Download Personality Disorders in Adults and Abnormal Behavior in Children

UNIT VII STUDY GUIDE
Personality Disorders in Adults and
Abnormal Behavior in Children
Learning Objectives
Reading
Assignment
Chapter 13:
Personality Disorders and
Impulse Control Disorders
Chapter 14:
Abnormal Behavior in
Childhood and
Adolescence
Key Terms
1. Antisocial personality
disorder
2. Asperger’s disorder
3. Autism
4. Avoidant personality
disorder
5. Borderline personality
disorder
6. Childhood
disintegrative disorder
7. Conduct disorder
8. Dependent personality
disorder
9. Ego dystonic
10. Ego syntonic
11. Encopresis
12. Enuresis
13. Fragile X syndrome
14. Histrionic personality
disorder
15. Impulse control
disorders
16. Kleptomania
17. Narcissistic
personality disorder
18. Obsessive-compulsive
personality disorder
19. Oppositional defiant
disorder
20. Paranoid personality
disorder
21. Pathological gambling
PSY 2010, Abnormal Psychology
Upon completion of this unit, students should be able to:
1. Recognize and classify personality disorders by odd and eccentric
behavior; dramatic, emotional, or erratic behavior; and/or anxious or
fearful behavior.
2. Discuss the psychodynamic, learning, family, biological, and
sociocultural perspectives of personality disorders.
3. Explain the psychodynamic, cognitive-behavioral, and biological
approaches of treating personality disorders.
4. Discuss how cultural beliefs play a role in mental health issues of
children and describe the prevalence and risk of mental health disorders
in children.
5. Explain pervasive developmental disorders; especially autism.
6. Explain causes and interventions for mental retardation.
7. Describe the types of learning and communication disorders and their
treatment approaches.
8. Recognize the types of attention deficit and disruptive disorders, and
childhood anxiety and depression disorders, as well as treatments for
these disorders.
Written Lecture
Personality Disorders
Take a look at the “reality” shows on TV. We have bridezillas lambasting anyone
who does not agree with what they want for their wedding, dating shows where a
bachelor stays on the show just to make fun of the star bachelorette and dupe
the rest of the bachelor participants, and singing contests where it’s not always
about the talent, but about which contestant gets the most votes. YouTube
allows unmonitored self-promotion, and anyone can blog about his or her social
and sexual escapades. These sometimes rude and crude media productions
invite offers of book deals and movie rights. If you promote yourself well, you can
become a millionaire. These “reality” antics both intrigue and irritate us as
viewers. This is the paradox of a narcissist. If narcissists were just complete
fools, we would avoid them. However; their entertaining and funny side hides
their aggression and manipulation; but only for a while. Our fascination and
attraction with this odd combination makes it hard to recognize this personality
disorder (Kaufman, 2011).
A question to ponder: Are we creating narcissists by promoting and indulging
children’s self-esteem?
Personality disorders are characterized by patterns of persistent, maladaptive
behaviors that affect how a person relates to others. Together these behaviors
result in an enduring personality profile. An individual with a personality disorder
has very poor insight into the disorder and is generally unaware that their
behavior is abnormal. In other words, they are not bothered by their maladaptive
pattern of functioning. In contrast, people with clinical disorders, such as major
1
22. Pervasive
developmental
disorders
23. Phenylketonuria
24. Rett’s disorder
25. Schizoid personality
disorder
26. Schizotypal
personality disorder
depression, experience distress due to the disorder. This prompts them to seek
out treatment. The person with a personality disorder rarely seeks out treatment
for maladaptive behavior associated with their personality. Personality disorders
are divided into three clusters in the DSM-IV-TR. They are listed below.
