Untitled

Personality Disorders Overview

General Announcements

  • Class will continue with a focus on personality disorders, possibly extending into the next week due to time constraints.
  • Upcoming guest lecture by TA Brie on Thursday, contents will be included in exams.
  • Instructor will not be present on Thursday due to a professional conference in Chicago; will not hold office hours; students can reach out via email with questions.

Narcissistic Personality Disorder (NPD)

  • Definition: Characterized by a grandiose sense of self-importance.
    • Beyond just positive self-regard, the hallmark of narcissism is intolerance and hostility towards criticism.
Causes of Narcissistic Personality Disorder
  • Undetermined causes, considered understudied.
  • Normative Developmental Perspective:
    • Children exhibit egoistic traits, viewing themselves as central and expecting praise. Most outgrow these traits.
  • Sociocultural Viewpoint:
    • Increasing prevalence of narcissistic traits, especially among younger generations; relation to the 'me' generation and overemphasis on self-esteem.
  • Parental Practices:
    • Lack of empathy learned in childhood. Parenting behaviors can lead to narcissism.
    • Balance between excessive praise and unrealistic expectations can cause confusion in self-worth.
    • Example: receiving endless praise but facing harsh disapproval for inadequate performance.
  • Severe Emotional Abuse:
    • Fluctuating messages from parents (e.g., "You are wonderful" vs. "You are a failure") can create self-esteem issues.
Treatment
  • Generally considered challenging due to limited understanding of causes.

Borderline Personality Disorder (BPD)

  • Characterization:
    • Most stigmatized personality disorder, known for unstable moods and relationships.
    • The term ‘borderline’ indicates it lies on the border between mood disorders and personality disorders.
Symptoms and Features
  • Dramatic Emotional Instability: Fluctuations from euphoria to irritability and negativity.
  • Relationships: Intense relationships characterized by idealization and devaluation, known as splitting.
    • Example: Rapid shifts from feeling close and loving to perceiving someone as worthless.
  • Impulsivity: Engaging in risky behaviors (e.g., substance use, reckless driving).
  • Fear of Abandonment: An intense fear leading to frantic efforts to avoid perceived rejection.
  • Self-Harm and Suicidal Gestures: Acts motivated by excessive emotional distress.
Diagnosis Criteria
  • Must exhibit 5 or more of the following traits:
    • Frantic efforts to avoid real or imagined abandonment.
    • Instability in interpersonal relationships, self-image, and affect.
    • Marked impulsivity in various aspects of life.
    • Identity disturbance and chronic feelings of emptiness.
    • Difficulty controlling anger or frequent angry outbursts.
    • Affective instability characterized by emotional dysregulation.
Treatment Approaches
  • Dialectical Behavioral Therapy (DBT): Specifically developed for BPD by Marsha Linehan.
    • Combines acceptance and change strategies.
    • Four modules: Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness.
  • Use of mood stabilizers or antidepressants may be considered.
Co-morbid Conditions
  • High rates of comorbid mood disorders (e.g., major depressive disorder, bipolar disorder).
  • Substance use disorders and eating disorders are also prevalent in BPD patients.
Potential Causes
  • Biological components: Genetic predisposition, particularly for high levels of neuroticism.
  • Environmental Factors: Trauma or neglect during childhood; presence of invalidating environments restricts emotional regulation.

Avoidant Personality Disorder (AvPD)

  • Clinical Features:
    • Extreme sensitivity to opinions of others leading to social avoidance.
    • Low self-esteem and an intense fear of rejection or humiliation.
Comparison to Social Anxiety Disorder
  • AvPD viewed as a more pervasive and severe form of social anxiety, where individuals may avoid most social relationships entirely.
Treatment Approaches
  • Similar strategies as for social anxiety disorders.
    • Cognitive therapy, exposure therapy, and social skills training.
  • Establishing a therapeutic relationship is critical for effective treatment.

Dependent Personality Disorder (DPD)

  • Clinical Features:
    • Heavy reliance on others for emotional and decision-making needs; often submissive.
    • Leaves individuals vulnerable to exploitation or abuse in relationships.
Causes
  • May stem from traumatic separation in childhood and issues related to attachment.

Obsessive-Compulsive Personality Disorder (OCPD)

  • Definition: Not to be confused with OCD; characterized by a preoccupation with order, perfectionism, and control over tasks and thoughts.
    • Key traits include rigidity, excessive devotion to work, and difficulties with spontaneity.
Distinctions from OCD
  • Obsessions in OCD are intrusive and unwanted; traits in OCP person viewed as acceptable and valued.
  • OCPD is far more common compared to OCD in clinical populations.
Treatment Approaches
  • Addressing perfectionistic tendencies through cognitive therapy and exposure techniques that encourage flexibility in routine and acceptance of imperfections.
Misconceptions Regarding OCPD
  • Often misunderstood as synonymous with OCD; treated as separate entities in clinical psychology.
  • OCPD often results in adverse life impacts, including reduced productivity and relationship difficulties.

Conclusion

  • Summary of three clusters of personality disorders:
    • Cluster A: Odd or eccentric disorders.
    • Cluster B: Dramatic, emotional, or erratic disorders: NPD, BPD, etc.
    • Cluster C: Anxious or fearful disorders: AvPD, DPD, OCPD.
  • Students encouraged to study these disorders by their core distinguishing characteristics rather than just prevalence or gender distribution.
  • Reminder: Upcoming guest lecture and lack of office hours due to instructor commitments.