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12. Personality Disorders.pdf

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PSYC 3230
James Alcock

12. Personality Disorders Monday, March 11, 20139:00 AM What is a personality disorder? • Enduring pattern of inflexible and maladaptive thinking, feeling, and acting that cause significant subjective distress and/or impairment in social or occupational functioning • Contrasted with personality traits: pattern of experiencing and interacting with environment and other people • Boundary is inherently blurry Generaldiagnostic criteria • Enduring pattern leads to distress, impairment in important areas in functioning or causes others distress • Onset usually late childhood, early adolescence • Pattern is stable and of long duration • Pattern not better explained by another disorder • Pattern not due to substance abuse or a general medical condition Diagnosedon AxisII in DSM-IV • Long-lasting, chronic patterns of interaction • Complete recovery not possible Typesof personalitydisorders • Cluster A ○ Marked by eccentricity, odd behavior, not psychosis ○ Share a superficial similarity with schizophrenia  Paranoid personality  Schizoid personality  Schizotypal personality • Cluster B ○ Being self-absorbed, prone to exaggerated importance of events ○ Having difficulty maintaining close relationships  Antisocial personality  Borderline personality  Histrionic personality  Narcissistic personality • Cluster C ○ Chronic symptoms: anxiety, fearful, obsessive compulsive  Avoidant personality  Dependent personality  Obsessive-compulsive personality Paranoidpersonality disorder • Suspects that others are exploiting, harming, or deceiving him or her • Preoccupied with unjustified doubts about trustworthiness of friends and others • Preoccupied with unjustified doubts about trustworthiness of friends and others • Reluctant to confide in others fearing any information will be used maliciously against him or her • Reads hidden demeaning or threatening meanings into benign remarks or events SchizoidPersonalityDisorder • 7.5% of population • 2-to-1 male-to-female ratio • Neither desires nor enjoys close relationships, including being part of a family • Almost always chooses solitary activities • Little or no interest in having sexual experiences with another person • Lacks close friends or confidants other than first-degree relatives Schizotypalpersonalitydisorder • 3% of the population • Sex ratio is unknown • Greater association among biological relatives of schizophrenic patients • Enduring pattern of discomfort with others and odd, peculiar thinking and behavior • Shares symptoms with both paranoid and schizoid personality disorders • The premorbid personality of the schizophrenic patient • Ideas of reference • Odd beliefs inconsistent with subcultural norms • Unusual perceptual experiences, including bodily illusions • Odd thinking and speech (e.g., vague, over-elaborate) • Suspiciousness • Inappropriate or constricted affect • Behavior or appearance that is odd, eccentric, or peculiar • Lack of close friends or confidants other than first-degree relatives • Excessive social anxiety due to paranoid fears rather than being negatively evaluated Antisocialpersonalitydisorder • 3% in men and 1% in women • Consistent irresponsibility-- e.g., pattern of financial irresponsibility; erratic employment history; reckless disregard for safety of self or others • Lack of remorse-- e.g., indifferent to effects of hurting, stealing from others • Antisocial behavior-- e.g., repeatedly performing acts that are grounds for arrest • Deceitfulness-- repeated lying, using of aliases, or conning others for personal profit or pleasure • Impulsivity-- failure to plan ahead • Irritability and aggressiveness, as indicated by repeated physical fights or assaults • Age 18 years, and evidence of Conduct Disorder with onset before age 15 years Borderlinepersonalitydisorder • 1-2% of the population; twice as common in women than in men • Pattern of unstable and intense interpersonal relationships-- alternating between extremes of idealization and devaluation • Frantic efforts to avoid real or imagined abandonment • Identity disturbance-- markedly and persistently unstable self-image or sense of self • Chronic feelings of emptiness • Chronic feelings of emptiness • Impulsivity that is potentially self-damaging (e.g., spe
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