Lesson 8 - Personality Disorders

What are the characteristics of personality disorders?

• Being able to last a lifetime 

• Causing other mental illnesses 

• Leading to the development of immature and deformed personality structures 

• Influence on the formation of erratic behaviors 

• Influence on mutations in cognition 

• Mental disorders that are very difficult to treat 

• Causing personal relationships to break down

What is a personality disorder?

It is a long-term pattern of thinking, feeling, and behaving that significantly deviates from cultural expectations, leading to difficulties in daily life, including relationships, work, and social interactions. These patterns typically emerge during adolescence or early adulthood and can cause distress or impair functioning.

What areas do personality disorders affect?

1. How we think about ourselves and others (distorted perceptions and thought patterns) 

2. Problematic emotional response pattern 

3. Ways of relating to other people (interpersonal difficulties) 

4. Method of controlling one's behavior (impulse control)

At which age do they diagnose people with personality disorders?

Persons aged 18 years or older

How many clusters of Personality Disorders are there? What are they?

3 clusters

1. Cluster A

2. Cluster B

3. Cluster C

What is the Personality Disorders in Cluster A?

• Paranoid Personality Disorder

• Schizoid Personality Disorder

• Schizotypal Personality Disorders

What is the common factors of Cluster A?

• People with these disorders display strange and bizarre behaviors. 

• The symptoms of these disorders are similar to those of schizophrenia. 

• People with these disorders rarely seek treatment.

What is Paranoid Personality Disorder?

It is a mental health condition where a person has a long-term pattern of distrust and suspicion of others, even when there is no reason to be suspicious. People with PPD often believe others are deceiving or harming them, are reluctant to confide in others, and may hold grudges for a long time

What is the criteria of Paranoid Personality Disorder?

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts

1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her. 

2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates. 

3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her. 

4. Reads hidden demeaning or threatening meanings into benign remarks or events.

5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights). 

6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack. 

7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

What are the causes for Paranoid Personality Disorder?

According to psychoanalysts, the cause of this disorder is the lack of proper parental love and care. 

• Maternal Deprivation, Over controlling, or Abandonment can make children more likely to develop this disorder later in life. 

• Genetic factors can also cause this. 

• This disorder is very difficult to treat. 

• These make even the therapist suspicious. 

• People don’t get involved in treatment because they think they do not need the help of others.

What is Schizoid Personality Disorder?

It is a mental health condition where a person avoids social relationships and prefers to be alone, showing little interest in emotional connections or intimacy. They often appear emotionally detached, indifferent to praise or criticism, and uninterested in social interactions. Unlike social anxiety, their isolation is due to a genuine lack of desire for relationships rather than fear of judgment.

What is the criteria for Schizoid Personality Disorder?

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts

1. Neither desires nor enjoys close relationships, including being part of a family. 

2. Almost always chooses solitary activities. 

3. Has little, if any, interest in having sexual experiences with another person. 

4. Takes pleasure in few, if any, activities.

5. Lacks close friends or confidants other than first-degree relatives. 

6. Appears indifferent to the praise or criticism of others. 

7. Shows emotional coldness, detachment, or flattened affectivity. 

What are the causes for Schizoid Personality Disorder?

According to psychoanalysts, the reason for this is the lack of proper love and care in childhood. 

• Children from broken families or families where parents have died can be victims of this disorder. 

• According to cognitionists, the cause of this disorder is cognitive deficits. 

• They are reluctant to seek treatment and seek treatment for other ailments, such as drug addiction.

What is Schizotypal Personality Disorder?

It is a mental health condition where a person has odd or eccentric behavior, unusual thinking patterns, and difficulty forming close relationships. They may experience paranoia, distorted perceptions, or magical beliefs (e.g., thinking they have special powers). While they may want social connections, their strange behavior and social anxiety often make relationships difficult.

What is the criteria for Schizotypal Personality Disorder?

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present

1. Ideas of reference (excluding delusions of reference). 

2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations). 

3. Unusual perceptual experiences, including bodily illusions.

4. Suspiciousness or paranoid ideation. 

5. Inappropriate or constricted affect. 

6. Behavior or appearance that is odd, eccentric, or peculiar. 

7. Lack of close friends or confidants other than first-degree relatives. 

8. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.

What are the Cluster B personality disorders?

