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Chapter Twelve.docx

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PSYC 3140
Joel Goldberg

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Chapter Twelve  Personality disorder: long-standing pattern of maladaptive behaviours, thoughts and feelings. Symptoms must be present from adolescence and early adulthood  Not on Axis I with acute disorders but on Axis II  They often experience one of the acute disorders such as major depression or substance abuse at some point  It is these that often bring them to medical attention, they generally don’t seek help until these affect them  Have serious problems relating to other people  Personality disorders are separated into three clusters: Cluster A: odd-eccentric Personality Disorder People with this have symptoms similar to schizophrenia including inappropriate or flat affect, odd thought and speech pattern and paranoia. They do, however, maintain their grasp on reality Cluster B: Dramatic-Erratic Personality People with this tend to be manipulative, Disorder volatile, and uncaring in social relationships. They are prone to be impulsive, sometimes violent behaviours that show little regard for their or safety or the safety or need of others Cluster C: Anxious-Fearful Personality People with this are extremely concerned Disorder about being criticized or abandoned by others and, thus, have dysfunctional relationships with others  Cluster A: odd or eccentric behaviour and thinking: includes three disorders such as paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder. Symptoms of schizophrenia but not psychotic  Cluster B: characterized by dramatic, erratic, emotional behaviour and interpersonal relationships and includes these four: antisocial personality disorder, histrionic personality disorder, borderline personality disorder, and narcissistic personality disorder. May even engage in suicidal attempts to gain attention  Cluster C: anxious, fearful emotions and chronic self-doubt. Includes: dependent personality disorder, avoidant personality disorder, and obsessive-compulsive personality disorder.  Problems with DSM: present disorders as quantitatively different from normal personality, rather it’s an extremity of normal behaviour  Also, there is a great deal of overlap in diagnosis  Third, some of the diagnosis requires information hard for clinician to obtain  Fourth, its conceptualized that these symptoms are stable across individuals but they vary.  TABLE 12.2  odd-eccentric personality disorder: behave in ways that are similar to the behaviours of people with schizophrenia, or paranoid psychotic disorder, but retain their grasp on reality to a greater degree. It comes in three labels: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder:  Paranoid personality disorder: unstable personal and intimate relationships, more men (three to one) and increased risk for acute psychological problems such as major depression, anxiety disorder, substance abuse  Paranoid Personality disorder: a pervasive and unwarranted mistrust of other people. Chronically think others are setting out to deceive them or exploit them. Hypervigilant and suspicious. Take trivial things like a slip of the tongue as very important  Theories and treatments: usually only come into contact with clinicians when in crisis i.e.: depression or anxiety but don’t necessarily feel the need to seek help for their paranoia. Therapist must be calm respectful and very straightforward to gain their trust  Therapist must not directly confront the paranoia but make patient raise questions in their own mind regarding it  Schizoid Personality disorder: lack the desire to form interpersonal relationships and are emotionally cold in interactions with others. Aloof, reclusive, detached. View relationships as unrewarding and messy. Very rare, 0.4-1.7%. can function just fine in society, three to one the men outnumber the women  Theories and treatments: people with relatives who have schizophrenia are more likely to have this, but the relationship between them is unknown and unclear. They are self-reliant. Treatment includes improving social skills. Help identify different feelings and express them  Schizotypal Personality Disorder: socially isolated, restricted range of emotions, and uncomfortable in interpersonal relationships and interactions. As children, passive, hypersensitive to criticism, and socially unengaged. Fall into four categories: 1. Paranoia or suspiciousness: perceive other people as deceitful and hostile, their social anxiety emerges from this paranoia 2. Ideas of reference: tend to believe that random events or circumstances are related to them 3. Odd beliefs and magical thinking: others know what they are thinking 4. Illusions: that are just short of hallucinations- example, think they see people in patterns of wallpapers  Theories and treatments: 0.6-5.2%. Transmitted genetically. Dysregulated dopamine similar to people with schizophrenia. Same drugs as schizophrenia, neuroleptics, etc. help relieve psychotic symptoms. Anti-depressants also help sometimes  Dramatic-erratic personality disorder: engage in behaviours that are dramatic and impulsive and show little regard for the safety of self or others. Label Key Features Similar Disorder on Axis I Antisocial personality disorder Pervasive pattern of criminal, Conduct disorder (diagnosed impulsive, callous, or ruthless in children) behaviour; disregard for the rights of others; no respect for social norms Borderline personality Rapidly shifting and unstable Mood disorder disorder mood, self-concept, and interpersonal relationships impulsive behaviour; transient dissociative states; self- effacement Histrionic personality disorder Rapidly shifting moods, Somatoform disorders, mood unstable relationships, and disorders intense need for attention and approval; dramatic, seductive behaviour Narcissistic personality Grandiose thoughts and Manic symptoms disorder feelings of one’s own worth; obliviousness to other’s needs; exploitative, arrogant demeanor  Antisocial personality disorder has more or less replaced the term psychopath. There are differences though.  Psychopaths can go on to lead successful lives because some are exceptional at masking their insanity and are very smart  Contributors to antisocial personality disorder: o G
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