PSYC 2530 - Chapter 16 - Mental and Physical Health

Is differences in personality good?

Yes - it is necessary for evolutionary survival, differences are valuable but can be an issue for mental and physical health

Personality disorders

Unusual ways of thinking, feeling, and/or behaving; causes problems for the person or others, involves cultural context and denial of reality

Ego-syntonic

A person with a personality disorder believes that they way they are thinking/feeling/acting is normal or a valued part of personality

What is the prevalence of personality disorders?

About 15% of American adults have a personality disorder diagnosis

What are the purposes of the DSM-5?

Make diagnosis more objective, guide treatment decisions, insurance billing

DSM - First edition

Created 1952, included 10 disorders in 3 clusters

Cluster A - 1st Ed. DSM

Odd and eccentric patterns of thinking - schizotypical, paranoid, schizoid

Cluster B - 1st Ed. DSM

Impulsive and erratic patterns of behavior - antisocial, borderline, narcissistic, histrionic

Cluster C - 1st Ed. DSM

Anxious and avoidant emotional styles - avoidant, obsessive-compulsive, dependent

Schizotypical personality disorder

(0.6 - 4.6%) slightly more common in men, can approach schizophrenia

Schizotypical personality disorder - Characteristics

Characteristics:

• peculiar thoughts

• odd actions

• superstitious beliefs

• difficulty in close relationships

Narcissistic personality disorder

(0 - 6.2%) make good first impressions but are annoying in the long run, difficult or impossible to treat

Narcissistic personality disorder - Characteristics

Characteristics:

• think they are special

• brag or show off

• expect and need recognition from others

• expect special treatment, feel entitled

• take advantage of and mistreat others, can be dangerous

Antisocial personality disorder

(0.2 - 3.3%) Deceitful, manipulative, and sometimes dangerous

Antisocial personality disorder - Characteristics

Characteristics:

• impulsivity, callousness

• think its a “dog eating world” - hurt them before they hurt you

• attack others

• illegal activities

• impulsive and risky behaviors

• irritable, aggressive, irresponsible

• not concerned about their impact on others

Borderline personality disorder

(2%) most severe personality disorder, 75% diagnosed are women, includes poor self-regulation skills and dysfunctional opioid system (cant feel pain as well → self harm)

What is one of the differences between psychopathy and ASPD?

Psychopathy is characterized by more of a lack of empathy than antisocial personality disorder - ASPD is more so characterized as callousness (not understanding that certain actions genuinely can have harmful consequences, rather than knowing consequences are harmful and still performing those actions)

Borderline personality disorder - Characteristics

Characteristics:

• chaotic emotions and confused thinking

• disorganized and unpredictable behavior

• self-harm (8-10% die by suicide)

• identity disturbance

• interpersonal relationship challenges, in part due to splitting

Splitting - BPD

the tendency to view other people as either all good or all bad

Dialectic behavioral therapy

Main tratment for BPD - teaches skills for emotional self-control. In individual and group sessions, the therapist and client closely examine past episodes of inappropriate emotional reactions and analyze how similar situations could be handled better next time

Avoidant personality disorder

(2.4%) The fundamental problem experienced by individuals with this disorder is that their fear of failure, criticism, or rejection may lead them to avoid normal activities of school, work, and interactions with others, similar prevalence in men and women

Avoidant personality disorder - Cahracteristics

Characteristics:

• Expect the absolute worst from others: “I may get hurt”

• Avoidance

• Need constant reassurance of uncritical acceptance

• Active inhibition of emotional expression

• Deep cravings for affection and social acceptance

Obsessive-compulsive personality disorder

(2.1-7.9%) People are bound by rituals and rules, can be severely judgmental of others, and are often miserly and stubborn

Obsessive-compulsive personality disorder - Characterisics

Characteristics:

• Bound by rituals and rules

• Severely judgmental of others

• Miserly and stubborn

• Lacks a sense of proportion

• Workaholics, perfectionists (but not productive)

• Inability to throw things away

• Extremely anxious

Personality Disorder Trait Specified (PD-TS)

Label used if a dysfunction is obvious but the criteria for any of the other 6 personality disorders isn’t met - includes the “Bad Five”

Bad Five - PD-TS

• Negative affectivity (vs emotional stability)

• Detachment (vs extraversion)

• Antagonism (vs agreeableness)

• Disinhibition (vs conscientiousness)

• Psychoticism (vs lucidity)

Negative affectivity

opposed to emotional stability - a tendency to feel negative emotions such as anxiety, depression, and suspicion

Detachment

opposed to extraversion - a tendency to withdraw from and to avoid emotional contacts with other people

Antagonism

opposed to agreeableness - including deceitfulness, grandiosity, callousness, and manipulativeness; you may recognize some of the hallmarks of narcissism here

Disinhibition

opposed to conscientiousness - characterized by carelessness and impulsive behavior

Psychoticism

opposed to lucidity - tendency to have bizarre thoughts or experiences and to exhibit eccentric behavior

the Hierarchical Taxonomy of Psychopathology (HiTOP) System

Aims to cover the whole range of psychological distress, not just personality disorders - includes internalizing disorders (fear, distress, sexual problems), thought disorders, externalizing disorders (disinhibited, antagonistic), detachment from others

3 steps to diagnosis

1. Assess whether personality functioning is seriously impaired and
   rate degree of dysfunction

2. Assess whether at least one of the defined types of personality
   disorder is present

3. Assess degree of the five maladaptive personality traits

Pathologizing

Describing behaviors as the result of mental illness
• Tells us almost nothing about the nature of mental health
• Too easy

Labeling

Assigning diagnoses to people
• Always a little misleading
• Can limit understanding
• Not an explanation
• Can be useful and are necessary

Healthy individuals

• High openness to feelings, positive emotions, straightforwardness
• Low depression and anxiety