• Histrionic Personality Disorder

• Narcissistic Personality Disorders

• Antisocial Personality Disorders

• Borderline Personality Disorders. 

What is the common factors of Cluster B?

• These personality disorders are generally easier to diagnose than other personality disorders. 

• The main features of these disorders are Dramatic, Emotional, and Erratic Behaviours.

What is the Histrionic Personality Disorder?

It is a mental health condition where a person constantly seeks attention, is overly emotional, and often behaves dramatically to gain approval from others. They may be highly suggestible, easily influenced, and uncomfortable when not the center of attention. Their emotions can seem shallow or exaggerated, and they may use their appearance or flirtatious behavior to attract attention.

What is the criteria for Histrionic Personality Disorder?

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts

1. Is uncomfortable in situations in which he or she is not the center of attention. 

2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior. 

3. Displays rapidly shifting and shallow expression of emotions. 

4. Consistently uses physical appearance to draw attention to self

5. Has a style of speech that is excessively impressionistic and lacking in detail.

6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.

7. Is suggestible (i.e., easily influenced by others or circumstances).

8. Considers relationships to be more intimate than they actually are.

What are the causes for Histrionic Personality Disorder?

• According to the socio culturalists, norms of society and expectations will cause this.

• According to psychoanalysts, this disorder is many similarities to Histeria. 

• People with this disorder usually refer to treatment. 

• But working with them can be very difficult to the therapist.

What is Narcissistic Personality Disorder?

It is a mental health condition where a person has an exaggerated sense of their own importance, a strong need for admiration, and a lack of empathy for others. Individuals with NPD often believe they are unique or superior, may expect special treatment, and can become angry or upset when they don't receive the attention or recognition they think they deserve. This can lead to difficulty in maintaining relationships.

What is the criteria for Narcissistic Personality Disorder?

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). 

2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. 

3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high status people (or institutions).

What is the causes of Narcissistic Personality Disorder?

• According to psychoanalysts, the cause of this disorder is the unpleasant experience of childhood. 

• They say children from broken families, families where parents have died, or children who have been sexually abused, or children who have not been properly cared for by their parents, are more likely to be victims of this disorder. 

• According to cognitivists and behaviorists, this is due to over-indulgence in childhood. 

• According to socio-culturalists, breakdowns in the family environment or in social and political contexts lead to this instability.

What is the criteria of Antisocial Personality Disorder?

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years

1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest. 

2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. 

3. Impulsivity or failure to plan ahead. 

4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults. 

5. Reckless disregard for safety of self or others. 

6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. 

7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

What is the causes for Antisocial Personality Disorder?

• Being subjected to various inconveniences and abuses during childhood. 

• Children from widowed, broken families and poor families are at higher risk of developing this disorder. 

• Lack of proper love and care in childhood 

• Excessive control

According to psychologists, what are the four factors that contribute to anti-social personality disorders?

• Family and surroundings 

• Misdiagnosis 

• Genetic factors 

• Certain impairments in median nerve function

What are the main problems people with Anti-social they face in treatment?

Lack of Conscience

Lack of motivation to change

What is Borderline Personality Disorder?

It is a mental health condition characterized by intense emotions, unstable relationships, impulsive behaviors, and a distorted self-image. People with BPD often experience rapid mood swings, fear of abandonment, and difficulty regulating emotions, leading to conflicts in relationships. They may also engage in self-harm or risky behaviors and struggle with feelings of emptiness or identity confusion.

What is the criteria for Borderline Personality Disorder?

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts

1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.) 

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 

3. Identity disturbance: markedly and persistently unstable self image or sense of self. 

4. Impulsivity in at least two areas that are potentially self damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self mutilating behavior covered in Criterion 5.) 

5. Recurrent suicidal behavior, gestures, or threats, or self mutilating behavior. 

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 

7. Chronic feelings of emptiness. 

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

What are the causes for Borderline Personality Disorder?

• According to psychoanalysts, the cause of this disorder is the unpleasant experiences of childhood, such as the lack of proper love and care from parents. 

• According to the biological approach, this is caused by certain negative activities in the brain. 

• Changes in society or family structure according to a sociocultural approach influence this anomaly.

What are the Cluster C personality disorders?

