Chapter 13: Personality Disorders

These flashcards cover key concepts and definitions related to personality disorders as discussed in the lecture notes.

Personality Disorder:

An enduring, rigid pattern of inner experience and outward behavior that repeatedly impairs one’s sense of self, emotional experiences, goals, capacity for empathy, and/or capacity for intimacy.

Schizoid Personality Disorder:

A personality disorder featuring persistent avoidance of relationships and little expression of emotion.

• Prefer to be alone and keep to themselves

• Limited expression of feelings

Schizotypal Personality Disorder:

A personality disorder characterized by extreme discomfort in close relationships, very odd patterns of thinking and perceiving, and behavioral eccentricities.

• Believe unrelated events pertain to them in important ways; bodily illusions.

• Demonstrate difficulty keeping attention focused

Antisocial Personality Disorder:

A personality disorder marked by a general pattern of disregard for and violation of other people’s rights.

• Lie, recklessness, and impulsivity

• Can be cruel, sadistic, aggressive, and violent.

Borderline Personality Disorder:

A personality disorder characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior.

Mentalization:

The capacity to understand one’s own mental state and those of other people.

• To recognize needs, desires, feelings, beliefs, and goals.

Dialectical Behavior Therapy (DBT)

A comprehensive treatment approach, applied in cases of BPD, suicidal intent, and/or other psychological problems; includes both individual sessions and group sessions.

Histrionic Personality Disorder:

Pattern of excessive emotionality and attention seeking, once called hysterical personality disorder.

• Vain, self-centered, and demanding

• Approval and praise are lifeblood

Narcissistic Personality Disorder:

A personality disorder marked by a broad pattern of grandiosity, need for admiration, and lack of empathy.

• Exagerration of achievements and talents; actions are driven by envy.

• Selective about friends; often favorable first impressions

Personality:

Uniquely expressed characteristics that influence behaviors, emotions, thoughts, and interactions

Personality traits:

Particular, predictable, flexible characteristics.

Odd or eccentric behavior:

Paranoid, schizoid, and schizotypal personality disorders

Dramatic, emotional, or erratic behavior:

Antisocial, borderline, narcisstic, and histrionic personality disorders

Anxious or fearful behavior:

Avoidant, dependent, and obsessive-compulsive personality disorders

Are personality disorders among the most difficult to treat?

Yes, they’re among the most difficult for various reasons.

Categorical approach:

1. Problematic personality traits are either present or absent in people

2. A personality disorder is either displayed or not displayed by a person

3. A person with a personality isn’t markedly troubled by personality traits outside of that disorder

• Questions about validity and reliability

Dimensional approach:

Classified by the severity of personality traits rather than presence of absence of specific traits.

Paranoid personality disorder:

Deep distrust and suspicion of motives of others.

• Excessive trust in own ideas and abilities; critical of weakness in others.

Explanations for paranoid personality disorder:

• Psychodynamic: Patterns of early interactions with demanding parents.

• Cog-beh: Tied to broad maladaptive assumptions of others.

• Biological: Genetic causes.

Psychodynamic treatment for paranoid personality disorder:

Object relations therapy

• Look past the client’s anger and work on what they view as the individual’s deep wish for a satisfying relationship.

Cog-beh treatment for paranoid personality disorder:

• Behavioral: Anxiety reduction and interpersonal problem-solving

• Cognitive: Realistic interpretation of other people’s words and actions.

In paranoid personality disorder similar but not as extensive as schizophrenia?

Yes, however, they may qualify for an additional diagnosis of schizophrenia or have close relatives with the disorder.

Schizoid personality disorder explanations:

• Psychodynamic: Roots in unsatisfied need for human contact; childhood unacceptable or abuse.

• Cog-beh: Deficiencies in thinking; inability to detect or react to emotional cues in others.

Schizoid personality disorder treatments:

• Helping clients to reconnect with world and recognize limits of their thinking and powers

• Teaching clients to evaluate unusual thoughts and perceptions, using specific behavior methods and antipsychotic drugs

Schizotypal Personality Disorder explanations:

• High activity of dopamine; enlarged brain ventricles, smaller temporal lobes, and loss of gray matter; genetic basis.

• Links to mood disorders: MDD or Bipolar

Schizotypal Personality Disorder treatments:

• Behavioral: Help clients reconnect with world; limits of their thinking and powers.

• Cog-beh: Recognize and evaluate unusual thoughts

• Biological: Low dose antipsychotic drug therapy

Do people with antisocial personality disorder develop a knack and think of their victims as deserving?

