Personality Disorders

What are the 3 clusters of personality disorders?

Cluster A: Odd/eccentric - paranoid, schizotypal, schizoid

Cluster B: Dramatic/emotional - borderline, narcissistic, histrionic, antisocial

Cluster C: Anxious/fearful - dependent, obsessive compulsive, avoidant

General criteria for a personality disorder

A) An enduring pattern of inner expeirence and behaviour that deviates markedly from the expectations of the individual’s culture

B) Pattern is manifested in two or more of the following areas: cognition, affectivity, interpersonal functioning and impulse control

C) Pattern is inflexible and pervasive across a range of personal and social situations

D) Pattern leads to clinically significant distress or impairment

Diagnostic criteria for BPD

Five or more of the following:

1. Frantic efforts to avoid real or imagined abandonment

2. Unstable and intense interpersonal relationships characterised by alternating idealisation and devaluation

3. Identity disturbance

4. Impulsivitiy

5. Affective instability and marked reactivity of mood

6. Chronic feelings of emptiness

7. Inappropriate intense anger or difficulty controlling anger

8. Transient stress-related paranoid ideation or severe dissociative symptoms

Biosocial model of BPD

• An invalidating rearing environment and a biological tendency toward emotional vulnerability and impulsivity

• Emotional vulnerability - high sensitivity to emotional stimuli, intense emotional reactions and slow return to emotional baseline

Differences between complex trauma and BPD

• Individuals with CPTSD experience a severe but stable negative self-concept whereas BPD report shifts between highly pos and highly neg self-perceptions

• CPTSD tend to avoid or have difficulty maintaining relationships whereas BPD associated with rapid ups and downs in relationships

Emotional cascade model of BPD

1. Event elicits a negative emotion which triggers intense rumination

2. Rumination increases intensity of the emotion

3. Person finds it more difficult to divert attention away from the emotional experiece

4. This results in behavioural dysregulation as a distraction from emotions (negative reinforcement)

5. Behaviours produce potent physical stimuli e.g., self-injurious behaviour