Download Personality

Personality
Disorders
A Closer Look at Psychological
Disorders
Personality Disorders

Personality disorders are a class of
disorders marked by extreme, longstanding, inflexible personality traits
that cause subjective distress or
impaired social and occupational
functioning.
 They are not so much severe mental
disorders as dysfunctional styles of
living.
Personality Disorders

They impair social functioning –
sufferers seem unable to establish
meaningful relationships with other
people, to assume social responsibilities,
or to adapt to their social environment.
 The
behavior patterns are usually
evident by adolescence and obvious
to others
 But the person with the disorder
often does not recognize the
problem exists, which makes
treatment difficult.
Classification of Personality Disorders

The DSM-IV lists 10 personality disorders, divided into
three “clusters,” or categories.
Personality
Disorders
Cluster A:
Odd or Eccentric
behaviors
Cluster B:
Dramatic, emotional,
or impulsive
behaviors
Cluster C:
Anxious or fearful
behaviors
Cluster A
Odd or Eccentric Behaviors
(Paranoid, Schizoid, and
Schizotypal Personality Disorders)
Paranoid Personality Disorder






Paranoid personality disorder is characterized by a
deep distrust of others and a constant suspicion
that people around you have sinister motives.
They search for hidden meanings in everything
and read hostile intentions into the actions of others.
This suspiciousness gets in the way of personal
connections, so they have few, if any, meaningful
relationships.
They are quick to challenge the loyalties of
friends and loved ones and often appear cold and
distant to others. They usually shift blame to others
and tend to carry long grudges.
They are described as being tense, volatile, and
sensitive to criticism.
Causes:


Possible relationship to schizophrenia
Possible role of early experience



Trauma
Abuse
Learning

“World is dangerous”
Schizoid Personality Disorder








Detached from social relationships, their social skills
are often weak.
They are the true hermits, preferring the life of the loner
and avoiding intimate interactions with others at all
costs.
They genuinely prefer to be alone and do not secretly wish
for popularity. They do not show a need for attention or
acceptance.
They tend to seek jobs that require little social contact and
are perceived as humorless and distant.
They show a limited range of emotion and appear cold
and detached.
They appear unaffected by both praise and criticism.
No disorder in thought.
Causes:



Limited research
Precursor: childhood shyness
Possibly related to:
 Abuse/neglect
 Autism
 Dopamine
Schizotypal Personality Disorder



Some people believe that schizotypal personality disorder is a mild
form of schizophrenia.
Psychotic-like symptoms (they do have disorder in thought)
 Magical thinking – the irrational belief that one can bring about a
circumstance or event by thinking about it or wishing for it; normal
in preschool children. Superstitions, preoccupations with the
paranormal or “magical.”
 Ideas of reference - the belief that casual events, people's
remarks, etc. are referring to oneself when, in fact, they are not.
 Illusions - having illusions, or attributing a particular event to
some mysterious force or person who is not present. Affected
people may also feel they have special powers to influence
events or predict an event before it happens.
Odd and/or unusual
 Appearance – Their personal appearance may look unkempt—
clothing choices that do not "fit together," clothes may be too
small or large, or clothes may be noticeably unclean.
 Behavior – odd perceptions, beliefs, behaviors and thoughts
(often unconventional beliefs such as being convinced of having
extra sensory abilities).
Schizotypal Personality Disorder, cont.



Socially isolated
 Detachment from, and great discomfort in, social
relationships
Highly suspicious
 Often suspicious of others and display paranoid
tendencies.
Causes:
 Schizophrenia phenotype (possibly related to
schizophrenia)

People with schizotypal PD, like patients with
schizophrenia, may be quite sensitive to interpersonal
criticism and hostility, and there is now evidence to
suggest that parenting styles, early separation and
early childhood neglect can lead to the development of
schizotypal traits
Drawings done by patients diagnosed
with schizotypal personality disorder
Drawing done by a 15 year old with schizotypal
personality disorder. Said he felt as though he
had a “two-sided personality.”
Titled “Birth, Death, Anger, tick,
tick, tick…Soul taker”
Cluster B
Dramatic, Emotional, or
Impulsive Behaviors
(Narcissistic, Histrionic, Borderline, and
Antisocial Personality Disorders)
Narcissistic Personality Disorder

