Transcript Personality disorders

Personality Disorders
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Personality Disorders

Long-standing patterns of thought, behavior,
and emotions that are maladaptive for the
individual or for people around him or her.
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
DSM-IV-TR Personality Disorders

Cluster A: Odd-Eccentric
Personality Disorders

Symptoms similar to those for
schizophrenia, including inappropriate or flat
affect, odd thought and speech patterns,
paranoia. People with these disorders
maintain their grasp on reality, however.

Cluster B: Dramatic
Emotional Personality
Disorders

Manipulative, volatile, and uncaring in social
relationships. Impulsive, sometimes violent
behavior that show little regard for their own
safety or the safety or needs of others

Cluster C: Anxious-Fearful
Personality Disorders

Extremely concerned about being criticized
or abandoned by others and thus have
dysfunctional relationships with them.
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Problems with the DSM-IV-TR Categories

Symptoms described are often only extreme versions of
otherwise “normal” traits.

Overlap in the diagnostic criteria and the majority of people who
are diagnosed with one disorder tend to meet the diagnostic
criteria for at least one other personality disorder.

Diagnosing a personality disorder often requires information
that is hard for a clinician to obtain.

Conceptualized as stable characteristics, yet they vary, so
individuals go in and out of the diagnosis
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Cluster A: The Odd-Eccentric Personality
Disorders
Paranoid personality disorder
Chronic and pervasive mistrust
and suspicion of other people that
is unwarranted and maladaptive.
Schizoid personality disorder
Chronic lack of interest in and
avoidance of interpersonal
relationships, emotional coldness
toward others.
Schizotypal personality disorder
Chronic pattern of inhibited or
inappropriate emotion and social
behavior, aberrant cognitions,
disorganized speech.
Weak
Chapter 12
Relationship to Schizophrenia
Strong
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Cluster B: Dramatic Emotional Personality
Disorders

Antisocial
personality disorder

Pervasive pattern of criminal, impulsive, callous,
or ruthless behavior; disregard for rights of
others; no respect for social norms. One of the
most common of the personality disorders and
one of the most difficult to treat.

Borderline
personality disorder

Rapidly shifting and unstable mood, selfconcept, and interpersonal relationships;
impulsive.

Histrionic
personality disorder

Rapidly shifting moods, unstable relationships,
and intense need for attention and approval;
dramatic, seductive behavior.

Narcissistic
personality disorder

Grandiose thoughts and feelings of one’s own
worth; obliviousness to others’ needs.
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Cluster B: Dramatic Emotional Personality
Disorders
Borderline Personality Disorder:
Clips from Marsha Linehan’s DVD
Clips from Fatal Attraction
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Antisocial Personality Disorder
Video clips (World of Ab Psych video – Program 5, 18:45 – 37:00)
Pervasive pattern of disregard for and violation of the rights
of others, as indicated by three or more of:
Failure to conform to social norms re: lawful behavior
Deceitfulness
Impulsivity / failure to plan ahead
Aggressiveness / irritability
Reckless disregard for safety of self or others
Consistent irresponsibility
Chapter 12
Lack of remorse
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Contributors to Antisocial
Personality Disorder


Interactive model (biological – environmental)
Biological
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Genetic predisposition (only a modest contribution)
Testosterone (evidence?)
Serotonin (low levels associated with impulsivity and aggression)
ADHD? (correlation vs. causation)
Executive functions (deficits in planful behavior) – structural
hypofrontality?
Arousability (low): fearlessness and/or stimulation-seeking
Environmental factors (next slide)
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Contributors to Antisocial
Personality Disorder and Violence

Environmental factors (Patterson, 2008)
Chapter 12
Copyright © 2007 by G.,
The McGraw-Hill
Inc. All rights reserved.
Patterson,
(2008) Companies,
in Perspectives
on
Psychological Science
Contributors to Violence


Violent behavior is controlled by its
consequences.
Extensive training precedes the violent act. In the
societal model (i.e., war), the training is planned,
whereas in the individual model the training by
parents and peers is inadvertent.
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Contributors to Violence


In both domains, the training is such that the
overlearned violent act becomes automatic. For
example, the violent individual who physically
assaults his wife has a prior history of thousands
of reinforcers for a wide variety of antisocial
behaviors.
Peers are thought to play a key role in providing
reinforcers for violence related behaviors.
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Prevention
Reducing the relative rate of reinforcement would
be associated with reductions in violence. To
date, there is empirical support for this assertion
as it applies to individual acts.
 Behavioral approaches to classroom
management
 Improving parenting skills/practices
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Treatment of ASPD and/or violent
offenders

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Difficult… Why?
 Most don’t seek treatment
 Those that do have a long history of
antisocial acts to “unlearn”
 Victim empathy training
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Cluster C: The Anxious-Fearful Personality
Disorders
Avoidant personality disorder
Pervasive anxiety, a sense of
inadequacy, and a fear of being
criticized, which leads to the
avoidance of social interactions
and nervousness.
Dependent personality disorder:
Pervasive selflessness, need to be
cared for, fear of rejection, leading to
total dependence on and submission
to others.
Obsessive-compulsive personality disorder
.
Pervasive rigidity in one’s activities and
interpersonal relationships, including emotional
construction, extreme perfectionism, and
anxiety about even minor disruptions in one’s
routine.
Chapter 12
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.