3-31

Cluster C — anxious or fearful

  • avoidant personality disorder

    • Four or more

    • Avoidance of interpersonal contacts due to fear of rejection

    • Involved with others only if certain of being liked

    • Fear of shame, ridicule in intimate relationships

    • Preoccupation with being rejected

    • Feelings og inadequacy

    • Feelings of inferiority

    • Reluctance to try new things (fear of embarrassment)

  • dependent personality disorder

    • Four or more

    • Indecisive

    • Needs other to take responsibility

    • Difficulty disagreeing with others

    • Difficulty acting independently

    • Does unpleasant things to gain favor

    • Feels helpless without others

    • Urgent need to be in relationship

    • Fears of needing to take care of self

  • Obsessive-compulsive personality disorder

    • Four or more

    • Preoccupation with rules to the extent that the point is lost

    • Perfectionism to the extent that nothing is finished

    • Excessive devotion to work

    • Inflexible morality

    • Difficulty discarding worthless objects

    • Reluctance to delegate

    • Miserliness

    • Rigidity and stubbornness

OCPD vs OCD

  • obsessions/compulsions

    • Present in OCD not OCPD

  • Referral reasons

    • OCD: stressed caused from obsessions/compulsions

    • OCPD: stress related to conflict between client and others

Personality state — related to specific circumstances, clinical condition, or period of time

Personality trait — personality characteristics that are stable over time, situations, events

Personality disorder (3 P’s) — ways of seeing, interpreting, or believing in the world becomes inflexible and maladaptive

  • persistent

  • Pervasive

  • Pathological

Treatment Of personality disorders

  • personality not easy to sum up into a clear construct

  • People rarely fit perfectly into one category

  • Dimensional models: high/low on trait

  • example: five-factor model (FFM)

    • Openness

    • Conscientiousness — responsible vs. Carelessness

    • Extraversion

    • Agreeableness

    • Neuroticism

Developmental considerations

  • diagnosis under age 18?

    • Retrospective look at behaviors in childhood

      • Many traits transient and typical of development

      • Some “red flags” evident early on

      • The role of parenting styles

    • Adolescent personality disorders/traits

Demographic characteristics

  • renames from .5% up to 14%

    • In this study: OCPD, Paranoid, ASPD most common

  • males vs. Females

    • Males: antisocial, schizoid, schizotypal

    • Females: avoidant, dependent, borderline

Biological perspective

  • temperament

  • Early traumatic events

    • Poor attachment

    • Lack of mentalism

    • Changes in neurobiological responses

    • Overperceiving, overresponding to threats

Psychodynamic perspective

  • early parent-child interactions

    • Internalize negative parental attitudes

    • Treat themselves like parents treated them

    • Consistent with high right of abuse/neglect

Cognitive behavioral perspective

  • thoughts can affect mood regulation

    • Ficus on mood regulation and core beliefs about self and the world

      • Ex: abusive relationship

  • Maladaptive core beliefs

    • “I am an unloveable person”

    • “Im not smart enough and i cant make these decisions on my own—i need my partner to do it for me”

Sociocultural perspective

  • culture as an influence in personality

  • Broad contextual view of personality development

  • Concept of self

Treatment

  • resistant to treatment

    • Usually others who want the person in treatment

    • Comorbid disorders make treatment more complicated

  • Not much empirical evidence

    • More studies have focused on ASPD, BPD

Treatment for cluster A

  • distrust and lack of interests are difficult barriers