Personality Disorders

personality disorders

• enduring, inflexible predisposition

• maladaptive, causing distress and/or impairment

• generally poor prognosis

• patients don’t feel that treatment is necessary

• leads to dysfunction in at least two of the following realms

  • cognition

  • emotion

  • social interactions

  • impulsivity

• the individual’s pattern is significantly different from ones usually found in their culture

• individual experiences significant distress or impairment

• emerge in adolescence of early adulthood

• 9-13% of all adults

• comorbidity

Clusters

• cluster A: odd or eccentric behavior

  • paranoid, schizoid, and schizotypal

  • displayed behaviors similar to, but not as extensive as schizophrenia

• cluster B: dramatic, emotional, or erratic behavior

  • antisocial, borderline, narcissistic, and histrionic

  • more common than others

• cluster C: anxious or fearful behavior

  • avoidant, dependent, and OCD

  • more responsive to treatment

paranoid personality disorder

• a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

  • limited close relationships, cold and distant affect

  • excessive trust in own ideas and abilities; critical of weakness and fault in others

  • recurrent suspicions about fidelity of spouse

  • persistently bears grudges and unwilling to forgive or let things go

• causes

  • may involve early learning that people and the world are dangerous or deceptive

  • cultural factors: more often found in people with experiences that lead to mistrust of others

schizoid personality disorder

• a pattern of detachment from social relationships and a restricted range of emotional expression

• prefer to be alone and keep to themselves

• appear indifferent to praise or criticism

• show emotional coldness, detachment, or flat affect

• seem socially inept/self-absorbed

• more common in men

schizotypal personality disorder

• a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

• extreme discomfort with and reduced capacity for close relationships, seeks isolation

• odd ways of thinking and speech and behavioral eccentricities

• ideas of reference, bodily illusions

• excessive social anxiety that doesn’t diminish with familiarity

• many meet the criteria for depression

• causes

  • mild expression of schizophrenia genes?

  • may be more likely to develop after childhood maltreatment or trauma, especially in men

• treatment

  • address comorbid depression

  • main focus is combination of medication, cognitive behavioral therapy, and social skills training

antisocial personality disorder

• a pattern of disregard for, and violation of, the rights of others, criminality, impulsivity, and a failure to learn from experience

• failure to comply with social norms

• violation of the rights of others

• irresponsible, impulsive, and deceitful

• lack of conscience, empathy, and remorse

• may be very charming, interpersonally manipulative

• often show early histories of behavioral problems, including conduct disorder

  • callous-unemotional type of conduct disorder link

• families with inconsistent parental discipline and support

• families often have histories of criminal and violent behavior

• person must be at least 18 years old