Cluster C PDs

cluster c

Anxious/Fearful Personality Disorders

• Avoidant PD, Dependant PD, Obsessive-Compulsive PD

avoidant PD characterized by

a lot of discomfort with other people due to feelings of inferiority, a lot of social anxiety

avoidant pd criteria

• Avoids occupational activities that involve significant interpersonal contact, due to fears of criticism, disapproval, or rejection

• Unwilling to get involved with people unless certain of being liked

• Shows restraint within intimate relationships because of the fear of being shamed, ridiculed, or rejected

• Preoccupied with being criticized/rejected in social situations

• Inhibited in new interpersonal situations because of feelings of inadequacy

• Views self as socially inept, personally unappealing, or inferior to others

• Is unusually reluctant to take personal risks or engage in any new activities because they may prove embarrassing

avoidant pd psychodynamic explanation

Childhood experience of being shamed or rejected is a key component to the development of avoidant pd

avoidant pd cognitive-behavioral explanation & intervention

• Assume they will be criticized or rejected

• Attend to details that support assumptions - cognitive bis towards noticing things that support their assumptions

• Intervention: challenge idea that rejection is too painful to bear, group therapy

avoidant pd biological explanation

• "slow-to-warm-up" temperament in infants --> shy children --> avoidant PD

• Antidepressant/anti-anxiety drugs often used to aid in benefiting from psychotherapy

dependent PD characterized by

a lot of clingy behaviors

dependent pd criteria

• Has difficulty making everyday decisions without an excessive amount of advice & reassurance from others

• Needs others to assume responsibility for most major areas of their life

• Difficulty expressing disagreement with others because of fear of loss of support/approval

• Difficulty initiating projects/doing things on their own because of lack of self confidence

• Goes to excessive lengths to obtain nurturance & support from others

• Feels uncomfortable/helpless when alone because of exaggerated fears of being unable to car for themselves

• Urgently seeks relationships as a source of care & support

• Unrealistically preoccupied with fears of being left to take care of themselves

dependent pd psychodynamic explanation

• Fears & anxieties develop in early childhood

• Can be due to having an insecure attachment

• If they don't have a secure attachment in childhood, they may never have the foundation to develop trust later in life

dependent pd cognitive-behavioral explanation & intervention

• Parents undermined children's independent behaviors & promoted/reinforced neediness & clinginess

• Intervention:

  • CBT

  • Assertiveness training & "homework assignments"

obsessive-compulsive PD vs OCD

*In obsessive-compulsive PD, there are no real obsessions or compulsions

obessive-complusive pd criteria

• Four of the following:

• Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

• Showing perfectionism that interferes with task completion

• Excessive devotion to work & productivity to the exclusion of leisure activities & friendships

• Being overconscientious, scrupulous, & inflexible about matters of morality, ethics, or values

• Inability to discard work-out worthless objects even when they have no sentimental value

• Reluctance to delegate tasks or to work with others unless they submit to exactly their way of doing

• Money viewed as something to be hoarded for future catastrophes

• Shows rigidity & stubbornness

obssessive-complusive pd psychodynamic explanation

• PD develops as a defense mechanism, unconscious response to deep desire to completely let loose & have zero control

• Unconscious urge/wish develops as a result of overly-controlling, anxious, or punitive parenting

• Wish to make mess --> anxiety --> opposite extreme

obssessive-complusive pd cognitive-behavioral explanation

• People with this PD are too cognitively focused on details

• Exposure "experiments" to demonstrate that relaxation does not have to interfere with productivity

  • Therapy experiments/hw assignments for the individual to do