• Avoidant Personality Disorders

• Dependent Personality Disorders

• Obsessive - Compulsive Personality Disorders. 

What are the main symptoms of Cluster C personality disorders?

• The main symptoms of these disorders are the display of anxious and frightening emotions and behaviors. 

•  Many of the symptoms of these disorders are similar to those of mental disorders such as anxiety and depression.

What is Avoidant Personality Disorder?

It is a mental health condition where a person has intense fear of rejection, criticism, or embarrassment, leading them to avoid social situations and relationships. They often feel inadequate, overly sensitive to criticism, and reluctant to take risks due to a deep fear of being judged. Despite wanting close relationships, their low self-esteem and anxiety make it difficult for them to connect with others.

What is the criteria for Avoidant Personality Disorder?

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts

1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.

2. Is unwilling to get involved with people unless certain of being liked. 

3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. 

4. Is preoccupied with being criticized or rejected in social situations. 

5. Is inhibited in new interpersonal situations because of feelings of inadequacy. 

6. Views self as socially inept, personally unappealing, or inferior to others. 

7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

What are the causes for Avoidant Personality Disorder?

• The cause of this disorder is especially symptomatic of anxiety-related disorders. 

• Biochemical abnormalities, Learned Fear, and Upsetting Thought Processes contribute to this disorder. 

• According to cognitionists, children who experience excessive rejection and criticism at an early age are more susceptible to this disorder.

What is Dependent Personality Disorder?

It is a mental health condition where a person has an excessive need to be taken care of, leading to clingy behavior, fear of abandonment, and difficulty making decisions without reassurance. They often struggle with independence, rely heavily on others for emotional and physical support, and may tolerate mistreatment to avoid being alone. This dependence can affect their ability to function independently in daily life.

What is the criteria for Dependent Personality Disorder?

A pervasive and excessive neediness that begins in adulthood and persists in a variety of contexts, leading to submissive and clingy behavior and separation anxiety

1. Difficulty making everyday decisions without too much advice and reassurance from others. 

2. Needs others to take responsibility for many major aspects of his or her life. 

3. Difficulty expressing disagreement with others for fear of losing support or approval. 

4. Difficulty initiating projects or doing things on one's own (due to lack of judgment or self-confidence in abilities rather than lack of motivation or energy). 

5. Goes to great lengths to volunteer to do unpleasant things, in order to gain the support and support of others. 

6. Exaggerated fear of not being able to take care of oneself makes one feel uncomfortable or helpless when alone. 

7. When an intimate relationship ends, another relationship is quickly sought as a source of care and support. 

8. Realistically worried about being left to fend for himself or herself.

What is the causes for Dependent Personality Disorder?

• According to psychoanalysts → depression is the cause of this disorder 

• According to behaviors → excessive control of children and punishment for children's independent activities lead to this disorder. 

• According to cognitivists  → finding someone else to protect oneself because of the belief that one is helpless is the cause of this personality disorder. 

• People with this disorder seek treatment indirectly.

What is Obsessive-Compulsive Personality Disorder?

It is a mental health condition where a person is excessively focused on order, perfection, control, and following rules, often at the expense of flexibility and relationships. They may be overly rigid, stubborn, and preoccupied with work or details, making it difficult for them to relax or delegate tasks. Unlike Obsessive-Compulsive Disorder (OCD), people with OCPD usually do not recognize their behavior as problematic.

What is the criteria for Obsessive-Compulsive Personality Disorder?

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts

1. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost. 

2. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met). 

3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity). 

4. Is overly conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification). 

5. Is unable to discard worn-out or worthless objects even when they have no sentimental value. 

6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things. 

7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes. 

8. Shows rigidity and stubbornness.

What are the causes for Obsessive Compulsive Personality Disorder?

• According to psychoanalysts, such abnormalities may be due to the high intensity and penalties of toilet training during anal stage. 

• According to cognitionists, the development of this disorder is due to the irrational thinking activity of individuals.

What is the Treatment?

1. Reducing subjective distress and symptoms such as anxiety and depression. 

2. Helping people understand aspects of their problems that are internal to themselves. 

3. Changing maladaptive and socially inappropriate behaviors, including inattention, social isolation, lack of assertiveness, and outbursts of anger. 

4. Changing problematic personality traits such as dependency, distrust, arrogance and manipulativeness.