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Chapter 12

Chapter 12 Personality Disorders.docx

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PSYC 3140
Stephen Fleming

Chapter 12 Personality DisordersAccording to the DSMIVTR personality disordersenduring patterns of perceiving relating to and thinking about the environment and oneself that are exhibited in a wide range of social and personal contextsare inflexible and maladaptive and cause significant functional impairment or subjective distresspersonality disorders are chronicSubjective stress due to the disorder isnt always felt by the individual but instead it can be felt by others because of the actions of the person with the disorderMany people who have personality disorders in addition to other psychological problems tend to do poorly in treatment Data shows that people who are depressed have a worse outcome in treatment if they also have a personality disorderPersonality disorders are included on a separate axis on Axis II because as a group they are distinctIn the axis system a patient can receive a diagnosis on only Axis I only Axis II or on both axes A diagnosis on both Axis I and Axis II indicates that a person has both a current disorder Axis I and a more chronic problem eg personality disorder Categorical and Dimensional ModelsPeople with personality disorders display problem characteristics over extended periodsTheir difficulty can be seen as one of degree rather than kindmeans that the problems of people with personality disorders may just be extreme versions of the problems many of us experience on a temporary basis such as being shy or suspiciousdistinction between problems of degree and problems of kind is usually described in terms of dimensions instead of categoriesIt is continuously debated whether personality disorders are extreme versions of otherwise normal personality variations dimensionsMost people in the field see personality disorders as extremes on one or more personality dimensionsYet because we diagnose using DSMuses categories it ends up being viewed in categoriesEither you have the disorder or do not DSM doesnt rate how example obsessive you are or compulsiveAdvantage of using categorical models is conveniencesimplificationProblems with categoriesleads clinicians to view disorders as real thingsex Realness of an infection or broken armSome argue that personality disorders are not things that exist but points at which society decides a particular way of relating to the world has become a problemresearchers believe that many or all personality disorders represent extremes on one or more personality dimensionssome have proposed that the DSMIVTR personality disorders section be replaced by a dimensional model in which individuals would not only be given categorical diagnoses but also would be rated on a series of personality dimensionsAdvantages a It would retain more information about each individual bit would be more flexible because it would permit both categorical and dimensional differentiations among individuals c it would avoid the often arbitrary decisions involved in assigning a person to a diagnostic categoryFive factor model of personalityBig Five people rated on a series of personality dimensions i extraversion Tendency to join in social situations and feel joy and optimism ii agreeableness Extent to which someone shows both compassion and hostility toward others iii conscientiousness Degree of organization and commitment to personal goals iv neuroticism Proneness to psychological distress and impulsive behaviour v openness to experience Curiosity receptivity to new ideas and emotional expressivenessOn each dimension people are rated high low or betweenFive dimensions are universalAlternative model byWesten and Shedleridentifies 12 personality dimensions Psychological health Ability to love others find meaning in life and gain personal insights Psychopathy Lack of remorse presence of impulsiveness and tendency to abuse drugs Hostility Deepseated ill will Narcissism Selfimportance grandiose assumptions about oneself and tendency to treat others as an audience to provide admiration Emotional Intense and uncontrolled emotional reactions dysregulation Dysphoria Depression shame humiliation and lack of any pleasurable experiences Schizoid orientation Constricted emotions inability to understand abstract concepts such as metaphors and few or no friends Obsessionality Absorption in details stinginess and fear of dirt and contamination Thought disorder Such as believing one has magical powers over others or can directly read their minds Oedipal conflict Adult pursuit of romantic partners who are already involved with others inappropriate seductiveness and intense sexual jealousy Dissociated Fragmenting of thought and perception often related to past sexual abuse consciousness
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