1. Cluster A: Characterized by odd and eccentric behavior
 Paranoid Personality Disorder—extreme suspiciousness of others
intentions; believes others are out to hurt them in some way;
absence of delusions
 Schizoid Personality Disorder—isolated from others and does not
seek out relationships with others; emotionally aloof and detached;
seems apathetic
 Schizotypal Personality disorder—also socially isolated; holds
bizarre or odd beliefs; no clear evidence of psychosis but seems to
be more pervasive in individuals with a family history of
Schizophrenia
2. Cluster B: Characterized by dramatic and erratic behavior
 Antisocial Personality Disorder—demonstrates disregard for social
norms, including laws; disregards and violates the rights of others;
irresponsible, and lacks remorse
 Borderline Personality Disorder—demonstrates difficulty regulating
emotion; impulsive with frequent mood changes; has problematic
and tumultuous relationships; extreme fear of abandonment leads to
behaviors, such as suicide threats and attempts, as well as selfmutilation
 Narcissistic Personality Disorder—demonstrates extreme and
grandiose self-admiration; lacks empathy for others
 Histrionic Personality Disorder—excessive display of emotions;
craves attention and loves being the center of attention;
manipulative
3. Cluster B: Characterized by extreme anxiousness/fearful behavior
 Avoidant Personality Disorder—fears rejection, which causes them
to avoid social situations and relationships with others
 Dependent Personality Disorder—displays the need to be taken
care of by others; the fear of losing support of others leads to clingy
behavior
 Obsessive-Compulsive Personality Disorder—preoccupation with
orderliness; perfectionist; inflexible. (Unlike Obsessive Compulsive
Disorder, people with this personality disorder are not distressed by
their need to be perfect or abide by strict rules and regulations.)
Causes and Treatment of Personality Disorders
According to the American Psychological Association, there are several factors
that have been found to be related to the development of personality disorders.
These include genetic factors, such as malfunctioning genes, childhood trauma
(such as sexual abuse), high reactivity to environmental stimuli (such as noise
and light), and verbal abuse (American Psychological Association, n.d.).
Personality disorders are notoriously difficult to treat. This, in part, is due to the
lack of insight presented by the individual with a personality disorder. They tend
to be quite resistant to suggestions that their behavior may be causing issues or
problems making therapy difficult, and often terminate treatment prematurely.
However, current research shows promise for treating personality disorders. For
instance, research on borderline personality disorder shows Dialectical Behavior
Therapy (DBT) and cognitive-behavioral therapy can be effective (Yager, 2010).
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DBT focuses on helping the individual regulate emotions, while CBT focuses on
changing faulty and dysfunctional beliefs. Other treatment methods include
psychodynamic therapy, which consists of helping the person find the root of
maladaptive behavior. Biological treatment consists of antidepressant and
antianxiety medication.
Case Example: Martha was recently hospitalized after
threatening suicide. During the initial evaluation, Martha reveals
she also cuts herself when she is upset. She often becomes
hostile and excessively weepy with others in the inpatient
hospital unit and fears that her current boyfriend will abandon
her while she is hospitalized. She has difficulties with the other
patients due to her impulsivity and excessive moodiness.
What personality disorder does Martha display? Borderline Personality Disorder
Impulse Control Disorders
Impulse control disorders are characterized by difficulties controlling impulses.
This classification of disorders includes pathological gambling, kleptomania
(compulsive stealing), intermittent explosive disorder (failure to control
aggressive impulses), pyromania (compulsive fire-setting), and trichotillomania
(compulsive pulling of one’s hair). Treatment of impulse control disorders
includes psychotropic medication and cognitive-behavioral therapy.
Case example: Gary has been arrested several times for
assaulting others. While in jail, it becomes clear that Gary easily
becomes aggressive; this leads to violent behavior. He is
constantly getting into physical altercations with others over
small things. For instance, he broke another inmates arm and
jaw because the inmate did not hear him when Gary asked him
to move.
What impulse control disorder is Gary displaying? Intermittent Explosive
Disorder
Childhood and Adolescent Disorders
It is important that culture and age be considered before determining what
constitutes abnormal behavior in childhood and adolescence. For instance,
imaginary friends during early childhood are developmentally normal and
considered age appropriate and should not be considered abnormal behavior or
evidence of a mental disorder. Risk factors that increase the likelihood of a
mental disorder during childhood includes genetics, environmental stressors;
such as unstable living conditions, and family factors; such as abuse. Disorders
that can be seen during childhood or adolescence and their symptoms are listed
below.
1. Pervasive Developmental Disorders—impairment in numerous areas of
functioning and behavior. Disorders under this category include autistic
disorder and asperger’s disorder.
2. Mental Retardation—broad-array of impairment in cognitive and social
functioning. Intelligence quotient, (IQ) scores of 70 or less combined
with inability to perform age-appropriate life tasks. Categories of Mental
Retardation include: Mild (IQ 50-70), Moderate (IQ 35-49), Severe
(20-34), and Profound (IQ 20 or below).
