PSYC 3406 Lecture 15: Lecture 15 - Personality Disorders
6 Jun 2018
School
Department
Course
Professor
Objectives
● Describe why it is important to identify personality disorders
● Understand the etiology of pers dis
● Identify screening questions
● List key features
Personality Disorders
● Enduring pattern of inner experience and behavior that manifests in two or more of the
following
○ Cognition (ways of perceiving and interpreting self and others), affectivity,
interpersonal functioning, impulse control
● Enduring pattern is inflexible
● Leads to significant distress or impairment in functioning
● Pattern is stable and can be traces back to adolescence or early adulthood
Why Should You Look for Personality Disorders?
● Very common: prevalence estimated between 6-13% of US adults has a personality
disorder
● Recognizing personality disorders can guide your approach to them
● Identifying personality disorders allows you to assess for comorbidities including Axis 1
disorders and suicide risk
Prevalence
● OCPD 2%
● Paranoid 2%
● Antisocial 1-4%
○ Variable by culture and geographic region
○ Bound to rules and regulation of a given society
● Schizoid 1%?
● Schizotypal 1%
● Avoidant 1-2%
● Histrionic 2%
● Borderline 2-3%
● Dependent .5%
● Narcissistic .5-1%
Knowing How to Approach These Patients Helps With:
● Understanding confusion about why patients don’t act how you expect
● Emotional distress they can illicit
● Protect you from inappropriate relationships and engaging in medical practice outside
your standard of care
Etiology
● Likely multifactorial like almost all other psych disorders
● Genetic and environmental factors such as chaotic home environment and abuse have
been implicated in development of maladaptive behavioral patterns
Heritability of Personality Disorders
● Paranoid .34
● Schizoid .43
find more resources at oneclass.com
find more resources at oneclass.com
● Schizotypal .54
● Antisocial .41
● Borderline .61
● Histrionic .59
● Narcissistic .56
● Avoidant .42
● Dependent .56
● Obsessive compulsive .6
Genetics of PD
● For comparison heritability of normal personality traits is approx. .5
● Molecular genetics studies of PDs indicate that genes linked to neurotransmitter
pathways particularly the serotonergic and dopaminergic systems are involved
Cultural Influences
● Studies have found that in Norway compared to US, UK, and Germany, avoidant
personality is 3-4x more prevalent, dependent 2-3x, schizoid 2x, borderline .5x,
antisocial .5x
● Pattern exhibits increased internalization personality disorders are prevalent and
externalization disorders are rarer
Personality Disorder Clusters
● A
○ Suspicious, odd
■ Paranoid, schizoid, schizotypal
● B
○ Dramatic
■ Antisocial, borderline, histrionic, narcissistic
● C
○ Anxious
■ Avoidant, dependent, obsessive compulsive
Paranoid Personality Disorder
● Pervasive distrust and suspiciousness of others such that their motives are interpreted
as malevolent
○ Suspects others are exploiting or deceiving them
○ Preoccupied with unjustified doubts of loyalty
○ Is reluctant to confide in others because they believed the others will use the
information against them
○ Reads hidden demeaning meanings in benign remarks
○ Persistently bears a grudge
○ Perceives attacks on their character
○ Recurrent suspicions regarding infidelity of spuse or secual patenr
● Paranoid schizophrenia includes illogical thinking
Schizoid Personality Disorder
● Pervasive pattern of detachment from social relationships and restricted expression of
emotion with 4 or more of the following
○ Neither enjoys nor desires close relationships
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Describe why it is important to identify personality disorders. Enduring pattern of inner experience and behavior that manifests in two or more of the following. Cognition (ways of perceiving and interpreting self and others), affectivity, interpersonal functioning, impulse control. Leads to significant distress or impairment in functioning. Pattern is stable and can be traces back to adolescence or early adulthood. Very common: prevalence estimated between 6-13% of us adults has a personality disorder. Recognizing personality disorders can guide your approach to them. Identifying personality disorders allows you to assess for comorbidities including axis 1 disorders and suicide risk. Bound to rules and regulation of a given society. Knowing how to approach these patients helps with: Understanding confusion about why patients don"t act how you expect. Protect you from inappropriate relationships and engaging in medical practice outside your standard of care. Likely multifactorial like almost all other psych disorders.