Characteristics of someone with Narcissistic PD:
 Exaggerated and unreasonable sense of
self-importance
 Extreme sensitivity to criticism
 A constant need for attention
 A tendency to arrogantly overestimate
personal abilities and achievements.
 Self-centered and envious.
 They exaggerate their achievements,
expecting others to recognize them as being
superior.
 They tend to be choosy about picking friends,
since they believe that not just anyone is
worthy of being their friend.
 They are generally uninterested in the
feelings of others and may take advantage of
them.
Narcissistic Personality Disorder, cont.

Other examples of narcissists:
 Do Facebook and other social networking
sites make us more narcissistic?
http://www.youtube.com/watch?v=71xHUBWLC1k

Causes
 Deficits in early childhood learning
 Altruism
 Empathy
 Sociological view
 Increased individual focus
 “Me generation”
Histrionic Personality Disorder








Common diagnosis in females
Emotional shallowness and overly dramatic
behavior.
Vague, superficial speech
They need to be the center of attention all the
time, often interrupting others in order to dominate
the conversation.
They may dress provocatively or exaggerate
illnesses in order to gain attention.
They also tend to exaggerate friendships and
relationships, believing that everyone loves them
Other characteristics: Excessively emotional,
sensational, sexually provocative, impulsive,
appearance-focused, impressionistic
Causes
 Little research
 Links with antisocial personality
Borderline Personality Disorder




A better name would be “emotionally unstable
disorder” – the term borderline goes back to when
sufferers were thought to be borderline
schizophrenic (docs now know they’re often not)
Lack of stability in interpersonal relationships,
self-image, and emotion.
 Impulsivity
 An intense fear of abandonment
 Very poor self-image
 Turbulent relationships
People with this disorder are prone to constant
mood swings and bouts of anger.
 They are quick to anger when their expectations
are not met.
 They will take their anger out on themselves,
causing themselves injury (self-mutilation)
Suicidal threats and actions are not uncommon
Borderline Personality Disorder, cont.

Comorbid disorders

Depression – 24-74%




Bipolar – 4-20%
Substance abuse – 67%
Eating disorders


Suicide – 6%
25% of bulimics have BPD
Causes

Genetic/biological components




Serotonin
Frontolimbic circuit (volume loss of the hippocampus and the
amygdala)
Cognitive biases
Early childhood experience



Neglect
Trauma
Abuse
Antisocial Personality Disorder
Formerly known as psychopathic or
sociopathic personality disorder
 It is the most dramatic and troubling of
all the personality disorders.

Symptoms of Antisocial Personality
Disorder




This disorder is more likely to occur in
males than females, and usually develops
by adolescence.
It is characterized by a lack of
conscience, empathy, and remorse for
wrongdoing, even toward friends and
family members.
People with this disorder exhibit a
persistent disregard for and violation of
others’ rights (“social predators”).
They treat people as objects – as things to
be used for gratification and cast aside
coldly when no longer wanted.

They live for the moment and take action without
thinking about consequences.
Symptoms of Antisocial Personality
Disorder

They seek thrills, they are often aggressive

Getting caught does not bother them,
either. No matter how many times they are
punished or jailed, they never learn to
stay out of trouble.

However, interestingly enough, they can
get away with destructive behavior
because they are intelligent,
entertaining, and able to feign emotions
they do not feel.

They win affection and confidence from others of
whom they then take advantage.
More on Antisocial Personality Disorder

People with this disorder are prone to
criminal behavior, believing that their
victims are weak and deserving of being
taken advantage of.

