Personality Disorders Overview

Chapter 12: Personality Disorders

Definition

  • Long-standing, inflexible patterns of thoughts and behaviors related to oneself and the environment.
  • Causes significant impairment or distress.
  • Caution: Avoid self-diagnosing or diagnosing others.

Classification of Personality Disorders

  • Total Number: 10 personality disorders.
  • Clusters:
    • Cluster A: Odd or eccentric.
    • Cluster B: Dramatic, emotional, erratic.
    • Cluster C: Anxious or fearful.
  • Note: Endorsement of all characteristics is not necessary for diagnosis. Consult DSM-5 for specific characteristics.
  • Personality disorders often comorbid with other disorders, impacting manifestation.

Cluster A: Odd or Eccentric

  1. Paranoid Personality Disorder

    • Key Features:
      • Distrust and suspicion towards others.
      • Expectation of being mistreated or exploited.
      • Reads hidden messages; extreme jealousy.
    • Causes:
      • Biological links unclear; possible connection to schizophrenia.
      • Psychological assumptions about others influencing behavior.
    • Treatment:
      • Difficult due to mistrust; cognitive approaches may yield low success.

  2. Schizoid Personality Disorder

    • Key Features:
      • Lack of interest in social relationships.
      • Emotionally cold and detached; prefers solitary activities.
    • Causes:
      • Unknown; possible dopamine involvement. Studies suggest changes in dopamine receptor count.
    • Treatment:
      • Limited; focuses on social skills and empathy development.

  3. Schizotypal Personality Disorder

    • Key Features:
      • Odd beliefs, magical thinking.
      • Social discomfort and constricted affect.
    • Causes:
      • Familial prevalence linked; environmental exposures may increase risk.
    • Treatment:
      • Combination of medication, community treatment, and skills training.

Cluster B: Dramatic, Emotional, & Erratic

  1. Histrionic Personality Disorder

    • Key Features:
      • Excessive emotionality and attention-seeking behavior.
      • Dramatic expressions; easily influenced by others.
    • Causes:
      • Uncertainty; some suggest relation to antisocial PD.
    • Treatment:
      • Focus on reducing attention-seeking behavior; improving relationships.

  2. Borderline Personality Disorder

    • Key Features:
      • Instability in relationships, self-image, and mood.
      • Impulsivity leading to self-harm behaviors.
    • Causes:
      • Possible familial genetic link; history of trauma or abuse.
    • Treatment:
      • Dialectical behavior therapy (DBT) is effective; focuses on skills training.

  3. Narcissistic Personality Disorder

    • Key Features:
      • Exaggerated sense of self-importance and entitlement.
      • Lack of empathy; needs constant admiration.
    • Causes:
      • Early parenting experiences may not model empathy.
    • Treatment:
      • Limited research; cognitive therapy focusing on empathy and grandiosity reduction.

  4. Antisocial Personality Disorder

    • Key Features:
      • Disregard for others' rights; deceitful and aggressive behavior.
      • History of conduct disorder before age 15 required for diagnosis.
    • Treatment:
      • Focus on high-risk children; parent training for early behavior recognition.

Cluster C: Anxious or Fearful

  1. Avoidant Personality Disorder

    • Key Features:
      • Social inhibition, feelings of inadequacy, and hypersensitivity.
    • Causes:
      • Low self-esteem and innate characteristics leading to fear of rejection.
    • Treatment:
      • Behavioral interventions like desensitization and rehearsal can yield modest improvements.

  2. Dependent Personality Disorder

    • Key Features:
      • Excessive need for care and difficulties making decisions independently.
    • Causes:
      • Early loss of caretakers causing fear of abandonment.
    • Treatment:
      • Limited research; patients may seem ideal but show submissiveness hindering independence.

  3. Obsessive-Compulsive Personality Disorder

    • Key Features:
      • Preoccupation with order, perfection, and control without obsessions/compulsions.
    • Causes:
      • Potential genetic predisposition and parental reinforcement.
    • Treatment:
      • Focus on addressing underlying fears leading to compulsive behaviors.