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Psychology 305B: Theories of Personality Lecture 21 Psychology 305 1 Lecture 21 Questions That Will Be Answered In Today’s Lecture Lecture 22 Cultural Differences in Personality, continued 1. Do trait theories adequately describe personality in non-Western cultures? (continued) Psychology 305 2 Personality Disorders 1. What is a personality disorder? 2. What personality disorders are recognized by the DSM-IV-TR? 3. Are personality disorders better represented by categories or dimensions? Psychology 305 3 Do trait theories adequately describe personality in non-Western cultures? (continued) In contrast to McCrae et al. (2005), other researchers have administered indigenously developed measures to participants in other cultures. The results of their studies suggest that there may be more than 5 dimensions underlying personality in some non-English speaking countries. For example, Church et al. (1997) developed an indigenous measure of personality in the Philippines: Psychology 305 4 Church et al. (1997) Employed the lexical approach: Personality attributes were identified through analysis of the Filipino language, starting with a dictionary-based list of 6,900 trait adjectives. Ultimately, 861 trait adjectives were identified and complied into a measure that was administered to participants in the Philippines. Psychology 305 5 Factor analysis revealed 7 dimensions underlying the personality attributes assessed by the measure: Gregariousness, Self-assurance, Concern for others vs. egotism, Conscientiousness, Intellect, Temperamentalness, and Negative valence. They found that the first 5 of these dimensions were highly correlated with the Big 5 dimensions of E, N, A, C, and O, respectively: Psychology 305 6 Correlations between Church et al.’s (1997) Filipino Dimensions of Personality and the Big 5 Filipino Dimension E N A C O Gregariousness .66** .03 -.13** -.37** .10** Self-Assurance .31** -.58** .13** .24** .36** Concern for others vs. Egotism -.03 -.17** .81** .56** .10** Conscientiousness -.35** -.20** .59** .77** -.01 Intellect .05 -.26** .30** .32** .56** **p < .01 7 However, they found that the latter 2 dimensions— temperamentalness and negative valence—were not correlated with the Big 5 dimensions. For this reason, Church et al. described these 2 dimensions as “indigenous Philippine dimensions”: Temperamentalness: Reflects emotional reactivity. Encompasses traits such as hot-headed and irritable vs. calm and understanding. Negative valence: Reflects social deviance. Encompasses traits such as crazy and sadistic vs. normal and loving. Psychology 305 8 On the basis of these findings, Church et al. (1997) suggested that there are at least 7 dimensions underlying personality in the Philippines: E, N, A, C, O, temperamentalness, and negative valence. Psychology 305 9 What is a personality disorder? • The American Psychiatric Association characterizes a personality disorder (PD) as follows: 1. A PD is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture. This pattern is manifest in 2 or more of the following areas: Psychology 305 10 (a) Cognition (i.e., ways of perceiving and interpreting the self, others, and events). (b) Affectivity (i.e., the range, intensity, ability, and appropriateness of emotional responses). (c) Interpersonal functioning. (d) Impulse control. Psychology 305 11 2. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. 3. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. 4. The enduring pattern is stable and of long duration, and its onset can be traced back to adolescence or early adulthood. Psychology 305 12 5. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. 6. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition, such as head trauma. Psychology 305 13 • The most widely accepted system for describing and diagnosing PDs is the Diagnostic and Statistical Manual of Mental Disorders (i.e., the DSM-IV). • The DSM-IV lists the symptoms associated with 200 mental disorders, 10 of which are PDs. Psychology 305 14 What personality disorders are recognized by the DSM-IV-TR? • The 10 personality disorders listed in the DSM-IV are divided into 3 clusters. We will consider 2 disorders from each cluster in depth. Cluster A: The Eccentric Cluster Individuals diagnosed with disorders belonging to this cluster are characterized by social awkwardness and odd or eccentric behaviour. The disorders included in this cluster are schizotypal PD, paranoid PD, and schizoid PD. Psychology 305 15 (a) Schizotypal PD (SPD) According to the DSM-IV, SPD is a “pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior." An individual is diagnosed with SPD if s/he displays at least 5 of the following symptoms: Psychology 305 16 Ideas of reference. Odd beliefs or magical thinking. Unusual perceptual experiences, including bodily illusions. Odd thinking and speech. Suspiciousness or paranoid ideation. Psychology 305 17 Inappropriate or constricted affect. Behavior or appearance that is odd, eccentric, or peculiar. Lack of close friends or confidants other than relatives. