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Personality Disorders
Maddux & Mundell pose 4 questions:
1) What is a PD and how is it different from normal
personality?
2) How are PDs similar to and different from other
types of psychological problems?
3) Is it better to think of PDs as diagnostic categories
or as extreme points on a continuum of individual
differences?
4) Are there different types of PDs that can be
distinguished from one another?
PDs According to DSM
“A PD is an enduring pattern of inner experience
and behavior that deviates markedly from the
expectations of the individual’s culture, is
pervasive and inflexible, has an onset in
adolescence or early adulthood, is stable over
time, and leads to distress or impairment”
Three important elements to this definition:
General definition of personality
Statistical abnormality
Impairment
DSM-IV PDs
Antisocial PD disregard for, and violation of, the rights of others
Avoidant PD
Borderline
PD
Dependent
PD
social inhibition, feelings of inadequacy, and
hypersensitivity to negative evaluation
instability in interpersonal relationships, self-image, and
affects, and marked impulsivity
submissive and clinging behavior related to an excessive
need to be taken care of
Histrionic PD
excessive emotionality and attention seeking
Narcissistic
PD
grandiosity, need for admiration, lack of empathy
Obs.-Comp.
PD
preoccupation with orderliness, perfectionism, and control
DSM-IV PDs cont’
Paranoid PD distrust and suspiciousness such that others
motives are interpreted as malevolent
Schizoid PD detachment from social relationships and
restricted range of emotional expression
Schizotypal PD
acute discomfort in close relationships,
cognitive or perceptual distortions, and eccentricities of
behavior
Features of Disordered Personality
According to Maddux & Mundell:
1) difficulty getting along with other people and
report histories of disruptive relationships
2) difficulty learning from experience (inflexible)
3) do not accept responsibility for own behavior
4) do not fare well in psychotherapy
Plus a few more from Millon:
5) tenuous stability (trouble bouncing back)
6) adaptive inflexibility (too few strategies)
7) vicious circles
Views of PDs
DSM categorical model makes three assumptions:
1) PDs are qualitatively distinct from normal personality
2) PDs are qualitatively distinct from Axis I disorders
3) PDs are qualitatively different from each other
Dimensional models assume:
1) (ab)normal/(mal)adaptive lie on continuum
2) PDs differ quantitatively rather than qualitatively
from normal personality
3) PD is extreme and maladaptive variation of
normal traits
Normal Personality vs. PDs
PDs versus general population
1) Categorical Distribution? (Livesley, Jackson, & Schroeder, 1992)
2) Different “structures”? (Livesley, Jackson, & Schroeder, 1992)
Livesley, Jackson, & Schroeder (1992)
Livesley, W.J., Jackson, D.N., & Schroeder, M.L. (1992).
Factorial structure of traits delineating personality
disorders in clinical and general population samples.
Journal of Abnormal Psychology, 103, 432-440.
Clinical sample (n = 158)
General population sample (n = 274)
Completed 100 personality scales
Two important findings:
No evidence for bimodality on personality scales
Factor structure identical across samples
Normal population vs. PD
questions continued
3) Bright lines? (Widiger, Sanderson, &
Warner, 1986)
Bright Lines?
A “bright line” is a line/definition/description that sharply
demarcates different groups/things/elements from one another.
Widiger, T.A., Sanderson, C., & Warner, L. (1986). The MMPI,
prototypal typology, and borderline personality disorder. Journal
of Personality Assessment, 50, 540-553.
71 inpatients
Administered MMPI
Administered semi-structured interview for each of 81 symptoms of
DSM-III PDs
No Bright Lines
No Bright Lines
See profile sheet
“The borderlines with only five symptoms had
significantly lower elevations than a) the borderlines
with seven or eight symptoms on scales D, Pt, Sc,
and Si (p < .05) and b) the borderlines with six or
more symptoms (n = 34) on scales D, Pt, and Sc (P
< .05). They differed significantly from nonborderlines
(n = 27) on only the K and Hs scales (p < .05).”
Biological Research
1) Some traits are rooted in biology but no evidence
that biology underlies PDs
2) Relative contribution of genes is similar in normal
personality and PDs
Axis I versus Axis II
Models arguing against a distinction
1) Spectrum Model (Axis I amplified into Axis II)
2) Vulnerability Model (Axis II as diathesis for Axis I)
Research arguing against a distinction
1) No differences in etiology (genetic and
psychosocial influences on Axes I and II)
2) Temporal stability does not distinguish Axes I and II
3) High degree of comorbidity across Axes I and II
Distinctions Among Disorders
Categorical approach assumes that each PD
represents a distinct group of individuals who differ
qualitatively from those in other PD categories.
Does not appear to be true
Skodol et al. (1991) found that individuals were given,
on average, four PD diagnoses
Widiger et al. (1991) found that 96% of individuals
with Borderline PD were given at least one other
diagnosis