PSYB32H3 Chapter Notes - Chapter 13: Hexaco Model Of Personality Structure, Psychoanalytic Theory, Histrionic Personality Disorder

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PSYB32 Chapter 13 Notes
Personality Disorder
Introduction:
Personality disorders (PDs): heterogeneous group of disorders that are
regarded as long-standing, pervasive, and inflexible patterns of behaviour
and inner experience that deviate from the expectations of a person’s culture
and that impair social, and occupational functioning. Some, but not all, can
cause emotional distress
We all posses parts of personality disorders; personality disorders are
defined by extremes of several traits and by their inflexible expression
People with PDs are rigid in behaviour and often cant change behaviours
accordingly to environment
Definitions:
Anti-social personality: a disorder in which a person, also called a
psychopath or sociopath, is superficially charming and a habitual liar, has no
regard for others, shows no remorse after hurting other, has no shame for
behaving in an outrageously objectionable manner, is unable to form
relationships and take responsibility, and does not learn from punishment.
Avoidant personality: a disorder in which individuals have poor self-
esteem and thus are extremely sensitive to potential rejection and remain
aloof even though they very much desire affiliation and affection
Borderline personality: a disorder in which people are impulsive and
unpredictable, with an uncertain self-image, intense and unstable social
relationships, and extreme mood swings.
Dependent personality: a disorder in which people lack self-confidence and
passively allow others to run their lives and make no demands on them so as
not to endanger these protective relationships.
Dialectical behaviour therapy: a therapeutic approach to borderline
personality disorder that combines client-centred empathy and acceptance
with behavioural problem solving, social-skills training, and limit setting.
Egosyntonic: the person with a personality disorder is typically unaware
that a problem exists and may not be experiencing significant personal
distress; they lack insight on their own personality
General personality disorder: a new DSM-5 category that reflects
establishing whether a personality disorder first exists in general and then
evaluating whether the criteria of a specific personality can also be applied
Histrionic personality: a disorder in which the person is overly dramatic
and given to emotional excess, impatient with minor annoyances, immature,
dependent on others, and often sexually seductive without taking
responsibility for flirtations. Formerly called “hysterical personality”
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Narcissistic personality: a disorder in which people are extremely selfish
and self-centered; have a grandiose view of their uniqueness, achievements,
and talents; and have an insatiable craving for admiration and approval from
others. They are exploitative to achieve their own goals and expect much
more from others than they themselves are willing to give.
Obsessive-compulsive personality (OCD): an anxiety disorder in which the
mind is flooded with persistent and uncontrollable thoughts or the individual
is compelled to repeat certain acts again and again, causing significant
distress and interference with everyday functioning.
Paranoid personality (PPD): a disorder in which a person expects to be
mistreated by others and becomes suspicious, secretive, jealous, and
argumentative. He or she will not accept blame and appears cold and
unemotional.
Personality disorders (PDs): heterogeneous group of disorders that are
regarded as long-standing, pervasive, and inflexible patterns of behaviour
and inner experience that deviate from the expectations of a person’s culture
and that impair social, and occupational functioning. Some, but not all, can
cause emotional distress
Personalized therapy: an approach advocated by Millon and Grossman.
Therapy is tailored to each person’s unique personality and associated needs
and personality styles. Comes with two key issues: (1) various self-report
measures of personality disorder differ in their content and are not
equivalent. (2) cut-off points used with self-report responses to determine
the presence of a personality disorder often overestimate the number of
people who meet diagnostic criteria.
Psychopathy: see anti-social personality
Schema therapy: a form of cognitive therapy developed primarily by Young.
It focuses on identifying and modifying specific cognitive schemas believed to
be at the root of personality dysfunction.
Schizoid personality: a disorder in which the person is emotionally aloof;
indifferent to the praise, criticism, and feelings of others; and usually a loner
with few, if any, close friends and with solitary interests.
Schizotypal personality: a disorder, in which a person is eccentric, has
oddities of thought and perception (magical thinking, illusions,
depersonalization, and derealization,) speaks digressively and with
overelaborations, and is usually socially isolated. Under stress he or she may
appear psychotic
Classifying Personality Disorders: Clusters, Categories, and Problems
DSM-1 Diagnosis were unreliable. DSM-3 introduced improved reliability
with axis (which were taken out in DSM-5)
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Theodore Millon (1986) identified 3 key criteria that help distinguish normal
vs. disorder personality.
i. Disordered personality is indicated by rigid and inflexible behaviour
ii. Person engages in self-defeating behaviour that fosters vicious cycles
(the behaviours perpetuate and exacerbate existing conditions)
iii. There is “structural instability”
This is the term Milon uses to refer to fragility to the self that
“cracks” under conditions of stress
Livesley regards personality disorder as a failure or inability to come up with
adaptive solutions to life tasks.
Livesley identified 3 types of life tasks and proposed that failure with any one
task is enough to warrant a personality disorder diagnosis
oThe 3 tasks are: to form stable, integrated and coherent
representations of self and others; (2) to develop the capacity for
intimacy and positive affiliations with other people; (3) to function
adaptively in society by engaging in proscoial and co-operative
behaviours
Livesley influenced DSM-V to propose definitions of personality disorder to
reflect “adaptive failure”
General Personality Disorder
Personality disorders can be construed as the extremes of characteristics we
all posses
The low stability or personality disorder diagnoses plagues the categorical
approach to the DSM-V.
Test-retest reliability is a good diagnostic tool for personality disorders
(consistency throughout tests is critical)
Focus on Discovery 13.1: A dimensional Approach to Personality Disorders
Most contemporary research on personality disorders focus on five-factor
model (FFM) (remember: OCEAN is the acronym for the 5 factors)
This dimensional approach of personality to personality disorder diagnosis
will always be controversial. The FFM is heavily debated, some proposing
HEXACO model and others
Assessing Personality Disorders
A significant challenge is that many disorders are egosyntonic
oBecause of this the distress by the patient’s significant others is
important for assessment and diagnosis
Another significant challenge is that a substantial proportion of clients are
deemed to have a general personality disorder and these clients don’t fit into
existing PD diagnostic categories.
Another challenge is PD diagnosis often rely on self-report measures:
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