Personality Disorders

5 - Factor model

Openness: try new things and open to new experiences

Conscientiousness: more careful, attention to detail, managing time

Extraversion: Outgoing and put your selves in new experiences and people

Agreeable: Easy to get along with and problem solve; and go along with ideas

Neuroticism: Negative emotions and affect emotions. High in neuroticism higher risk for anxiety; more tense or moody

All not inherently good or bad

General Feature of Personality Disorder

• Chronic interpersonal difficulties

• Problems with one’s identity or sense of self

• Inability to function adequately in society

• Enduring pattern of behavior must be

  • Persuasive

  • Stable

  • Long duration

  • Cause clinical significant distress or impairment in functioning

There are three Clusters

Cluster A: odd or eccentric behaviors

Cluster B : erratic behavior

CLuster C: Anxious or fearful behavior

Move away from clusters and more dimensional

10% will meet the criteria for personality disorder; most common is cluster c and least common is cluster b

PDs: Dimensions vs. Categories

• All disorders are categories to some extent (based on DSM - V criteria, either have it or not)

• But, there’s been a recent push for dimensional approaches to personality and PDs

• Dimensional seems better for research purposes, but hard to decide cutoffs for treatment

Challenges in PD Research

• Difficulties in diagnosing

  • how much time do you need for it to be a characteristic of their being or going through something at the moment

• Difficulties in studying the causes

• So why were categories kept as opposed to dimensions?

Possible Causes

Biological

• Temperament

• Genetics

Psychological

• Learning -based habits

• Maladaptive cognitive styles

Social

• Parents

• Abuse

• Society

Treatment Options

• PDs are hard to treat

• Not many well-researched, very effective txs

Treatment Options

• PDs are hard to treat

• Not many well-researched, very effective txs

Cluster A

• Paranoid

• Schizoid

• Schizotypal

Common features:

• People often seem odd or eccentric

• Unusual behavior

Paranoid PD

• pervasive distrust of nearly all others

• fear of malevolent malevolent in others

• reads hidden meanings into interactions

• Persistently bears grudges

• quick to counterattack over little things

Paranoid PD: Causes

Psychodynamic:

• parent’s persistnet, unreasonable demands create a hostile environment

• beleive others can’t be trusted —> feel angry

Cognitive:

• hold broad assumptions: “people will hurt you if given the chance”

Biological: genes; twins were most likely to share paranoia

Psychosocial

• Drugs

• Trauma

• Abuse

Paranoid PD: Treatments

• psychodynamic:

  • help client develop satisfying relationships

  • help clients “re-establish self- cohesion”

• Cognitive-Behavioral:

  • practice anxiety-reduction skills

  • improve interpersonal skills

  • reappraise others’ motives and behaviors

Schizoid PD

• Pervasive pattern of detachment from social relationships

• Restricted range of emotional expressions

• Uninterested in others (freinds, romantic partners)

• Indifferent to praise OR criticism

Schizoid PD: Causes

• Psychodynamic:

  • unaccepting, abusive parents —> unsatisfied need for human contact

  • cope with abuse by avoiding all contact

• Cognitive: lack social, cognitive, or emotional depth to respond appropriately to others even if they are just intelligent

• Biological

  • Heritablility

  • Impaired affiliative system

• Not the type to participate in research

Schizoid PD: Treatments

• Cognitive-Behavioral:

  • emotion education

  • recording pleasurable experiences

  • social skill practive

  • group therapy

Schizotypal PD

• discomfort with close relationships

  • excessive social anxiety does not diminish with increased familiarity associated with paranoid fears, not negative self-judgement

• Odd patterns of thinking

  • ideas, not delusions, of reference

• Eccentric behaviors

  • ex. wearing an odd assortment of clothes

• Sometimes perceived to be a prodromal form of schizophrenia

Schizotypal PD: Causes

Biological:

• attention and memory issues contribute

  • ex: some are similar to those seen in schizophrenia

• Increased dopamine activity

• enlarged brain ventricles

• loss of grey matter

Sociocultural:

• family conflicts may contribute

• Early trauma

Schizotypal PD: Treatments

Cognitive-Behavioral:

• help clients evaluate unusual thoughts

• help clients summarize instead of digressing in conversations

• social skills training

• increase positive social contacts

Biological:

• antipsychotic drugs in low doses help with unusual thoughts

Schiziodtypical want to make relationship while schiziod did not

• ideas of reference: take random occurrence and give personal meanning

• and delusions or reference: radio that message was meant for specifically you