PSY 1205 Lecture Notes - Lecture 14: Impulsivity, Dialectical Behavior Therapy, American Psychiatric Association
Abnormal Psych: Personality Disorders:
DSM: personality disorders not there till DSM III.
Personality disorders: deeply ingrained and enduring behavior patterns, manifesting themselves as
inflexible responses to a broad range of personal and social situations.
Personality disorders: gap between research evidence and clinical experience is largest.
Compared to other disorders, how best to define PDs as well as how to understand the detrimental impact
they have on people’s lives is lacking.
Often considered more “enduring” than other mental disorders.
This has led to debates of whether PDs should be considered mental illness in the way other disorders
(depression etc) are.
Individuals with PDs often don’t recognize they have a problem, come in for conflicts in different
domains of life, but don’t recognize its tied to their personality traits.
Individual with PDs may not seek treatment or if they do, they may not stay in treatment long enough to
experience change.
Dvlpt during 19th c: perosn’s character or type was used to refer to stable and unchangeable features of an
individual behavior. Conversely personality was used to refer to a person’s appearance rather than
contemp psych meaning.
20th c: Schneider: 1923: published what is largely considered contemporary approach to PDs: difference
between abnormal and disordered personal vs normal rang personality. Abnormal personality represent
extreme deviations from the average.
Reich 1933-1949: took note of difference between normal range neuroticism vs full on psychosis.
On the border to refer to people between these two areas→ borderline today.
Neurotic might be more anxious, more negative but without being considered pathological.
1980s: PDs introduced to DSM.
Specific criteria still poorly specified, different clinicians diagnoses same people with either borderline or
antisocial personality at 50-59% prevalence, we know today that's not true.
Current estimate at 5-15% with at least on PD,
.5-3% specific disorder prevalence.
DSM V:
Cluster A—the “odd, eccentric” cluster
Paranoid Personality Disorder: variety of paranoid features. Difference between psychosis. Paranoia
driven by realistic issues that may come up, psychosis: fears of unrealistic things, wouldn’t likely happen.
Schizoid Personality Disorder: lack of sex interest, disinterest in people in general
Schizotypal Personality Disorder: odd speech, don’t really make sense, can be perceive closer to
psychosis. Ex: willy wonka, talks differently than people normally do.
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Cluster B—the “dramatic, emotional, erratic”
cluster
Antisocial Personality Disorder: lack of regard for rules, often preceded by conduct disorder in
childhood.
Borderline Personality Disorder (BPD):anger difficulties and impulsivity, unstable and intense
interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Unstable self-image, recurrent suicidal behavior. see things as all good or all bad, affective instability,
marked mood reactivity, chronic feelings of emptiness (in depression the emptiness comes from they used
to have meaning but now don’t feel it, with BPD its that they’ve never known what meaning of their life
is/what they enjoy, etc). Many fights in a relationship is a first indication of borderline personality
disorder.
Histrionic Personality Disorder: flirtatious, dramatic, feel deeply emotion right at first, but if probe, they
can’t pin down why they feel that way, it's actually fleeting emotion swing back and forth but present as
deeply feeling
Narcissistic Personality Disorder: see things for personal gain, grandiose sense of self, but can also
present with vulnerability.
Cluster C—the “anxious, fearful” cluster
Avoidant Personality Disorder: wish they had social network, but too anxious to do that so remove
themselves from situations where could be negatively evaluate. A lot of overlap with social anxiety and
misdiagnosis. Avoidant: presents as more of a disinterest in society, pretend they don’t care but actually
are anxious.
Dependent Personality Disorder: low self esteem, worry about making decisions. Fear of abandonment
Obsessive-Compulsive Personality Disorder: NOT OCD. Like to make lists, have trouble adjusting when
have to change the plan, tend to be perfectionistic to the point that it interferes with deadlines or work.
Prevalence by cluster:
Cluster A: 5.7%
B: 1.5%
C: 6%
However: 9.1% for any personality disorders.
BUT 15% have at least one PD, so statistics get muddled.
Clinicians differ in diagnoses of dif PDs or if they have one at all, one clinician might say they meet the 5
criteria (for example) necessary where as another clinician might say 4 so since its categorical that can
make a big difference in prevalence rates.
PD NOS: not otherwise specified.
Dimensional Classification: more on a scale. Anyone with BPD could have between 1-9 symptoms, not a
necessary number like 4+ to be diagnosed.
Often work with how someone falls on the 5 factor model of personality.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Dsm: personality disorders not there till dsm iii. Personality disorders: deeply ingrained and enduring behavior patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations. Personality disorders: gap between research evidence and clinical experience is largest. Compared to other disorders, how best to define pds as well as how to understand the detrimental impact they have on people"s lives is lacking. Often considered more enduring than other mental disorders. This has led to debates of whether pds should be considered mental illness in the way other disorders (depression etc) are. Individuals with pds often don"t recognize they have a problem, come in for conflicts in different domains of life, but don"t recognize its tied to their personality traits. Individual with pds may not seek treatment or if they do, they may not stay in treatment long enough to experience change.