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self. Psychology 305 18 Thus, the individual with SPD is socially withdrawn and displays eccentric beliefs, paranoid tendencies, idiosyncratic speech, perceptual illusions, unusual appearance, inappropriate affect, and social anxiety (Frances, 1995). Estimated to afflict 3% of the general population. Sex differences have not been found. Psychology 305 19 Case Study: Fred is an unemployed 29 year old man. He states that he can often read people’s minds, and finds it disturbing to be in crowds. He thinks other people know that he is reading their mind and resent him. He often feels he is leaving his body, but can concentrate on not “slipping away.” He states he does not have hallucinations, but he does think that he can help his family by concentrating really hard on their safety when, for example, they take a trip on an airplane. He had a girlfriend for about a year when he was in college. He said that "she got tired of my reading her mind." She also wanted to go out and do more, but Fred stated that he was just too uncomfortable in social situations. Fred has held a number of relatively unskilled jobs such as dishwasher, parks cleaner, and book store clerk. He often had difficulty getting to work on time, and felt that his boss was always watching him. He has trouble with schedules, and sometimes feels “too spacy” to be around anyone. Psychology 305 20 (b) Paranoid PD (PPD) According to the DSM-IV, PPD is a “pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent." An individual is diagnosed with PPD if s/he displays at least 4 of the following symptoms: Psychology 305 21 Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him/her. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him/her. Reads hidden demeaning or threatening meanings into benign remarks or events. Psychology 305 22 Is unforgiving of perceived insults, injuries, or slights on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack. Has recurrent suspicions, without justification, regarding the fidelity of his/her spouse or sexual partner. Psychology 305 23 Thus, the individual with PPD is suspicious, guarded, and vindictive. This individual tends to view him/herself as righteous and mistreated, and will pursue perceived conflict with great tenacity, never seeming to tire in the quest for self-vindication (Beck, 1990; Kantor, 1992). Estimated to afflict 0.5 – 2.5% of the general population. PPD is more common in men than in women. Psychology 305 24 Case Study: Derek worked in a large office as a computer programmer. When another programmer received a promotion, Derek felt that the supervisor "had it in for him" and would never recognize his worth. He was sure that his coworkers were subtly downgrading him. Often he watched as others took coffee breaks together and imagined they spent this time talking about him. If he saw a group of people laughing, he knew they were laughing at him. He spent so much time brooding about the mistreatment he received that his work suffered and his supervisor told him he must improve or receive a poor performance rating. This action reinforced all of Derek's suspicions. He began to look for a new job. Within a few weeks, he found a position in another large company. Soon, however, he began to feel that others in the office didn't like him, excluded him from all conversations, made fun of him behind his back, and eroded his position. Derek quit. Soon thereafter, he mailed angry letters to his former co-workers, threatening to sue them. Psychology 305 25 Cluster B: The Erratic Cluster Individuals diagnosed with disorders belonging to this cluster are characterized by poor emotional control. The disorders included in this cluster are borderline PD, histrionic PD, narcissistic PD, and antisocial PD. Psychology 305 26 (a) Borderline PD (BPD) According to the DSM-IV, BPD is a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity." An individual is diagnosed with BPD if s/he displays at least 5 of the following symptoms: Psychology 305 27 Frantic efforts to avoid real or imagined abandonment. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Markedly and persistently unstable self-image or sense of self. Impulsivity in at least two areas that are potentially selfdamaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Psychology 305 28 Recurrent suicidal behavior, gestures, or threats, or selfmutilating behavior. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety). Chronic feelings of emptiness. Inappropriate, intense anger or difficulty controlling anger. Transient, stress-related paranoid ideation or severe dissociative symptoms. Psychology 305 29 Thus, the individual with BPD experiences intense abandonment fears and inappropriate anger even when faced with a time-limited separation. They may believe that this "abandonment" implies they are "bad." They are intolerant of being alone. Their frantic efforts to avoid abandonment include impulsive actions such as selfmutilation or suicidal behaviors. Estimated to afflict 2% of the general population. BPD is 3 times more common in women than in men. Psychology 305 30 Case Study: Becky is 25 years old. She was recently released from the hospital after she drove her car into her boyfriend’s office. She said she wanted to kill herself and him because he split up with her, and she is "devastated" with pain. Becky has had 7 live-in boyfriends since she left her parents home at the age of 15. She