Nature of psychopathy





Grandiose sense of self-worth
Proneness to boredom/need for stimulation
Pathological lying
Manipulative
Lack of remorse
Overlap and lack of
overlap among
antisocial personality
disorder, psychopathy,
and criminality.
Examples of People who have
Antisocial Personality Disorder




Serial killers who have no regard for the victims (“I think
of killing like smoking a cigarette, like another habit”)
Alfred Jack Oakley – a con-artist who met women
through personal ads claiming to be a millionaire movie
producer, pilot, and novelist. He used his smooth-talking
charm to steal all of their possessions. When convicted,
Oakley complimented the prosecutor’s skills and the
jury’s wisdom and claimed remorse. This may be what
got him probation instead of jail time.
Some leaders of religious sects or cults are believed to
be suffering from antisocial personality disorder.
Movies/books featuring APD: A Clockwork Orange, Fight
Club, In Cold Blood, The Dark Knight, Silence of the
Lambs (Hannibal Lector) Girl, Interrupted (Lisa) and
American Psycho
Etiology of Antisocial Personality Disorder




Developmental considerations
 Early histories of behavioral problems
 Conduct disorder
 Family history of:
 Inconsistent parental discipline
 Variable support
 Criminality
 Violence
Brain differences
 PET scans of 41 murderers revealed reduced activity in
the frontal lobes. In a follow-up study, repeat offenders
had 11% less frontal lobe activity (Raine et al., 1999;
2000).
Gene-environment interaction
 Genetic predisposition
 Environmental triggers
Normal
 Family stress
 Reinforcement of antisocial behaviors
 Alienation from good role models
 Poor occupational/social function
Arousal hypotheses
 Underarousal hypothesis – Cortical arousal is too low
 Fearlessness hypothesis – Fail to respond to danger
cues
Murderer
Cluster C
Anxious or Fearful Behaviors
(Avoidant, Dependent, and
Obsessive-Compulsive
Personality Disorders)
Avoidant Personality Disorder




They are so sensitive about being rejected
that personal relationships become difficult.
Similar to social phobia in the sense that these
people tend to be “loners” with a longstanding pattern of avoiding social situations
and of being particularly sensitive to criticism or
rejection.
They consider themselves to be socially
inept or personally unappealing, and avoid
social interaction and relationships for fear of
being ridiculed or humiliated.
Causes
 Difficult temperament
 Early parental rejection
 Interpersonal isolation and conflict
Dependent Personality Disorder





Characterized by a pervasive psychological
dependence on other people.
They behave in clingy, submissive ways and
display a strong need to have others take care
of them.
They display helplessness and a difficulty
in making even minor decisions without an
excessive amount of advice and reassurance
from others.
They also have an unreasonable fear of
abandonment, feelings of inadequacy,
extreme sensitivity to criticism, and a timid,
passive demeanor.
Causes
 Little research
 Early experience



Death of a parent
Rejection
Attachment
Obsessive-Compulsive Personality
Disorder






Characterized by a general psychological
inflexibility, rigid conformity to rules and
procedures, perfectionism, and excessive
orderliness.
People with OCPD tend to stress perfectionism
above all else, and feel anxious when they perceive
that things aren't "right".
They have a preoccupation with details, orderliness,
perfection (doing things the “right way”), and control
Poor interpersonal relationships
Obsessions and compulsions are rare
Causes
 Limited research
 Weak genetic contributions
 Predisposed to favor structure?
The Three Clusters of Personality
Disorders - Recap

Cluster A: Odd or Eccentric
Schizoid – defective in capacity for forming social relationships
Schizotypal – social deficits and oddities in thinking, perception, and
communication
 Paranoid – pervasive and unwarranted suspiciousness and mistrust.



Cluster B: Dramatic, Emotional, or Impulsive





Cluster C: Anxious or Fearful




Histrionic – overly dramatic, tending to exaggerate expressions of emotion
Narcissistic – grandiosely self-important, lacking interpersonal empathy
Borderline – unstable in self-image, mood, and interpersonal relationships
Antisocial – chronically violating the rights of others, non-accepting of social
norms, inability to form attachments.
Avoidant – excessively sensitive to potential rejection, humiliation or shame
Dependent – excessively lacking in self-reliance and self-esteem
Obsessive-compulsive – preoccupied with organization, rules, schedules, lists,
and trivial details.
Specific personality disorders are poorly defined, and there is much overlap
among them…some theorists propose replacing the current categorical
approach with a dimensional one.
Table 14-2, p. 580