Personality Disorders Overview

Overview of Personality Disorders

• Personality: A set of distinctive psychological traits and behavioral characteristics that makes us unique to individuals.

  • Consistency in behavior observable across different contexts.

  • No two people are alike (not even identical twins)

  • Unique patterns in how individuals relate to others and engage with the world.

The Five Factor Model

• Dimensions of Personality: (High or Low on a scale)

  • Extraversion: Tendency toward sociability and assertiveness.

  • Agreeableness: Tendency to be compassionate and cooperative.

  • Conscientiousness: Discipline, reliability, and organization.

  • Neuroticism: Tendency toward emotional instability and anxiety.

  • Openness: Willingness to try new experiences and engage in imaginative thinking.

Characteristics of Personality Disorders

• Nature:

  • Enduring and inflexible predispositions that are maladaptive.

  • Source of distress and impairment in functioning.

  • Associated with high comorbidity and poor prognosis.

• Ego-syntonic: Patients may feel their behaviors align with their identity, often rejecting the need for treatment.

• Prevalence: Roughly 1% of the general population affected.

Theoretical Perspectives on Personality Disorders

Origins

. Thought to begin in childhood

1. Psychodynamic:

   • Focus on issues from early childhood, such as the development of self-identity.

   • Links to disorders such as narcissistic and borderline personality disorders.

   • More recent psychodynamic theories have generally focused on the earlier per-Oedipal period of 18-3 years, during which infant Belgian to develop identities separate from those of their parents.

2. Learning Theories:

   • Emphasize maladaptive behaviors learned through life experiences and environmental factors.

   • How behaviors are reinforced or punished during out development.

   • What gets attention and what doesn’t get attention.

   • Suggest childhood experiences contribute to personality development.

3. Biological Perspectives:

   • Genetic factors play a role; family history increases risk.

   • Environmental factors also critically influence development.

4. Family Perspectives:

   • Suggest that dysfunctional family environments contribute to personality disorders.

   • Rejection and neglect - although many neglected children do not go on later to develop a personality disorder.

   • Child maltreatment is a common link. (Abuse)

5. Sociocultural Perspectives:

   • Social conditions and stressors (e.g., poverty) can contribute to development.

DSM-5 Personality Disorder Clusters

• Cluster A (Odd/Eccentric):

  • Paranoid: Mistrust and suspicion.

  • Schizoid: Detachment from social relationships.

  • Schizotypal: Social and communication deficits, cognitive distortions.

• Cluster B (Dramatic/Erratic):

  • Antisocial: Disregard for others’ rights, impulsivity.

  • Borderline: Instability in moods and relationships, impulsivity.

  • Histrionic: Need for attention and overly dramatic behavior.

  • Narcissistic: Inflated sense of self-importance, lack of empathy.

• Cluster C (Fearful/Anxious):

  • Avoidant: Extreme sensitivity to negative evaluation and avoidance of social situations.

  • Dependent: Excessive reliance on others for support and decision-making.

  • Obsessive-Compulsive: perfectionistic, high need for order, without the obsessions/compulsions of OCD.

Assessment of Personality Disorders

• Clinical Assessment Tools:

  • Semi-structured clinical interviews, SCID-5-PD for diagnostic criteria.

  • Specific questionnaires: MMPI, SNAP-2, Personality Assessment Inventory.

Diagnostic Issues

• Gender distribution may lead to biases in diagnosis (e.g., antisocial personality disorder more common in males).

• Diagnostic categories need careful consideration due to overlaps and shared symptoms across different disorders.

Summary of Key Concepts

• Personality disorders represent persistent and pervasive patterns of behavior that begin in childhood and can lead to functional impairment.

• Ongoing debate over how to categorize these disorders—either as discrete categories or as dimensions on a spectrum of personality traits.