psychopathology Exam #3

What is Personality Disorder

• a characteristic way of thinking, feeling, and behaving; moods, attitudes, opinions, interactions with others

• the “disorder” is the meeting point between you and your environment (ie, not you)

• “enduring pattern, pervasive, across context”

• Age 18+, long documentation (ie, not just over the last few weeks)

• 3 Clusters: A, B, and C

Characteristics of cluster A

• odd and eccentric

• evokes schizophrenia, ASD

• leads to interpersonal deficits

names of the cluster 3 disorder

• schizoid

• paranoid

• schizotypal

Schizoid Personality Disorder

• not to be confused with schizophrenia, moreso ASD

• “Schiz” here = schism between you and others

• Characterized by poor relationships, lack of interest in social relationships (including sexual), prefers solitary activities

  • disordered for not wanting social relationships?

• Not shyness/enxiety: cold/distant affect, anhedonia

• DSM: “great difficulty differentiating individuals with schizoid personality disorder from individuals with autism spectrum disorder … autism spectrum disorder may be differentiated by stereotyped behaviors and interests” + theory of mind/empathy

Paranoid Personality disorder

• not schizophrenia

• characterized by: Distrust, suspiciousness, in absence of evidence, believing people trying to mistreat you, out ot get you

• often bears grudges

• ultimately, trust/attachment issues

  • trust and original sin?

• treatment → perspective-taking

Schizotypal Personality Disorder

• more similar to “schizophrenia,” although more relational, and more emphasis on “oddness” or eccentricity

• acute discomfort and lack of capacity with relationships

  • lack of close friends, social anxiety

• odd perceptions, thinking, speech, affect, clothing/appearance

  • eg, ideas of reference (this happened because I did something), “paranormal” (telepathy) or superstitious, magical thinking

Characteristics of Cluster B

• dramatic, emotional, relational extremes

• tend to be quite common in counseling

• more “famous” or well known

• lots of bipolar overlap

cluster B disorders

• histrionic

• narcissistic

• borderling

• antisocial

Histrionic personality disorder

• attention-seeking, dramatic, excessive emotion, sexual/provocative (comments/appearance), suggestible, misreads relationships, impressionistic speech

• more commonly diagnosed in females; sexism?

narcissistic personality disorder

• grandiosity (inflated sense of achievement), fantasies of success, need to be around other successful people, need for acknowledgement, entitled, exploitative, lack of empathy, envious, arrogant

• most common “vicarious diagnosis”?

  • people we don’t like

• Quite rare (1%), why is it so commonly assumed?

borderline personality disorder

• instability of self, emotions, others

• fear of abandonment, reckless impulsivity, chronic feelings of emptiness, recurrent suicidal threats/behavior, transient psychotic/dissociative states, anger outbursts

  • cutting; to feel something, make self feel real

• manipulation: not (necessarily) intentional

• suicide risk

Antisocial Personality Disorder

• reckless disregard for the rights of others/their property/authority, etc

• not abiding by laws, deceptive, impulsivity, aggressiveness, disregard for safety, irresponsibility, lack of remorse 

• manipulation

• must be 18+ (conduct disorder present prior to age 15)

  • killing animals, disobeying parents

characteristics of cluster C

• characterized by anxiety, low self-esteem

• avoidant, dependent, perfectionistic

cluster C disorders

• avoidant

• dependent

• obsessive compulsive

avoidant personality disorder

• social inhibition, low self-esteem, hypersensitivity

  • avoids due to fear of rejection, avoids risks

  • painful shyness

• different from social anxiety disorder?

  • mostly due to low self-esteem features, may simply be more “severe,” age criteria

Dependent personality disorder

• need to be taken care of, submissive/clinging behavior

  • difficulty making decisions without excessive comfort/assurance, others responsible for major areas of life, helpless, not able to care for self, fear of being left alone to take care of self

  • also low self-esteem, self-efficacy

  • families

obsessive compulsive personality disorder

• not obsessive-compulsive disorder

• preoccupation with orderliness, perfectionism, control, even when inefficient, etc

  • details, rules, not completing tasks, workaholism, scrupulosity, hoarding tendencies, wants things a particular way, stingy, rigid/stubborn