usually meets someone, falls “madly in love” and moves in with them within weeks. After a few months she discovers that they are not as wonderful as she first thought. She starts to see the men as mean, withholding, selfish, and lazy. They often have numerous fights with separations and reunions. After a year or so, Becky usually finds a new man, and begins the cycle again. Becky had been living with her most recent boyfriend for about 3 months prior to the accident. Psychology 305 31 Case Study, continued: Becky has held numerous jobs. She is often enthusiastic and a great worker for the first few weeks. She then starts to complain about the coworkers, and begins to have conflicts with her supervisor. She often quits, or is fired after an angry shouting match with her supervisor. Becky is requesting rehabilitation services because she is so “depressed” and hurt she is not sure she will ever feel happy again. She still sometimes thinks about killing herself. She wants help finding a job where the people will appreciate her, and they don't all turn out to be mean and selfish. Psychology 305 32 (b) Histrionic PD (HPD) According to the DSM-IV, HPD is a “pervasive pattern of excessive emotionality and attention seeking." An individual is diagnosed with HPD if s/he displays at least 5 of the following symptoms: Psychology 305 33 Is uncomfortable in situations in which s/he is not the center of attention. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior. Displays rapidly shifting and shallow expression of emotions. Consistently uses physical appearance to draw attention to self. Psychology 305 34 Has a style of speech that is excessively impressionistic and lacking in detail. Shows self-dramatization, theatricality, and exaggerated expression of emotion. Is suggestible or easily influenced by others or circumstances. Considers relationships to be more intimate than they actually are. Psychology 305 35 Thus, the individual with HPD seeks continuous excitement, attention and appreciation. S/he is characterized by shallow and labile affect, selfdramatization, suggestibility, and self-indulgence. This individual may engage in inappropriate seductiveness and is excessively concerned with physical attractiveness. S/he longs to be loved and taken care of by someone who is both powerful and able to be controlled through the use of charm and seductiveness. Estimated to afflict 2 – 3 % of the general population. HPD is more common in women than in men. Psychology 305 36 Case Study: Roxanne was a student who also worked in the evenings as a dancer at a strip club. She would tell people that her job was temporary. However, she readily admitted that the job met her two most important needs: money and attention, “two things I cannot live without.” Roxanne decided to take some psychology courses for self-improvement. She typically came to class “dressed to kill” and seemed out of place. Once she went to her professor’s office yet did not seem to have any direct questions to discuss. Instead, she seemed just to want to talk about herself and her job. After this meeting, she told several students that she was on a first-name basis with her professor and that he was her good friend. In class, she frequently behaved in ways that drew attention to herself, such as sighing loudly when the professor made a point, or blurting out answers to rhetorical questions. Toward the end of the course, Roxanne stopped going to class and missed the final exam. She e-mailed her professor, saying that she had been experiencing a debilitating condition and had been seen by several doctors. The professor never heard from her again. Psychology 305 37 Cluster C: The Anxious Cluster Individuals diagnosed with disorders belonging to this cluster are characterized by behaviours that are designed to reduce or avoid anxiety. The disorders included in this cluster are obsessivecompulsive PD, avoidant PD, and dependent PD. Psychology 305 38 (a) Obsessive-Compulsive PD (OCPD) According to the DSM-IV, OCPD is a “pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.” An individual is diagnosed with OCPD if s/he displays at least 4 of the following symptoms: Psychology 305 39 Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost. Shows perfectionism that interferes with task completion. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships. Is excessively conscientious, scrupulous, and inflexible about matters of morality, ethics, or values. Psychology 305 40 Is unable to discard worn-out or worthless objects even when they have no sentimental value. Is reluctant to delegate tasks or to work with others unless they submit to exactly his/her way of doing things. