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Lecture 9

PSYC 465 Lecture 9: PSYC 361 Lecture 9

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PSYC 465

PSYC 361 Lecture 9 Abnormal Psychology Personality Disorders • Personality Disorders o Pervasive pattern of inner experience and behavior that is resistant to change and lasts a long time o DSM definition of personality disorder ▪ “… Deviates markedly for the expectations of… culture, is pervasive and inflexible, … and leads to distress or impairment” o Ego Syntonic ▪ “It’s not me, it’s everybody else” o Patterns are rigid, occur predictably across situations, and are long-standing o Typically resistant to treatment, takes a long time • Clusters : A, B, C o Cluster A ▪ Odd/Eccentric • Includes : Paranoid, Schizoid, Schizotypal o Cluster B ▪ Dramatic/Emotional/Erratic • Includes : Antisocial, Borderline, Histrionic, Narcissistic o Cluster C ▪ Anxious/Fearful • Includes : Avoidant, Dependent, Obsessive-Compulsive • Narcissistic Personality Dx ▪ Personality organized around maintaining self-esteem o Diagnostic Criteria (5 or more) ▪ 1) Grandiose self-importance, expects to be seen as superior ▪ 2) Fantasizes (success, power, beauty, etc.) ▪ 3) Believe can only be understood by other superior people ▪ 4) Requires excessive admiration ▪ 5) Entitlement (expects superior treatment) ▪ 6) Exploitative • Narcissistic extension – uses others for own goals ▪ 7) Lack empathy ▪ 8) Envy, and believes others envy them too ▪ 9) Arrogant/haughty o Grandiosity vs. Vulnerability ▪ Unlike DSM, clinical theory stresses fragile self-esteem, negative affect, and suicidality ▪ Excessive fears around being shamed, exposed inferior o Tragic Flaws : ▪ Creates exaggerated ideals for self, others ▪ However, can never achieve perfection, so can never be satisfied ▪ Devalues others, so their praise/adoration is meaningless o How does it develop? ▪ Excessive praise in childhood • Borderline Personality Disorder ▪ “On the border” between neurotic and psychotic o Characteristics ▪ 1) Frantic efforts to avoid abandonment ▪ 2) Identity disturbance, unstable self-image ▪ 3) Unstable, chaotic relationships ▪ 4) Chronic feelings of emptiness ▪ 5) Affect instability, impulsivity ▪ 6) Recurrent suicidality/self-harm ▪ 7) Dissociation/paranoia in response to stress o Major Dimensions in BPD ▪ Splitting • Inability to integrate good and bad • Black and white, good or bad type thinking • Feelings toward self/others run hot and cold o Other is either perfect caregiver, or abandoning abuser ▪ Early Trauma • Emotional/sexual abuse histories common • Early enmeshed relationship w/ abusive and/or inconsistent parent • Likely a combination or temperamental vulnerability, early trauma and later stress • Antisocial Personality Disorder o Diagnostic Criteria (3 or more) ▪ 1) Repeated illegal behaviors ▪ 2) Deceitfulness (e.g., lying, using aliases, conning) ▪ 3) Im
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