N363 Personality Disorders

Personality 

complex pattern of characteristics which compromise the individual’s distinctive pattern of perceiving, feeling, thinking, coping, and behavior

outside of the person’s awareness

personality is largely

Personality traits

prominent aspects of personality that are exhibited in a wide range of social and personal contexts

stable

personality and personality traits over time

Cognition

ways of perceiving and assigning meaning to self, others, and events

Affectivity

the range, intensity, and appropriateness of emotionality

cognition

affectivity

interpersonal behavior

impulse control

factors involved in personality

response to biological and psychological influences

how does personality develop

adolescence and early adulthood

when do personality disorders manifest

depression and anxiety

what do personality disorders often co-occur with

avoidant

dependent

paranoid

what disorders are women at an increased risk for

antisocial 

what disorders are men at an increased risk for

African American

young adults

low socioeconomic status

divorced

never married

populations at a higher risk for personality disorders

Personality disorder 

a rigid, stereotyped behavioral pattern that persist throughout a person’s life 

high degree of inner distress

what does personality disorder cause

mood disorder

anxiety

substance abuse

self-harm

psychiatric co-morbidities that go along with personality disorders

inflexible

rigid

maladaptive

what happens to personality traits in personality disorder

insight and understand of their behavior’s impact on others

what do individuals with personality disorder lack

Psychoanalytic

empathize importance of nurturing from immediate caregivers and loved ones for fostering positive personality traits

Biologic

stress influence of genetic transmission combined with environmental exposures for the formation of personality

Social learning and cognitive perspectives

people acquire personality characteristics through thought and interaction with their environment

development is stalled or disrupted

when is their risk for problems with personality formation

significant impairment in self/interpersonal functions

1+ pathological personality trait

impairments stable over time

personality traits not normative 

not due to substance use or medical condition

overarching criteria that a personality disorder must meet

odd or eccentric

behaviors in Cluster A

paranoid

schizoid

schizotypal

personality disorders under cluster A

dramatic, emotional, erratic

behaviors in cluster B

Antisocial

Borderline

Histrionic

Narcissistic

personality disorders under cluster B

anxious or fearful

behaviors in cluster C

avoidant

dependent

obssesive-compulsive

personality disorders under cluster C

Paranoid PD

pervasive distrust and suspiciousness of others

others motives interpreted as malevolent 

don’t acknowledge

project on others

what do individuals with paranoid PD do with their negative feelings

constantly on guard

hypervigilant

distorts environmental cues

trusts nobody

constantly tests honesty of others

traits of an individual with paranoid PD

hereditary link

early parental antagonism and harassment

predisposing factors for paranoid PD

Schizoid PD

profound defect in ability to form personal relationships

failure to respond to others in a meaningful emotional way

indifference to others

aloof

withdraws from social events

flat affect

inappropriately serious

traits of individuals with schizoid PD

hereditary

bleak, cold, unempathetic childhood lacking in nurturing

predisposing factors for schizoid PD

Schizotypal PD

enduring and pervasive pattern and interpersonal deficits with extreme discomfort and intolerance for close relationships

bizarre speech pattern

psychosis

delusional thought process

bland and apathetic manners

traits of schizotypal individuals

hereditary

early family dynamics of indifference and impassivity

predisposing factors for schizotypal PD

dysregulation of dopaminergic pathways

potential neruochemical dysfunctions with schizotypal individuals

labile and shallow

moods in individuals with cluster B disorders

Antisocial PD

aggressive, irresponsible behaviors

superficially charming but lack genuine warmth

conduct disorder

what is typically seen in younger individuals that then manifests into antisocial PD

socially irresponsible

exploitative

manipulative

guiltless behavior

traits/patterns in individuals with antisocial PD

sociopathic/alcoholic parent

aggressive temperament as child

parental deprivation (first 5 yrs)

Hx of ADHD or conduct disorder

extreme poverty

absence of parental discipline

predisposing factors for antisocial PD

Borderline PD

pattern of intense and chaotic relationships with affective instability

Fluctuating and extreme attitudes and moods 

highly impulsive

mood swings

depression/anxiety

anger

self-harm

aggressive for attention

traits of borderline PD

childhood abuse, neglect

separation from caregivers

changes in areas of brain involved in emotion regulation, impulsivity, aggression

predisposing factors for borderline PD

75%

what percentage of individuals that have borderline PD are female

extreme affective instability

hallmark of borderline PD

intensity and instability of affect and behavior

how are BPD pts most strikingly identified by

depression

inability to be alone

clinging

splitting

manipulation 

common behaviors in BPD

Histrionic PD

long standing pattern of excessive emotionally charged interactions and attention seeking behaviors

highly distractible

flamboyant

easily influenced

difficulty forming close relationships

center of attention

frustrate easily

traits of histrionic PD

learned behavior patterns

hereditary

linked to noradrenergic and serotonergic systems

predisposing factors for histrionic PD

Narcissistic PD

lifelong pattern of self-centeredness, self-absorption, inability to empathize, insensitive of others, grandiose, self-esteem is fragile

men

who is narcissistic PD more common in

overly pampered and indulged

learned to view themselves as special

grow to expect special treatment 

parents were narcissistic

predisposing factors for narcissistic PD

mood easily changes

overly sensitive to what others think

lack empathy

traits with narcissistic PD

Avoidant PD

pattern of social discomfort, timid, fear of rejection

will only form relationships if acceptance is guaranteed

hereditary

parental rejection and criticism

predisposing factors for avoidant PD

awkward and uncomfortable (social situations)
desire close relationships but avoid 

fear of being rejected

inappropriate displays of anger 

dissociative 

traits seen with avoidant PD

Dependent PD

excessive need to be taken care of, submissive and clinging behaviors

Difficulty in making independent decisions

women

youngest children

who is dependent PD more common amongst

hereditary

stimulation and nurturance exclusively from one source

singular attachment made by infant

predisposing factors for dependent PD

lack self-confidence

passive

overly generous

avoid positions of responsibility 

traits in dependent PD

solve immediate crisis

complete social skills training 

goals with personality disorders in cluster A

prevent suicide and harm

help them gain insight

improve coping

goals with personality disorders in cluster B

enhance social functioning

solve immediate crisis

assertiveness training

cognitive reconstruction

goals with personality disorders in cluster C