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded. Shows rigidity and stubbornness. Psychology 305 41 Thus, the individual with OCPD is afraid of making a mistake or being accused of being imperfect. In response, the individual engages in a quest for perfection that results in inconsiderate domination of others and an inclination to blame and criticize people with whom they are connected. They engage in blind obedience to authority or principle. They are extremely self-disciplined, restrained, and self-critical (Benjamin, 1993) Estimated to afflict 1% of the general population. OCPD is 2 times more common in men than in women. Psychology 305 42 Case Study: Maria was a 39-year old woman who had been married for 18 years. She was always orderly and kept a very neat house. She vacuumed every day, whether or not the house needed it. She constantly nagged her husband or was angry at him because he did not seem to care as much as her that things be neat, clean, and orderly. They did not have children because, according to Maria, children would be too much additional work for her, and she certainly could not count on her husband to do anything right in terms of taking care of children or the house. Besides, children would disrupt the order and neatness of her life. Maria’s boss often complained that she was slow. Her boss did not appreciate the fact that she checked her work over and over again before turning it in. Maria also had difficulties working as part of a team because none of the other workers met her standards. She felt they were sloppy and imprecise. Her boss eventually had to isolate her and give her independent work because she could not get along with her co-workers. Maria did not have many friends. She claimed she never had time for friends. Psychology 305 43 (b) Avoidant PD (APD) According to the DSM-IV, APD is a “pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation.” An individual is diagnosed with APD if s/he displays at least 4 of the following symptoms: Psychology 305 44 Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection. Is unwilling to get involved with people unless certain of being liked. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. Is preoccupied with being criticized or rejected in social situations. Psychology 305 45 Is inhibited in new interpersonal situations because of feelings of inadequacy. Views self as socially inept, personally unappealing or inferior to others. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. Psychology 305 46 Thus, the individual with APD feels inadequate, unacceptable, and incapable of being loved. S/he retreats from others in anticipation of rejection and, therefore, leads a socially impoverished life. Interpersonally, s/he is ill at ease, awkward, and tense. S/he experiences unremitting self-consciousness and self-contempt, yearning for social relations that are perceived to be unattainable (Oldham, 1990). Estimated to afflict 0.5 - 1% of the general population. Sex differences have not been found. Psychology 305 47 Case Study: John is 21 year old university student who has gone to the university’s psychological clinic with the general complaint that he is uncomfortable in social settings. Because he is so shy and nervous, he keeps his contact with others to a minimum. He is worried about starting new classes next semester and having to be in rooms with total strangers. He is especially worried about his psychology courses, where “they might find out I am a nutcase.” He adds that he is thinking of switching his major from psychology to computer science. Although he is curious about people, and therefore likes psychology, he nevertheless feels awkward around them. Computers, he thinks, are much easier to get along with. Psychology 305 48 Case Study, continued: John reports that, as a child, he was teased mercilessly by other children. He remembers withdrawing from others at about this time in his life. He says that in grade school he would try to make himself small and inconspicuous, so others would not notice him. John has never held a real job. At university, he apparently has no friends, or at least cannot name any. He says he is afraid others will not like him “when they find out what I am really like,” so he avoids social contact. Psychology 305 49 Are personality disorders better represented by categories or dimensions? • Although the DSM-IV uses categories to differentiate personality disorders, many theorists argue that the use of categories is flawed. Among the primary criticisms offered by these theorists are: 1. the subjective identification of diagnostic categories. 2. the occurrence of comorbid diagnoses. 3. the high rate of “PD NOS” diagnoses. 4. the poor test-retest reliability of diagnoses. Psychology 305 50 • In light of these criticisms, many theorists argue that personality disorders are better represented as extremes of personality dimensions rather than categories. • In recognition of the dimensional alternative to the categorical approach, the DSM-IV notes: “An alternative to the categorical approach is the dimensional perspective that Personality Disorders represent maladaptive variants of personality traits that merge imperceptibly into normality.” Psychology 305 51 • Several dimensional models of personality disorders have been proposed. Among the most influential are: 1. Cloninger’s Model of Psychopathology 2. The Five Factor Model of Personality Dysfunction Psychology 305 52 Questions That Were Answered In Today’s Lecture Lecture 22 Cultural Differences in Personality, continued 1. Do trait theories adequately describe personality in non-Western cultures? (continued) Psychology 305 53 Personality Disorders 1. What is a personality disorder? 2. What personality disorders are recognized by the DSM-IV-TR? 3. Are personality disorders better represented by categories or dimensions? Psychology 305 54