chp 17

Personality Disorders

Configurations of traits considered socially undesirable, leading to patterns like social awkwardness, arrogance, and strangeness.

Pathological Traits

Difficult to determine the exact point where normal personality traits become pathological, making it challenging to define personality disorders precisely.

Prevalence of Personality Disorders

Approximately 15% of adult Americans are estimated to have at least one personality disorder, indicating a significant impact on individuals and those around them.

DSM Purposes

The DSM aims to provide a common vocabulary for psychological diagnosis, enhancing objectivity in discussions and aiding in insurance billing for treatment.

Extreme Behavior

Personality disorders involve unusually extreme and problematic behaviors, often causing significant issues for the individual or those around them.

Stability of Personality Disorders

Personality disorders are stable over time, persisting from adolescence into adulthood, and are challenging to change through therapeutic interventions.

Ego-Syntonic

Personality disorders can be ego-syntonic, where individuals do not perceive their traits as problematic and may even value them, complicating treatment efforts.

Major Personality Disorders

The DSM-5 lists 10 major personality disorders organized into Clusters A, B, and C, each characterized by distinct patterns of extreme behavior and emotional styles.

Personality Disorders

Conditions characterized by basic beliefs, attitudes, and behaviors associated with each disorder.

Cognitive-Behavioral Therapy

Therapy based on changing mistaken core beliefs or thinking styles to improve behavior patterns.

Schizotypal Personality Disorder

Disorder characterized by odd thoughts, strange ideas, unconventional behavior, and discomfort in relationships.

Narcissistic Personality Disorder

Disorder where individuals have an exaggerated sense of self-importance, lack empathy, and expect special treatment.

Antisocial Personality Disorder

Disorder involving deceit, manipulation, impulsive behaviors, aggression, and disregard for social norms.

Borderline Personality Disorder

Disorder characterized by unstable behavior, poor sense of identity, and self-harming patterns.

Borderline Personality Disorder (BPD)

A disorder characterized by emotional instability, rapid mood changes, and intense suffering akin to emotional hemophilia.

Self-harm in BPD

Common behaviors like cutting, driven by the need to alleviate negative emotions and communicate distress.

Interpersonal Relationships in BPD

Chaotic, unstable relationships due to splitting, where individuals view others as either all good or all bad.

Dialectical Behavioral Therapy

A therapeutic approach for BPD focusing on emotional self-control and analyzing past emotional reactions.

Avoidant Personality Disorder

A disorder marked by extreme fear of failure, criticism, or rejection leading to avoidance of normal activities and interactions.

Obsessive-Compulsive Personality Disorder (OCPD)

A disorder characterized by rigidity, perfectionism, and compulsions, often leading to inefficiency and anxiety.

OCPD vs

OCPD involves rigid personality traits, while OCD is an anxiety disorder with specific compulsions and obsessions.

OCPD

An extreme pattern of rigidly conscientious behavior, including an anxious and inflexible adherence to rules and rituals, perfectionism, and a stubborn resistance to change.

Negative Affectivity

One of five trait domains associated with personality disorders in the DSM-5, characterized by a tendency to feel negative emotions such as anxiety, depression, and suspicion.

Detachment

One of five trait domains associated with personality disorders in the DSM-5, characterized by a tendency to withdraw from and avoid emotional contacts with other people.

Antagonism

One of five trait domains associated with personality disorders in the DSM-5, characterized by deceitfulness, grandiosity, callousness, and manipulativeness.

Disinhibition

One of five trait domains associated with personality disorders in the DSM-5, characterized by a lack of self-control and impulsive behavior.

Psychoticism

One of five trait domains associated with personality disorders in the DSM-5, characterized by a tendency to have bizarre thoughts or experiences, and to exhibit eccentric behavior.

Continuum between normality and abnormality

The modern research literature on personality disorders suggests that there is no clear distinction between psychopathology and normal variation, with normal personality traits being associated with a wide range of psychopathologies.

Exaggerated traits in personality disorders

Each personality disorder can be seen as an exaggerated version of a trait that, in the normal range, can have some advantages, highlighting the overlap between normal traits and elements of personality disorders.

Implications for health

Personality traits have important relationships with physical health outcomes, with factors like Type A personality, emotionality, and conscientiousness playing significant roles in influencing health and longevity.

Type A Personality

The concept of the Type A personality, characterized by competitiveness and ambition, was initially linked to heart disease risk but later research suggests that hostility, rather than ambition, may be the key factor associated with negative health outcomes.

Hostility and health

Chronic hostility, rather than ambition or hard work, appears to be detrimental to health, with studies showing that cynical distrust and irritability can lead to inflammation and increased risk of atherosclerosis.

Tobacco industry influence

Research on Type A personality was subsidized by the tobacco industry, aiming to shift the blame for health issues onto personality traits rather than smoking, highlighting the importance of critically evaluating research funding sources.

Negative Emotionality

The general tendency to experience negative feelings, associated with poor physical health and neuroticism.

Positive Emotions and Health

Research shows that while positive emotions can encourage healthy behaviors and enhance resilience, claims that they directly improve health are often false.

Conscientiousness

A personality trait linked to better health outcomes, as highly conscientious individuals tend to handle stress better and engage in behaviors that promote good health.

Relationship between Neuroticism and Health

Studies show contradictory results regarding the impact of neuroticism on health, with some suggesting a positive relationship due to behaviors influenced by impulsivity.

Emotions and Health

The relationship between emotions and health is complex, with negative emotions influencing behaviors that lead to stress and potentially poor health outcomes.

Optimism and Health

While excess optimism can lead to ignoring health risks, moderate optimism can motivate individuals to engage in healthy behaviors and enhance resilience in facing challenges.

Ego-syntonic

Refers to personality disorders that are not perceived as problematic by the individuals diagnosed with the disorder.

Major Personality Disorders

Divided into three clusters in the DSM-5 - Cluster A (odd/eccentric), Cluster B (impulsive/erratic), and Cluster C (anxious/avoidant).

Incorrect Beliefs

Conceptualized by Aaron Beck as the basis for personality disorders, leading to maladaptive behavior patterns.

"Bad Five" Personality Traits

Negative affectivity, detachment, antagonism, disinhibition, and psychoticism, used in the DSM-5 to describe personality disorders.

DSM-5 Diagnosis Steps

Assess client's function, recognize the presence of one of the six recognized disorders, and evaluate the client's characteristics based on the "Bad Five" traits.

Pathologizing Behavior

Raises moral issues and may lead to overdiagnosis, blurring the line between mental illness and normal behavior.

Type A Personality

Initially linked to heart disease due to achievement-seeking and hostility, later research has questioned its overall impact on health.

Emotionality

Negative emotions may result from poor health and can motivate health monitoring, while positive emotions like optimism can lead to beneficial behavior changes.

Conscientiousness

Associated with better health outcomes and longevity due to health-promoting behaviors and overall success in life.

Healthy Personality

Characterized by the capability for love and work, contributing to mental and physical well-being.