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Chapter 12

Psychology 2030A/B Chapter 12: chapter 12

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Psychology 2030A/B
Ian Nicholson

Chapter 12 When personality characteristics interfere with relationships with others, cause the person distress, or in general disrupt activities of daily living, however, we consider these to be “personality disorders” Personality disorders are chronic and are defined as persistent patterns of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and relationships. They may not feel any subjective distress. Tend to do poorly in treatment - The distinction between problems of degree and problems of kind is usually described in terms of dimensions and categories - Diagnostic criteria should be supplemented by a dimensional model in which individuals would not only be given categorical diagnoses but also would be rated on a series of personality dimensions. Such a system would advantages over a purely categorical system: 1. It would retain more info about each individual 2. It would be more flexible because it would permit both categorical and dimensional differentiations among individuals 3. It would avoid the often arbitrary decisions involved in assigning a person to a diagnostic category. Personality Disorder Clusters ¬ Cluster A: called the “odd” or “eccentric” cluster; it includes paranoid, schizoid, and schizotypal personality disorders. ¬ Cluster B: the “dramatic”, “emotional”, or “erratic” cluster; it consists of antisocial, borderline, histrionic, and narcissistic personality disorders. It is characterized by elevated impulsivity ¬ Cluster C: the “anxious” or “fearful” cluster; it includes avoidant, dependent, and obsessive-compulsive personality disorders. Statistics and Development ¬ Schizoid, narcissistic, and avoidant personality disorders are relatively rare, occurring in less than 1% of the general population. ¬ Paranoid, schizotypal, histrionic, dependent, and OCD personality disorders are found in 1-4% of the general population. ¬ One could receive a diagnosis at one point in time but years later no longer meet the criteria for his or her original diagnosis and now have characteristics of a second (or third) personality disorder. ¬ There are gaps in knowledge though because many individuals do not seek treatment in the early developmental phases of their disorder, but only after years of distress. ¬ People with borderline are characterized by their volatile and unstable relationships; tend to have persistent problems in early adulthood, with frequent hospitalizations, unstable personal relationships, severe depression, and suicidal gestures. o Almost 10% attempt and 6% succeed. o Symptoms improve gradually improve if they survive into 30s. ¬ APD o Behaviors and symptoms burn out after the age of 40 and so they engage in fewer criminal activities. ¬ Generally, problems continue over the years Gender Differences ¬ Men with a personality disorder tend to display traits characterized as more aggressive, structured, self-assertive, and detached. ¬ Women tend to present with characteristics that are more submissive, emotional, and insecure. ¬ APD is present more often in males ¬ Dependent personality disorder is present more often in females ¬ The criteria for disorders may themselves be biased (criterion gender bias) or the assessment measures and the way they are used may be biased (assessment gender bias) OR ¬ There may be some tendency for clinicians to use their own bias when using the criteria and therefore diagnose males and females differently Comorbidity ¬ % of people in general population that have a personality disorder is 0.5-2.5% ¬ Comorbidity is used to describe the condition in which a person has multiple diseases Cluster A Paranoid Personality Disorder ¬ Excessively mistrustful and suspicious of others, without any justification. ¬ Assume others are out to get them and so never confide in anyone Clinical Description ¬ Defining characteristic: very pervasive unjustified distrust ¬ Events that have nothing to do with them are interpreted as personal attacks ¬ Having this increase the risk of suicide attempts and violent behavior o Poor overall quality of life. ¬ Although they’re very suspicious of others, their suspiciousness does not reach delusional proportions ¬ Paranoid of schizophrenia type and this disorder are similar but this type does not have psychotic symptoms like hallucinations. Causes ¬ Relatives of this individuals with schizophrenia may be more likely to have paranoid personality disorder than people who do not have a relative with schizophrenia. ¬ In general, there appears to be a strong role for genetics in paranoid personality disorder. ¬ Early mistreatment or traumatic childhood experiences may play a role in the development of this disorder. ¬ Some psychologists point to the thoughts (“schemas”) of people with paranoid personality disorder as a way of explaining their behavior. ¬ They think everyone and everything is about them and this maladaptive way to view the world pervades every aspect of their lives. ¬ Cultural factors are implicated as well. Risk: elderly, prisoners, refugees, people with hearing impairments. Treatment ¬ Don’t usually seek therapy but when they do, the trigger is usually a crisis or other problems like anxiety or depression, and not necessarily their personality disorder. Schizoid Personality Disorder ¬ Show a pattern of detachment from social relationships and a very limited range of emotions in interpersonal situations. ¬ Seem aloof, cold, and indifferent to other people. Clinical Description ¬ Seem neither to desire not enjoy closeness with others, including romantic or sexual relationships ¬ Do not seem affected by praise or criticism ¬ Social deficiencies here re similar to those with paranoid personality disorder, although the deficiencies are more extreme. Share the social isolation, poor rapport, and constricted affect (showing neither
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