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3. Learning Disorders—exists when there is a deficiency in a specific
learning ability. Disorders in this category include mathematics disorder,
disorder of written expression, and reading disorder. The most
commonly recognized Learning Disorder is the reading disorder known
as dyslexia. Dyslexia is characterized by impairment in reading abilities.
4. Communication Disorders—characterized by impairment in the use of
and comprehension of language. Disorders include expressive language
disorder, mixed receptive/expressive language disorder, phonological
disorder, and stuttering.
5. Attention-Deficit and Disruptive Behavior Disorders—this group of
disorders is characterized by socially disruptive behaviors. Disorders
seen under this category include Attention-Deficit Hyperactivity Disorder
(ADHD), conduct disorder, and oppositional defiant disorder.
6. Anxiety Disorders in childhood—like adults, children can also experience
the many different anxiety disorders, such as obsessive-compulsive
disorder and panic disorder. One disorder unique to childhood is
separation anxiety disorder, which is characterized by excessive fear of
being separated from parent or caretaker.
7. Depression Disorders in childhood—children and adolescents can also
experience depressive disorders similar to that of adults. Symptoms
tend to be the same, but it is common for children to demonstrate
irritability instead of sadness. It is important to note that suicide is a risk
in adolescence. In fact, it is the third leading cause of death in
adolescence. Risk factors for suicide at this age include being a girl,
living in a rural or less populated area, white race or Native American in
the U.S., depression, history of suicide attempts, history of sexual
abuse, family conflicts, stressful life events (such as going to a new
school), substance abuse, and social contagion (imitating peer suicidal
behavior).
8. Elimination Disorders—impairment in ability to control either urination
(Enuresis) or bowel movements (Encopresis) in the absence of an
organic disorder.
Chapter 14 in the textbook does a good job of summarizing all the symptom
criteria for each of the disorders discussed above. Additionally, theoretical
perspectives and treatment approaches for each disorder are also reviewed.
Take time to look over each disorder carefully. Then, read the case below and
identify the disorder and a treatment approach. Finally, try to conceptualize the
case from one of the theoretical perspectives discussed in the textbook.
Take a look at the case of Donna.
Donna has just started nursery school. She is 3-years-old. Her
parents are hoping her language skills will develop now that she
will be in school as she has not yet developed language skills.
As a result, communication between Donna and her parents has
been difficult because she is not speaking in coherent words as
of yet. Additionally, Donna is not expressive. For instance, she
does not make eye contact or show facial expressions. Donna
spends most of day in her playroom playing with the wheels on
her Barbie car. Her parents are concerned because she will sit
for hours doing this. If they try to stop her, she becomes very
upset.
What disorder is Donna displaying? Autistic Disorder
How should Donna be treated? There is no cure. However, early intervention
has the best prognosis. The use of intensive behavioral treatment is the most
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effective treatment method for Autism. Treatment would include the use of
operant conditioning techniques using reinforcement to increase language and
social skills. Treatment programs need to be highly structured and individualized.
The National Institute of Mental Health’s website at http://www.nimh.nih.gov
provides good information regarding the treatment of Autism Spectrum
disorders.
How would you conceptualize Donna’s disorder? From a cognitive-learning
perspective, Donna is slow to learn because of perceptual deficits. She can only
process and attend to one stimulus at a time, which limits her ability to integrate
information and make associations. From a biological perspective, though, there
is evidence that suggests that brain abnormalities along with environmental
factors, such as exposure to viruses or toxins, lead to Autism.
References
What causes personality disorders? (n.d.). American Psychological Association.
Retrieved from www.apa.org/topics/personality/disorders-causes.aspx
Kaufman, S. B. (2011). The peacock paradox: You can’t help falling for them,
and by the time you’ve gleaned their true colors, you’re hooked—and
possibly hurt. Welcome to the contradictory universe of narcissism.
Psychology Today, 44(4), 56(8). Retrieved from Academic OneFile.
Yager, J. (2010). Treatments for borderline personality disorder. Journal Watch
Psychiatry. doi: http://dx.doi.org/10.1056/JP201001040000003
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