Yes, often develop a knack for gaining personal profit at the expense of others and see their victims as weak and deserving of such wrong doing.

Antisocial Personality Disorder psychodyanmic explanation:

Psychodynamic factors

• Absence of parental love during infancy

Antisocial Personality Disorder cog-beh explanations:

• Operant conditoning by parents who unintentionally teach antisocial behavior.

• Those with ASPD often hold attitudes that trivialize the importance of others needs.

Antisocial Personality Disorder biological explanations:

• Lower activity of serotonin linked to impulsivity and aggression.

• Deficiency in prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, and temporal cortex.

• Respond to warning or expectations of stress with low brain and bodily arousal

Additional Antisocial Personality Disorder biological explanations:

• Respond to warning or expectations of stress with low brain and bodily arousal

• Poor communication between brain structures and produce low reactions.

Antisocial Personality Disorder Treatments:

• Teach to objectively evaluate unusual thoughts or perceptions; think about moral issues and needs of others.

• Reconnecting with world, setting limits, easing loneliness, reducing overstimulation.

Do people with borderline personality disorder have unstable, intense, conflict-ridden interpersonal relationships?

Yes, they often idealize another person’s qualities and abilities.

• They become furious when those expectations aren’t met, yet remain very attached to the relationship.

Do people with borderline personality disorder experience bouts of anger?

Yes, which sometimes results in violence and direct impulsive anger inward and harm themselves.

• Often as relief, distraction, and coping with emptiness identity confusion.

Do people with borderline personality disorder often threat suicide as a way to prevent abandonement?

Yes, they may do this due to fears of impending abandonment even if it’s imagined. Often a reason why it’s hard to treat.

• 70% attempt; 6% die.

Antisocial Personality Disorder Explanations:

• Biological: Genetic predisposition; lower brain serotonin activity

• Sociocultural: Impact of rapidly changing cultures

Do people with boderline personality disorder have an abnormal brain structure?

Poor interconnectivity, among the amygdala, hippocampus, prefrontal cortex, and other areas in frontal lobes.

• Help people plan, form good judgements, make good decisions, self-control, and express emotions properly,

Antisocial Personality Disorder Integrative Explanations:

• Biosocial: Children have intrinsic difficulty identifying and controlling emotions; parents teach them to ignore their feelings.

• Developmental Psychopathology: Childhood traumas and dysfunctional parental attachments lead to flawed capacity for healthy relationships; positive factors can counter.

Object Relations Theory for Borderline Personality Disorder:

Lack of early acceptance or abuse/neglect by parents (some research support)

• Loss of self-esteem, increased dependence, and an inability to cope with separation.

Do people with histrionic personality disorder overract to minor events that get in the way of wanting attention?

Yes, they’re unable to delay gratification for long so they overreact as a result.

• They may even make attempts to die by suicide, often manipulating others.

Histrionic personality disorder psychodynamic explanation:

Unhealthy relationships w/ parents

• Behave dramatically as a defense, inventing crises that would require others to act protectively.

Histrionic personality disorder cog-beh explanation:

Lack of substance and extreme suggestibility

• Must rely on others or hunches of what they never learned and hold that they’re helpless to care for themselves.

Histrionic personality disorder sociocultural explanation:

Partially influenced by cultural norms and expectations

• May actually be an exaggeration and stereotype of feminity as society defined it once.

Histrionic personality disorder treatment:

• Cognitive-behaviorist theorists: Change belief of helplessness and develop more deliberate thinking strategies

• Psychodynamic theorists: Therapy/group therapy used

Narcissistic personality disorder explanations:

• Psychodynamic: Focus on cold, rejecting parents; life spent feeling unsatisfied, rejected, unworthy, ashamed, and world wary

• Cognitive-behavioral: Propose narcissistic personality disorder may develop when people are treated too positively rather than too negatively in early life; overvalue self-worth

Narcissistic personality disorder sociocultural explanations:

See a link between narcissistic personality disorder and eras of narcissism in society

• Producing generations of young people who’re materialistic and have short attention spans.

Object Relations Theory for narcissistic personality disorder:

Focus on grandiouse self-presentation; self-sufficiency replaces warm relationships

Narcissistic personality disorder Treatment:

• Psychodynamic: Recognize and work through basic insecurities and defenses

• Cog-beh: Focus onto the opinions of others, teach them to interpret criticism more rationally, and increase their ability to empathize

Is narcisstic personality disorder among one of the most difficulty personaity patterns to treat?

Yes, may only be consulted due to depression. No major treatments have had much success.

• Individuals may try to manipulate therapists to support their sense of superiority.