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Chapter XII.docx

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University of Toronto St. George
Martha Mc Kay

Chapter XII Personality DisorderPersonality All the ways we have of acting thinking believing and feeling that make each of us unique Personality Trait A complex pattern of behaviour thought and feeling that is stable across time and across many situations Personality Disorder Longstanding patterns of maladaptive behaviours thoughts and feelingsEnduring pattern of behaviour that is pervasive and inflexible as well as stable and of long durationCauses clinically significant distress or impairment in functioningManifests in at least 2 of the following cognition affectivity interpersonal functioning or impulse controlMust show symptoms since adolescence or early adulthoodOn Axis II of DSMPeople with an Axis II diagnose often experience an Axis I disorder as well acute disordersOften do not seek treatment DSM Personality Disorders Groups Cluster A OddEccentricSymptoms similar to schizophrenia inappropriateflat affect odd thought and speech patterns paranoiaMain their grasp on reality Cluster B DramaticErraticManipulative volatile uncaring in social relationshipsProne to impulsive violent behaviours w little regard for ownothers safety Cluster C AnxiousFearfulExtremely concerned about being criticized or abandoneddysfunctional relationshipsProblems with DSMSymptoms are treated as discrete categories when they are often only extreme versions of otherwise normal traits Overlap in the diagnostic criteria and the majority of people who are diagnosed with one disorder tend to meet the diagnostic criteria for at least one other personality disorderDiagnosing a personality disorder often requires information that is hard for a clinician to obtain Conceptualized as stable characteristics yet they vary so individuals go in and out of the diagnosisBiasesDifferences in frequencies with which men and women and individuals of minority groups are diagnosed with different personality disordersdoes this reflect bias and an application of negative stereotypes Lack of recognition that the expressions of symptoms of a disorder may vary between women and menLack of recognition that the expressions of symptoms of a disorder may vary between groupsOddEccentric Personality Disorders May exhibit mild signs of schizophrenia ParanoidChronic and pervasive unwarrantedmaladaptive mistrust and suspicion of othersPreoccupied with concerns about the loyalty and trustworthiness of othersBelieve people are chronically trying to deceive or exploit themHypervigilant for confirming evidence of suspicionsMisinterpret or overinterpret situations in line with their suspicionseg wifes cheerfulnessshes having an affairResistant to rationale arguments against their suspicionsWithdrawal from others in order to protect themselvesUnstable relationships including intimate onesWeak relationship to schizophrenia A Evidence of pervasive distrust or suspiciousness of others present in 4 of the following ways 1 Pervasive suspiciousness of being deceived harmed or exploited 2 Unjustified doubts about loyalty or trustworthiness of friends or associates 3 Reluctance to confide in others because of doubts of loyalty or trustworthiness 4 Hidden demeaning or threatening meanings read into benign remarks or events 5 Bears grudges does not forgive insults injuries or slights 6 Angry reactions to perceived attacks on his or her character or reputation 7 Recurrent suspicions regarding fidelity of spouse or sexual partner B Does not occur exclusively during course of Schizophrenia Mood Disorder with Psychotic Features or other psychotic disorderPrevalence estimates are between 055MalesFemales31Increased risk for acute psychological problems major depression anxiety substance useGenerally poor prognosis symptoms intensify under stressFamily History studies more common in families with a history
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