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.