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Chapter 13

Chapter 13 - Personality Disorder.docx

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Wilfrid Laurier University
Lawrence Murphy

Chapter 13 – Personality Disorders (6 questions + SA) Personality Disorders are: Regarded as: longstanding, pervasive and inflexible patterns of behaviour and inner experience that deviate from cultural expectations, causes impairment in social and occupational and can cause emotional distress (Axis 2 on DSM) Personality Disorder Clusters CLUSTER A: Odd/ Eccentric Paranoid Personality Disorder Characteristics:  Suspicious of others, tend to blame others  Expect to be mistreated or exploited by others  Reluctant to confide in others, can be extremely jealous Prevalent in 1%, occurs most frequently in me. Comorbid with schizotypal, avoidant and paranoid personality disorders. Schizoid Personality Disorder Characteristics:  No desire for enjoyment of social relationships  Appear dull, bland and aloof; rarely report strong emotions  No interest in sex, experience few pleasurable activities  Indifferent to praise and criticism Prevalent in <1%, comorbid with schizotypal, avoidant and paranoid personality disorders. Schizotypal Personality Disorder Characteristics:  Interpersonal difficulties of schizoid personality  Increased social anxiety  Eccentric symptoms identical to schizophrenia (magical thinking, recurrent illusions, odd speech); eccentric behaviour and appearance Prevalent in 3%, slightly more frequent in men than women. Comorbid with borderline, avoidant and paranoid personality disorders.  ETIOLOGY OF CLUSTER A - Genetically linked to schizophrenia - Perhaps less severe variants of this Axis 1 Disorder - Could be linked to a history of PTSD and childhood maltreatment CLUSTER B: Dramatic, erratic Borderline Personality Disorder Characteristics:  Core features: impulsivity and instability in relationships, mood and self image  Attitudes and feelings towards others vary dramatically  Emotions are erratic and can shift abruptly  Argumentative, irritable, sarcastic, quick to take offence, etc. Prevalence is 1 to 2%, more common in women, comorbid with mood disorder, substance abuse, PTSD, eating disorders and Cluster A Personality Disorders  ETIOLOGY OF Borderline - Object-relations theory: psychodynamic approach focusing on relations with parents or other people  they way children incorporate values - Biological evidence: runs in the family (poor functioning of frontal lobes) - ***Linchan’s diathesis-stress theory kids that have a hard time controlling their emotions are raised in a family environment where the kid’s feelings are disregarded or even punished Histrionic Personality Disorder 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 Prevalent in 2 to 3%, more common in women than me, comorbid with depression and Borderline  ETIOLOGY: UNKNOWN Narcissistic Personality Disorder (Voldemort) 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 and arrogant, exploitive and entitled Prevalent in less than 1% comorbid with borderline personality disorder  ETIOLOGY: product of our time and system of values Antisocial Personality Disorder Characteristics: (2 major components) 1) Conduct disorder present before age 15 and 2) Pattern of anti-social behaviour continues in adulthood o Irresponsible and anti-social behaviour o Work only inconsistently Break laws o Irritable, physically aggressive and impulsive/ fail to plan ahead Prevalent in 3 % of adult men and 1% women (USA), 3% in Canada; comorbid with substance abuse Psychopathy Characteristics:  Poverty of emotions  doesn’t understand negative and positive emotions  Lack of remorse, no sense of shame  Manipulates others for personal gain Lack of anxiety always looking for stimulus) Antisocial Personality Disorder and Psychopathy **Robert Hare** - 20% of people with APD score high on the Hare PCL-R  to help diagnose psychopathy by the use of a checklist (Predicts aggressive behaviour but doesn’t take in the lack of anxiety) - Almost all psychopaths are diagnosed with APD but many people with APD don’t meet the criteria for psychopathy - A higher % of convicted felons met the criteria for ADP  much l
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