Psychology 2030A/B Chapter Notes - Chapter 12: Schizotypal Personality Disorder, Paranoid Personality Disorder, Histrionic Personality Disorder

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Chapter 12 Personality Disorders
Overview
Personality disorder = persistent pattern of emotions, cognitions and behaviour that
results in enduring emotional distress
When personality characteristics interfere w/ relationships w/ others, cause person
distress or in general disrupt activities
I soe ases, affeted perso at ake judgeet  do’t eperiee distress
DSM lists 10 specific personality disorders
Prior to DSM-5, there were Axis, Axis 1, which included traditional disorder, and 2 which
included personality bc as a group seen as distinct
o More ingrained and inflexible and less likely to be modified
Categorical and Dimensional Models
People with personality disorders (PDs) display problem characteristics over extended
periods, however, display problem characteristics over extended periods, great
emotional pain for themselves
Difficulty then can be seen as one of degree rather kind
Distinction b/w problems of kind and degree have been described in terms of
dimensions and categories
PDs are extreme variations of otherwise normal personality variations (dimensions) or
ways of relating that are different from psychologically healthy behaviour (categories)
Most people in field see PDs as extremes on one or more personality dimensions yet
bc way people are diagnosed, ends up being viewed as categorical
Using categorical models has advantages (convenience)
Some suggest should also be rated on some degree of personality dimensions; 3
advantages over pure categorical
o 1. Retain more info about each individual
o 2. More flexible
o 3. Avoid often arbitrary decisions involved in assigning person to diagnostic
category
cross cultural research establishes universal nature of the 5 dimensions
trying to determine whether people w/ personality disorders can also be rated in a
meaningful way along dimensions identified in 5 factor model and whether system will
help us better understand these disorders
alternative model; Shedler and Westen identifies 12 personality dimensions; overlaps
with DSM criteria but also introduces new aspects of personality
Personality Disorder Clusters
DSM divides PDs into 3 groups; cluster division based on resemblance
A: alled the odd or eetri luster; paraoid, shizoid, shizotpal
B: draati, eotioal or errati; atisoial, orderlie, histrioi ad arissisti
C: anxious or fearful, includes avoidance and obsessive-compulsive PDs
Cluster structure only holds when PDs are assessed by clinicians, not when assessed via
patients self reports
Stats and Development
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Narcissistic, avoidant are rare, occurring in less than 1%
Paranoid, schizo, histrionic, dependent and obsessive found in 1-4%
PDs can remit over time; however they may be replaced by other PDs
People with borderline; volatile and unstable relationships, 10% attempt suicide and
approx. 6% succeed; symptoms gradually improve if survive to 30s
Gender Differences
Men diagnosed w/ personality disorder tend to display traits characterized as more
aggressive, structured, women seen as submissive, emotional and insecure
Equal number of males and females may have histrionic and borderline but
predominately diagnosed in females
One study; where histrionic personality and antisocial described
o When antisocial labelled male, most gave correct diagnosis
o When labelled female, most diagnosed as histrionic
Being labelled a women increased likelihood of a diagnosis if histrionic
o stereotpial feale i Wester orld
according to Kapla, reflets soiet’s iheret ias agaist feales
criteria for disorder itself may be biased (criterion gender bias) or assessment measures
and way they are used may be biased (assessment gender bias)
Comorbidity
general population w/ PD is estimated to be b/w 0.5-2.5%; major concern is comorbidity
Cluster A Disorders
Paranoid Personality Disorder
excessively mistrustful and suspicious of others w/out justification
do’t ofide i others eause thik eeroe is out to get the
Clinical Description
defining characteristic is pervasive unjustified distrust
suspicious in which most other people would agree they are unfounded
bears relationship to two other disorders
o 1. Paranoid type of schizophrenia
o 2. Delusional
hoeer, suspiios do’t reach delusional proportion
another difference b/w paranoid type of sch. And paranoid PD is that form involves
other pshoti sptos like halluiatios hereas paraoid does’t
Causes
evidence for biological contributions to paranoid is limited
slightly more common among the relatives of people who have sch., although
assoiatio does’t see to e strog
appears to be a strong role for genetics in paranoid PD
seems to be some relationship w/ sch. Causing some to suggest eliminating it as
separate disorder
however its retrospective, and should be caution that early mistreatment remembered
there may be strong bias in recall bc already prone to viewing world negatively
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cultural factors have also been implicated in paranoid
cognitive and cultural may interact; one can misinterpret ambiguous stimuli
Treatment
be forewarned, that to date there are no confirmed demonstrations that any form of
treatment can improve the lives of people w/ paranoid personality disorder
cognitive restructuring could be helpful in reducing paranoid beliefs
Schizoid Personality Disorder
pattern of detachment from social relationships and very limited range of emotions in
interpersonal situations
schizoid is odd, having been used by Bleuler ppl who have tendency to turn inward
and way from outside world
o lack emotional expressiveness and pursued vague interests
Clinical Description
do’t see affeted  praise or ritiis
people with schizoid personality disorder are similar to those of people with paranoid
personality; deficiencies more extreme
ideas of references, mistaken beliefs that meaningless events relate to them
share social isolation, poor rapport and constricted affect (schizoid)
Causes and Treatment
little research published on nature and causes of disorder
childhood shyness reported as precursor to later adult schizoid PD; may be that this
personality trait is inherited and serves as important determinant in development of this
disorder
abuse and neglect in childhood point to biological causes of autism and parents of
children w/ autism are more likely to have schizoid personality disorder
bio dysfunction found both in autism and schizoid PD combines w/ early learning or
early problems w/ interpersonal relationship to produce social deficits that define
schizoid PD
lower density of dopamine receptors scored higher on measure of detachment
may contribute to social aloofness w/ schizoid
skills were never established or have atrophied through lack of use, people with schizoid
PD often receive social skills training and practice role playing
Schizotypal personality disorder
socially isolated, like those with schizoid
also behave in ways that would seem unusual to many of us, tend to be suspicious and
have odd beliefs
considered by some to be on continuum w. sch. But without some of more debilitating
symptoms such as hallucinations
DSM 5 includes this disorder under both heading of PD and schizophrenia spectrum
disorder
Clinical Description
People given diagnosed w/ schizotypal have psychotic-like symptoms (but not psychotic)
o Such as believe everything relates to them personally
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