chapter 12 personality disorders

Personality disorders

Long-standing and ingrained ways of thinking, feeling, and behaving that cause significant distress for the person affected and/or for others and may cause difficulties with work and relationships.

Cluster A Personality Disorders

Includes paranoid, schizoid, and schizotypal personality disorders, characterized by odd or eccentric behaviors.

Paranoid Personality Disorder

: A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent; they expect others to do them harm.

 Schizoid Personality Disorder

 A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings; individuals are aloof, cold, and indifferent.

Schizotypal Personality Disorder

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

Cluster B Personality Disorders

 Includes antisocial, borderline, histrionic, and narcissistic personality disorders, characterized by dramatic, emotional, or erratic behaviors.

Antisocial Personality Disorder

A pervasive pattern of disregard for and violation of the rights of others, including irresponsibility, impulsivity, and deceitfulness.

Borderline Personality Disorder

 A pervasive pattern of instability of interpersonal relationships, self-image, affects, and control over impulses, often leading to poor self-esteem and risk of suicide.

Histrionic Personality Disorder

A pervasive pattern of excessive emotion and attention-seeking, with individuals often appearing overly dramatic.

 Narcissistic Personality Disorder

 A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy; individuals think highly of themselves beyond real abilities.

 Cluster C Personality Disorders

 Includes avoidant, dependent, and obsessive-compulsive personality disorders, characterized by anxious or fearful behaviors.

Avoidant Personality Disorder

 A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, leading to avoidance of social relationships due to fear of rejection.

Dependent Personality Disorder

A pervasive and excessive need to be taken care of, which leads to submissive and clinging behavior and fears of separation, relying on others for decisions.: Obsessive-Compulsive Personality Disorder

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.

 Eccentricity

 Behaviors or traits that are unconventional or quirky but do not necessarily indicate a mental disorder; they are benign and do not impair functioning. 

Personality Pathology

Enduring patterns of thinking, feeling, and behaving that are maladaptive and lead to significant impairment or distress, assessed in the context of personality

Ego-syntonic

A characteristic of personality disorders where symptoms feel consistent with one's identity, leading patients to not feel that treatment is necessary.

Categorical Model of Personality Disorders

 Assumes each personality disorder is a separate and distinct category, separate from other disorders and 'normal' personalities.

Dimensional Model of Personality Disorders

 Views various personality features along several continuous dimensions (continuums), where individuals are rated on the degree to which they exhibit traits.

Five Factor Model (Big Five)

A model of personality based on five universal dimensions: Openness to experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.

Comorbidity in Personality Disorders

: The rule rather than the exception, meaning individuals often have two or more personality disorders or an additional mood or anxiety disorder.

Sadistic Personality Trait

A trait where an individual enjoys inflicting pain upon others.

Personality Disorders (DSM-V definition)

Enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts. These patterns are inflexible, maladaptive, and cause either significant functional impairment or subjective distress.

 Personality

 A general term used to describe characteristic ways that people think and behave.

Origin and Comorbidity of Personality Disorders

Disorders originate in childhood, continue throughout adulthood, and most are associated with high rates of comorbidity with other Axis I and II conditions.

Ego Syntonic

One's behaviors do not create anxiety or internal discomfort for the person; common in personality disorders, where individuals may not perceive their behavior as problematic.

Ego Dystonic

 One's behaviors do create anxiety and internal discomfort for the person, indicating a conflict with their self-image or desires.

Flashcard #6
Term: Categorical Models (in DSM-V)

Designed to differentiate syndromes according to separate kinds, viewing personality disorders as distinct conditions rather than problems of degree. (e.g., one either has or does not have borderline personality disorder).

: Dimensional Classification Models

 View personality disorders on a continuum of normal personality and behavior, suggesting they are extreme versions of normal personality variations, described by a profile of traits or severity.

 Five-Factor Model

 A proposed dimensional classification model that includes extraversion, agreeableness, conscientiousness, emotional stability (neuroticism), and openness to experience as personality dimensions.

: Gender Bias in PD Diagnosis

Knowledge of a client's gender can significantly influence personality disorder diagnosis. For example, antisocial PD is assigned more often to males, while similar behaviors in females might be labeled histrionic PD.

: Criterion Gender Bias

 The criteria for a disorder may be biased towards one gender.

Assessment Gender Bias

The measures and how they are used to assess disorders may be biased towards one gender.

 Paranoid Personality Disorder (PPD)

 Excessively mistrustful and suspicious of others without justification,assuming others intend harm. Characterized by pervasive distrust, suspiciousness, argumentativeness, grudges, and sensitivity to criticism.

Treatment for PPD

Difficult due to lack of trust. Focuses on developing trust and cognitive therapy to counter mistaken assumptions about others. No good studies show effective treatment for PPD.

Schizoid Personality Disorder (SZPD) 

Pervasive pattern of detachment from social relationships and a very limited range of emotions in interpersonal situations. Characterized by lack of desire for close/sexual relationships, preference for solitary activities, and indifference to others' behaviors.

Etiology of SZPD

Unclear; preference for social isolation resembles aspects of autism, though no established link. Homelessness is prevalent.

Treatment for SZPD

Focuses on the value of social relationships, learning empathy skills, and social skills training (e.g., role-playing). Prognosis is poor, and most rarely seek treatment.

 Schizotypal Personality Disorder (STPD)

Socially isolated, like SZPD, but also thinks and behaves in odd/unusual ways and holds odd beliefs. Tend to be suspicious and have unusual perceptual experiences.

ideas of reference (STPD)

Belief that insignificant events relate directly to oneself (e.g., a news report is specifically about them).

Magical thinking (STPD)

 Belief in having extraordinary abilities, such as clairvoyance or telepathy.

 Illusions (STPD)

Unusual perceptual experiences, such as feeling the presence of another person when alone.

Etiology of STPD

Viewed by some as a phenotype of schizophrenia genotype, supported by genetic research. May also be linked to exposure to influenza during pregnancy and mild-to-moderate cognitive deficits (suggesting left hemisphere damage) or generalized brain abnormalities.

 Treatment for STPD

 Few controlled studies. Main focus on developing social skills and alleviating depressed mood (as 30-50% meet criteria for major depressive disorder). Medical treatment often follows that for schizophrenia. Prognosis is not good.