Personality Disorders

characteristics of personality disorders

• traits are rigid, undesirable, and maladaptive

• ingrained and pervasive (the effect many asp[ects of the persons life, not easily changed)

• chronic (evidence from childhood, extends to adulthood)

• ego-syntonic versus ego-distonic

  • egosyntonic = the persons self view, for that reason, it is not distressing for the individual, but the people around the person experience distress

  • egodistonic: inconsistent with the persons self view—they feel distress. (anxiety and depression)

• impact on relationships

• very little treatments

general diagnostic criteria for Personality Disorder

enduring patterns of inner experience and behavior that deviate the expectations from the individuals culture in two ways

• affectivity — emotional responses

• interpersonal functioning

• impulse control

• cognition — thoughts, way of perceiving yourself and others

personality disorder leads to distress and impairment

it has an onset in adolescence and is stable overtime

it is not accounted for as a manifestation with another disorder

PD is ___ and ___ across social and personal contexts

pervasive and inflexible

what is the current approach for personality disorders

categorical—but comorbidity for other personality disorders is about 50%

what is the conversation to move towards a dimensional approach

that instead of 10 disorders, limit it to 6 disorders and rate each on a scale of negative affectivity, detachment, antagonism, disinhibition, psychotism

What falls under cluster a

odd or eccentric: Paranoid personality disorder, schizotypal personality disorder, schizoid personality disorder

paranoid personality disorder

a pervasive distrust and suspiciousness of others shown by four or more of the following

• is preoccupied with doubts about their loved ones loyalty to them

• is reluctant to confide in others because of their feae that such information will be used against them

• reads hidden threatening meaning into benign remarks or events

• persistently bears grudges

• perceives attacks on their character that are not apparent and is quick to angrily counteract

• has recurrent suspicions with infidelity

shhizotypal personality disorder

pervasive pattern of interpersonal deficits, cognitive distortions, eccentricities of behavior indicated by five or more of the following

• idea of reference — (a cloud blocking the sun = something bad is happening)

• odd beliefs — tapping the door three times = special event

• unusual perceptions

• odd thinking and speech

• suspicious or paranoid ideation

• inappropriate affect

• behavior or appearance is odd

• lack of close friends

• excessive social anxiety that are associated with paranoid fears

prevalence of schizotypal

.6% of the population get diagnosed; equal in males and females

what other disorder is common with schizotypal

depression

schizoid personality disorder

a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings shown by 4 or more of the following

• does not want or enjoy close relationships

• almost always chooses solitary activities

• has little interest in social experiences

• take pleasure in few activities

• lacks close friends

• indifference to praise or criticism from others

• is emotionally cold

prevalence of schizoid personality disorder

.6%; more common in males than females

CLUSTER B

dramatic, emotional, erratic; includes narcissistic personality disorder, histrionic disorder, and

DSM criteria for narcissistic personality disorder

grandiosity, need for admiration and lack of empathy, as indicated by five or more of the following

• grandiose sense of self importance

• preoccupied with fantasies of unlimited success power, brilliance, or love

• believes they are “special” and can only be understood by high status people

• lacks empathy

• is interpersoanlly exploitive

• entitled

• believes others are envious of them

prevalence of NPD

1% of the population, more common in males

what is the core of NPD

a really fragile sense of self esteem

DSM Criteria for Histrionic personality disorder

a pervasive patterer of excessive emotionality and attention seeking, as indicated by five or more of the following

• is uncomfortable in situations in which they are not the center of attention

• often shows inappropriate sexual behavior

• displays rapidly shifting and shallow expression of emotion

• consistently uses physical appearance to draw attention to self

• excessively impersonate speech style, lacking in detail

• exaggerated/dramatic emotions

• easily influenced by others

• considers relationships to be more intimate than they actually are

prevalence

.3% of population is diagnosed, more common in females

potential cause of Histrionic Personality disorder

often praised for certain things, sibling rivalry, praised for looks, etc

Diagnostic criteria for Borderline personality disorder

pervasive pattern of instability or interpersonal relationships, self image, and affects, and marked impulsivity as indicated by five or more of the following

• frantic efforts to avoid real or imagined abandonment

• a pattern of unstable/ intense interpersonal relationships shown by rapid shifting between idealization and devaluation

• identity disturbance — unstable self image

• impulsivity in at least two areas that are self damaging

• recurrent suicidal behavior/self mutilation

• affective instability —- happy to intense irritability

• chronic feelings of emptiness

• intense anger

• paranoid ideation

prevalence of BPD

2.7% in general pop, more common in women