Download ABNORMAL PSYCHOLOGY SIXTH EDITION

Personality Disorders
Symptoms
Diagnosis
Frequency
Personality: enduring patterns of thinking and behavior
that define the person and distinguish him or her from
other people.
 Personality disorder - emphasizes the duration of the
pattern and the social impairment associated with the
traits in question.
 Disorders characterized by extreme and rigid
personality traits that cause impairment
 Axis II disorders
 Ego syntonic

 The
concept of social dysfunction plays an important
role.
 If the personality characteristics typically interfere
with the person’s ability to get along with other people
and perform social roles, they become more than just
a collection of eccentric traits or peculiar habits.
Social
Motivation
 Motives
describe the way that the person would
like things to be, and they help to explain why
people behave in a particular fashion.
 Two of the most important motives in
understanding human personality are
 affiliation—the desire for close relationships
with other people.
 power—the desire for impact, prestige, or
dominance.
Social
 Many
Motivation
of the symptoms of personality
disorders can be described in terms of
maladaptive variations with regard to
needs for affiliation and power.
Cognitive
Perspectives Regarding Self
and Others
 One
central issue involves our image of
ourselves.
Is the self-image stable?
Is self-esteem maintained by external
validation?
 Prevalence
in Community and
Clinical Samples
 The
overall lifetime prevalence for
having at least one personality disorder
varies between 10% and 14%.
 Highest prevalence rates for OCPD,
ASPD, and APD.
 75% of patients with Axis II disorder also
have Axis I disorder.
 Low rates for NPD may not recognize the
nature of their own problems.
 Gender
 The
Differences
overall prevalence of personality
disorders is approximately equal in men
and women.
 Antisocial personality disorder: 5%
reported for men and 1% for women
 Gender Bias and Diagnosis
 Critics contend that the definitions of
some categories are based on sex role
stereotypes and therefore are
inherently sexist.
Stability
of Personality Disorders
over Time
 Temporal
stability is one of the most
important assumptions about personality
disorders.
 The long-term prognosis is less
optimistic for schizotypal and schizoid
personality disorders. People with these
diagnoses are likely to remain socially
isolated and occupationally impaired.
 Cluster A
are
people who are
perceived as odd or
eccentric
Includes paranoid,
schizoid, and
schizotypal
personality
disorders
Cluster B are people
whose behavior is overly
dramatic, emotional, or
erratic
 Includes
antisocial,
borderline, histrionic and
narcissistic personality
disorders
Cluster C are people who
often appear anxious or
fearful
Includes avoidant,
dependent, and obsessivecompulsive personality
disorders
Paranoid Personality Disorder
Personality traits involving
extreme distrust and
suspiciousness.
Paranoid Personality Disorder
 Includes
four or more of the following:
Suspiciousness of others
 Unjustified doubts about disloyalty
 Reluctance to confide in others
 Reading threatening meanings into benign events
 Persistent tendency to bear grudges
 Tendency to feel attacked and counterattack
 Unjustified suspiciousness about infidelity of partner

