Personality disorders-

psychopath final

Personality

enduring qualities of a person across many circumstances including perceptions attitudes and emotions that are consistent and resistant to change

Personality influences

shaped by biological genetic factors and environmental interactions over time

Personality traits

stable characteristics that develop from these influences

Five Factor Model OCEAN

dimensional model including openness conscientiousness extraversion agreeableness and neuroticism

Openness to experience

curiosity creativity and openness to new ideas and feelings

Conscientiousness

organization responsibility and reliability

Extraversion

sociability assertiveness and outgoingness

Agreeableness

kindness cooperation and trust

Neuroticism

emotional instability anxiety and negative emotions

Five Factor Model support

cross cultural research from 56 countries supports these traits

Dimensional vs categorical approach

dimensional traits are consistent across self report and observation while categorical may be limiting

Personality disorders overview

chronic long term patterns first included in DSM III in 1980 and previously coded on Axis II in DSM IV TR

DSM 5 TR personality disorders

identifies 10 specific disorders

Prevalence

5 to 10 percent of general population

Socioeconomic factor

higher rates in lower socioeconomic groups

Borderline personality prevalence

more common in psychiatric settings

Antisocial personality prevalence

more common among prison inmates

Onset

begins in childhood and continues into adulthood not due to recent stress

Comorbidity

high overlap with anxiety mood substance use and other disorders

Diagnosis problem inter rater reliability

low agreement between clinicians

Diagnosis problem comorbidity

high overlap among disorders

Diagnosis problem retrospective data

over reliance on past self report

Diagnosis problem categorical limits

categorical classification may not be best

Personality disorder trait extremes

may reflect extreme versions of normal traits

Negative affectivity

extreme neuroticism

Detachment

extreme introversion

Antagonism

extremely low agreeableness

Disinhibition

extremely low conscientiousness

Cluster system

personality disorders grouped into Cluster A Cluster B and Cluster C based on similarities

Cluster A

odd or eccentric disorders

Cluster B

dramatic emotional erratic disorders

Cluster C

anxious fearful disorders

Schizoid Personality Disorder

Cluster A disorder with detachment from relationships and limited emotional expression

Schizoid feature no relationships

does not desire or enjoy close relationships including family

Schizoid feature solitary behavior

prefers to be alone

Schizoid feature low sexual interest

little interest in sexual experiences

Schizoid feature limited pleasure

few enjoyable activities

Schizoid feature no close friends

lacks confidants except relatives

Schizoid feature indifferent

unaffected by praise or criticism

Schizoid feature emotional coldness

detached or flattened affect

Schizoid vs avoidant

schizoid lacks desire for relationships while avoidant fears rejection

Schizoid autism link

possible association with autism spectrum disorder

Schizoid five factor profile

high introversion low openness to feelings

Schizoid treatment

focuses on social skills empathy and role playing

Schizoid prognosis

poor and rarely seeks treatment unless crisis

Cluster B overview characteristics

unstable moods relationships impulsivity fear of abandonment poor self image emotional dysregulation suicidal or self harming behaviors intense mood shifts

Borderline Personality Disorder

Cluster B disorder with instability in relationships self image emotions and impulsivity

BPD feature abandonment fear

frantic efforts to avoid abandonment

BPD feature unstable relationships

alternating idealization and devaluation

BPD feature identity disturbance

unstable self image

BPD feature impulsivity

risky behaviors such as spending sex substance use reckless driving binge eating

BPD feature suicidal behavior

threats gestures or self harm

BPD feature affective instability

rapidly shifting intense moods

BPD feature emptiness

chronic feelings of emptiness

BPD feature anger

intense or poorly controlled anger

BPD feature paranoia dissociation

stress related paranoia or dissociation

BPD prevalence

1 to 2 percent of general population higher in clinical settings

BPD clinical rates

about 10 percent of outpatients and 20 percent of inpatients

BPD suicide risk

about 6 percent complete suicide

BPD comorbidity

mood disorders bulimia substance use

BPD improvement

many improve between ages 30 and 50

BPD five factor profile

high neuroticism low agreeableness low conscientiousness high openness to feelings and actions

BPD etiology

genetic links emotional reactivity and early trauma

BPD treatment

includes medications but complicated by noncompliance substance use and suicide risk

Dialectical Behavior Therapy DBT

evidence based treatment for BPD

DBT targets

suicidal behavior therapy interfering behaviors and quality of life

DBT skills

distress tolerance emotion regulation and problem solving

DBT effectiveness

reduces suicide attempts hospitalizations and treatment dropout

Cluster C overview characteristics

extreme sensitivity to opinions avoidance of relationships interpersonal anxiety and fear of rejection

Avoidant Personality Disorder

Cluster C disorder with social inhibition feelings of inadequacy and hypersensitivity to evaluation

Avoidant feature occupational avoidance

avoids jobs with interpersonal contact due to fear of criticism

Avoidant feature relationship hesitation

unwilling to engage unless certain of being liked

Avoidant feature intimacy restraint

fears shame or ridicule

Avoidant feature preoccupation with rejection

expects criticism

Avoidant feature social inhibition

feels inadequate in new situations

Avoidant feature low self view

sees self as inferior or unappealing

Avoidant feature risk avoidance

avoids new activities due to embarrassment fears

Avoidant treatment

similar to social anxiety focusing on social skills anxiety reduction and therapeutic alliance

Avoidant five factor profile

high introversion and high neuroticis