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Chapter 13.docx

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John Stephens

Chapter 13- Personality Disorders - Heterogeneous group of disorders coded on Axis II of the DSM - Regarded as… o Long-standing, pervasive, and inflexible patterns of behaviour and inner experience that… o Deviate from cultural expectations o Causes impairment in social and occupational o Can cause emotional distress - Clusters o Cluster A  Paranoid, Schizoid, and Schizotypal  Oddness and avoidance of social contact o Cluster B  Anti-social, Borderline, Histrionic, and Narcissistic  Dramatic, emotional, or erratic  Extrapunitive and hostile o Cluster C  Avoidant, Dependent, and Obsessive-Compulsive  Appear fearful Cluster A: Odd/ Eccentric Cluster - Paranoid o Characteristics  Suspicious of others  Expect to be mistreated or exploited by others  Reluctant to confide in others  Tend to blame others  Can be extremely jealous o Prevalence and Comorbidity  Prevalence about 1%  Occurs most frequently in men  Comorbid with schizotypal, avoidant, and paranoid personality disorders - Schizoid o Characteristics  No desire for or enjoyment of social relationships  Appear dull, bland, and aloof  Rarely report strong emotions  Have no interest in sex  Experience few pleasurable activities  Indifferent to praise and criticism o Prevalence and Comorbidity  Prevalence < 1%  Slightly more common in men  Comorbid with schizotypal, avoidant, and paranoid personality disorders - Schizotypal o Characteristics  Interpersonal difficulties of schizoid personality   social anxiety  Eccentric symptoms identical to prodromal and residual phases of schizophrenia  Odd beliefs or magical thinking  Recurrent illusions  Odd speech  Ideas of reference  Suspiciousness,  Paranoid ideation  Eccentric behaviour and appearance o Prevalence and Comorbidity  Prevalence about 3%  Slightly more frequent among men than women  Comorbid with borderline, avoidant and paranoid personality disorders - Etiology o Genetically linked to schizophrenia o Perhaps less severe variants of this Axis I disorder o Could be linked to a history of PTSD and childhood maltreatment Cluster B: Dramatic/ Erratic Cluster - Borderline o Characteristics  Core features are impulsivity and instability in relationships, mood, and self-image  Attitudes and feelings toward others vary dramatically  Emotions are erratic and can shift abruptly  Argumentative, irritable, sarcastic, quick to take offence, etc. o Prevalence and Comorbidity  Prevalence 1 to 2%  More common in women than in men  Comorbid with mood disorder, substance abuse, PTSD, eating disorders, and Cluster A PDs o Etiology  Object-relations theory  Biological evidence  Runs in families  Poor functioning of the frontal lobes  Linehan’s diathesis-stress theory - Histrionic o Characteristics  Overly dramatic and attention-seeking  Use physical appearance to draw attention  Display emotion extravagantly  Self-centred  Overly concerned with their attractiveness  Inappropriately sexually provocative and seductive  Speech may be impressionistic and lacking in detail o Prevalence and Comorbidity  Prevalence 2 to 3%  More common among women than among men  Comorbid with depression and BPD o Etiology  Unknown - Narcissistic o Characteristics  Grandiose view of own uniqueness and abilities  Preoccupied with fantasies of great success  Require almost constant attention and excessive admiration  Lack empathy  Envious of others  Arrogant, exploitive, entitled o Prevalence and Comorbidity  Prevalence < 1%  Comorbid with BPD o Etiology  Product of our times and system of values? - Antisocial o Characteristics  Two major components: 1) Conduct disorder present before age 15 and 2) Pattern of anti-social behaviour continues in adulthood  Irresponsible and anti-social behaviour  Work only inconsistently  Break laws  Irritable  Physically aggressive  Impulsive and fail to plan ahead o Prevalence and Comorbidity  Prevalence 3% of adult men and 1% of women (US stats)  3% in Canada  Comorbid with substan
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