Schizoid
Personality
Disorder
Personality traits
involving detachment
from social relationships
and a restricted range of
emotional expression
Schizoid
 Include
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
Personality Disorder
four or more of the following:
Neither desires nor enjoys close relationships
Almost always chooses solitude
Little if any interest in sexual relationships
Takes pleasure in few activities
Lacks close friends
Indifferent to praise or criticism
Emotional coldness, detachment or flatness
Schizotypal
Personality Disorder
Personality traits
involving
eccentricities of
behavior, cognitive
or perceptual
distortions, and
acute discomfort in
close relationships
Schizotypal
Personality Disorder
Five or more of the following:
Ideas of reference
Odd beliefs or magical thinking
Unusual perceptual experiences
Odd thinking and speech
Suspiciousness or paranoid ideas
Inappropriate or constricted affect
Odd, eccentric or peculiar behavior or
appearance
Lack of close friends
Excessive social anxiety
Antisocial
Personality
Disorder
 Personality traits
involving profound
disregard for, and
violation of, the rights
of others
Antisocial Personality Disorder
Includes three or more of the following:
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Failure to conform to lawful behavior
Deceitfulness
Impulsivity
Irritability or aggressiveness
Reckless disregard for safety of self and
others
Consistent irresponsibility
Lack of remorse
Borderline
Personality Disorder
Personality traits involving
instability in interpersonal
relationships, self-image,
and emotions, impulsivity,
and self-destructive
behavior
Borderline
Personality Disorder
Five or more of the following:
Frantic efforts to avoid
abandonment
Unstable and intense relationships
Unstable self image
Impulsivity (self destructive)
Suicidal behavior
Affective instability
Chronic feelings of emptiness
Inappropriate, intense anger
 One
of the most perplexing, most disabling,
and most frequently treated forms of PD.
 Otto Kernberg (1967, 1975)
 BPD refers to a set of personality features or
deficiencies that can be found in individuals
with various disorders.
 Common features/abnormal behaviors of BPD
 Splitting- alternately seeing people as entirely
good or entirely bad.
 Impulse control problems
 See Figure 9-1
Treatment
 Most
difficult to treat.
 Between 1/2 to 2/3 of all patients with BPD
discontinue treatment prematurely.
 Marsha Linehan – Dialectical Behavioral Therapy
(DBT)
 Emphasis: Learning to be more comfortable
with strong emotions.
 Emphasis: Therapist’s acceptance of the
patient and their negative behaviors.
 Women
treated with DBT tend to drop
out of treatment at a lower rate; tend
to experience more improvement than
women in control groups.
 Medication is frequently used
adjunctively.
 Antipsychotics
 Antidepressants
 Lithium
 Anticonvulsants.
Histrionic
Personality Disorder
Personality traits
involving excessive,
superficial emotionality
and attention seeking
Histrionic
Personality Disorder
Five or more of the following:
Uncomfortable if not the center of attention
 Inappropriately seductive or provocative
 Rapidly shifting and shallow emotions
 Use of appearance to draw attention
 Speech is impressionistic and lacking in detail
 Self-dramatization, theatricality
 Suggestibility
 Considers relationships more intimate than they
are

Narcissistic
Personality Disorder
Personality traits
involving extreme
grandiosity, need
for admiration, and
lack of empathy
Narcissistic
 Five
Personality Disorder
or more of the following:
Grandiose sense of self-importance
 Preoccupied with fantasies of unlimited success, power,
brilliance, etc.
 Belief that he or she is “special”
 Requires excessive admiration
 Sense of entitlement
 Interpersonally exploitative
 Lacks empathy
 Often envious
 Arrogant or haughty

• Avoidant Personality Disorder
Personality traits involving social
inhibition, feelings of inadequacy,
and hypersensitivity to negative
evaluation
Avoidant
Personality Disorder
Four or more of the following:
Avoids activities due to fear of criticism,
disapproval or rejection
Unwilling to get involved with people unless certain
of being liked
Restrained in relationships due to fear of being
shamed or ridiculed
Preoccupied with criticism or rejection in social
situations
Inhibited in new situations due to feelings of
inadequacy
Views self as inept, unappealing, inferior
Reluctant to take personal risks
Dependent
Personality Disorder
Personality traits
involving submissive and
clinging behavior related
to an excessive need to
be cared for by others
Dependent
Personality Disorder
Five or more of the following:
Excessive need for advice and reassurance to make
decisions
Needs others to assume responsibility for most areas
of life
Difficulty expressing disagreement
Difficulty initiating or doing things on own
Goes to excessive lengths for nurturance or support
Feels helpless when alone, due to exaggerated fears
of being unable to care for self
Urgently seeks new relationship if close relationship
ends
Preoccupied with fears of being left to care for self
CAUSES
Little research on the
etiology of DPD.
 Overprotective,
authoritarian parents
are likely to foster
development of
dependency.
 Insecurely or anxiously
attached children are
likely to become
dependent.

TREATMENT
Virtually no literature
on the outcome of
treatment for DPD.
 Enter therapy for
other reasons, such as
depression, anxiety or
substance use
disorder.
 Cognitive therapy
 Psychopharmacology
is typically not used.

Obsessive-Compulsive
Personality traits
involving
preoccupation with
orderliness,
perfectionism, and
control at the
expense of
spontaneity,
flexibility, and
enjoyment
Personality Disorder
Obsessive-Compulsive
Personality Disorder
Four or more of the following:
Preoccupation with rules, lists, order, schedules, etc.
Perfectionism
Excessive devotion to work and productivity
Over-conscientious, scrupulous, inflexible about morality
Inability to discard worn-out or worthless objects
Reluctance to delegate tasks or work with
others unless they submit to exactly his or
her way of doing things
Miserly spending style
Rigidity and stubbornness