Personality Disorders

What is personality?

“aspects of oneself that are brought to every situation and how individuals put their own unique imprint on everything they do”

contributes to thinking, behavior, and coping

How can a personality be disordered?

• inability to adjust and exercise flexibility

• personality traits lead to consistent distress, impairment, and interpersonal difficulties with limited insight

• for diagnosis- traits must be inflexible and cause significant functional impairment

What characterizes personality disorder- cluster A?

odd or eccentric with disordered thinking

What are the 3 disorders under cluster A?

• paranoid personality disorder

• schizoid personality disorder

• schizotypical personality disorder

What is paranoid personality disorder?

• pervasive distrust and suspiciousness of others

• may withdraw and avoid social situations

  • sensitive and quick to react or take offense

What is schizoid personality disorder?

• pervasive pattern of social detachment and restricted range of emotional expression in interpersonal settings

• may be oblivious to social cues and nuances and appear superficial or aloof

  • primarily engage in solitary activities

What is schizotypal personality disorder?

• pervasive pattern of social and interpersonal deficits marked by acute discomfort

• reduced close relationships

• cognitive or perceptual distortions

• eccentric behavior

• may exhibit odd beliefs or magical thinking inconsistent with cultural norms as well as odd speech patterns or mannerisms

• associated with excessive social anxiety and depression

What is characterisitic of personality disorders- cluster B?

dramatic, erratic, or emotional with limited impulse control and difficulty with emotional regulation

What disorders are under personality disorders- cluster B?

• borderline personality disorder

• antisocial personality disorder

• histrionic personality disorder

  • narcissistic personality disorder

What is borderline personality disorder?

• pervasive pattern of instability of interpersonal relationships, self-image, and affect with marked impulsivity

• experience fear of rejection and may exhibit extreme behaviors to avoid abandonment

• see the world as black and white

• unstable sense of self

What is antisocial personality disorder?

• pervasive pattern of disregard for and a violation of, the rights of others

• exhibit hostility or manipulation

• associated with inflated sense of self and disregard of the well-being of others

• limited remorse for causing harm

in children, first diagnosed as conduct disorder

What is histrionic personality disorder?

• pervasive and excessive emotionality and attention-seeking behavior

• frequently feel uncomfortable or unappreciated when they aren’t the center of attention

• typically involved in “drama”

• may imagine relationships to be more intimate

What is narcissistic personality disorder?

• pervasive pattern of grandiosity

• need for admiration

• lack of empathy

• may demonstrate arrogant behaviors and be preoccupied with power and prestige

• associated with fragile self-esteem

• limited risk-taking in professional settings when defeat is a possibility

What is characteristic of personality disorders- cluster C?

anxious and fearful

What disorders are under personality disorders cluster-C?

• avoidant personality disorder

• dependent personality disorder

• obsessive-compulsive personality disorder

What is avoidant personality disorder?

• pervasive pattern of social inhibition

• feelings of inadequacy and hypersensitivty to criticism

• want to have friends but avoid interpersonal contact that may lead to criticism or rejection

• perceive themselves to be socially inept

• personally unappealing or inferior to others

• appear to be painfully shy

What is dependent personality disorder?

• pervasive and excessive need to be taken care of that leads to submissive and clinging behaviors and fear of separation

What is obsessive-compulsive personality disorder?

• preoccupation with orderliness

• perfectionism and control at the expense of flexibility, openness, and efficiency

• difficulty with decision-making

• hold themselves to such high standards that they aren’t able to follow through leading to distress and disfunction

Personality disorders at a party: cluster A

“weird”

PaSS

Personality disorders at a party: cluster B

“wild”

BANHed

Personality disorders at a party: cluster C

“worried”

DOA

Etiology of personality disorders

• Genetics and biology: moderately heritable and component of biological vulnerability

• Environmental: fit between parent and baby, adverse childhood experiences increase risk

Prevalence and course of personality disorders

between 6 and 10%

most common: obsessive-compulsive, narcissistic, and borderline

personality disorders typically emerge in adolescence or early adulthood, can be diagnosed under 18 if symptoms are present for >1 year (except antisocial PD)

Gender and culture specific information

most common in males (antisocial personality disorder)

most common in females (borderline, histrionic, and dependent disorders)

highly situated in cullture, as one’s personality charactersitics must be outside of cultural norms

Impact on occupational performance

• cognition: typically experience cognitive distortions about the world, themselves, and others

• affectivity: problematic emotional responses

• impulse-control: under or over controlled impulses

• interpersonal: difficulty with interpersonal relationships is most common symptom

Treatment for personality disorders

• psychotherapy: improving functioning by acknowledging previous experiences and addressing present-day struggles (CBT, DBT, psychodynamic)

  • medication: may be prescribed to treat associated symptoms (antidepressants, anti-anxiety, and antipsychotics)

Common intervention approaches for personality disorders

• cognitive behavioral approach: challenging distorted beliefs

• dialectical behavioral therapy: training skills in mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance

• anger management: develop alternative methods for managing unpleasant emotions

• family psychoeducation: education and support to improve family relationships and support