness (4) 1. Little enjoyment/desire for close relationships 2. Preference for solitary activities 3. Little interest in sex 4. Takes pleasure in few activities 5. Lacks friends/confidants 6. Indifference to praise/criticisms 7. Emotional coldness, detachment, flat affect Henry Darger: does he fit criteria for schizoid personality disorder? Schizotypal personality disorder Social deficits, perceptual distortions, eccentricity (5) 1. Ideas of reference 2. Odd beliefs/magical thinking 3. Unusual perceptual experiences 4. Odd thinking/speech 5. Suspicious/paranoid ideation 6. Inappropriate/constricted affect 7. Odd behaviour/appearance 8. Lacks friends/confidants 9. Excessive social anxiety Cluster A Disorders Epidemiology Disorder % Gender Paranoid Gen. population: 0.5-2.5% Males > Females Outpatient clinics: 2-10% Inpatient settings: 10-30% Schizoid Uncommon in clinical settings Males > Females Schizotypal General population: 3% Males > Females B: Dramatic-erratic (antisocial, etc.) Manipulative, volatile, and uncaring Impulsive, sometimes violent behaviour Little regard for own/others safety or needs 69Antisocial personality disorder Criminal, callous, or ruthless behaviour; disregard for others rights and social norms (3) 1. Failure to respect lawful behaviour 2. Deceitfulness 3. Impulsivity/failure to plan 4. Irritability/aggressiveness 5. Reckless disregard for safety 6. Consistent irresponsibility 7. Lack of remorse There should also be evidence of conduct disorder before 15 years old (3) (conduct disorder is a disorder that is diagnosed in childhood, and refers to repetitive/constant behaviours during which societal rules are violated): o Aggression to people and animals o Deceitfulness or theft o Destruction of property o Serious violations of rules Borderline personality disorder Instability in relationships, identity, and affect (5) 1. Preoccupation with abandonment 2. Unstable/intense relationships 3. Identity disturbance 4. Self-damaging impulsivity 5. Suicidal/self-harm behaviour 6. Affective instability due to reactivity of mood 7. Chronic feelings of emptiness 8. Inappropriate, intense, controllable anger 9. Parano
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