Exam 4 Study Guide: Personality Disorders

General Personality Disorder

  • Criterion A:
    • Enduring pattern deviating from cultural expectations.
    • Manifested in two or more areas:
      • Cognition
      • Affectivity
      • Interpersonal function
      • Impulse control
  • Criterion B:
    • Inflexible and pervasive pattern.
  • Criterion C:
    • Leads to distress or impairment.
  • Criterion D:
    • Stable, long duration, onset in adolescence or early adulthood.

Three Clusters of Personality Disorders

  • Cluster A: Odd-Eccentric
    • Similar to schizophrenia but less severe.
    • Includes Paranoid, Schizoid, and Schizotypal.
  • Cluster B: Dramatic-Emotion
    • Manipulative, uncaring, low empathy.
    • Emotional dysregulation.
  • Cluster C: Anxious-Fearful
    • Extreme concern of criticism and abandonment, which leads to impaired relationships

Cluster A Disorders vs. Schizophrenia

FeatureCluster A DisorderSchizophrenia
Contact with RealityMostly intactOften lost
Severity of SymptomsMilder, long-lasting personality traitsMore severe, with psychotic episodes
Hallucinations/DelusionsUsually not presentCommon
FunctioningOften socially isolated but can still functionFunctioning is often seriously impaired during episodes
DurationLong term personality patternMay involve periods of crisis and recovery

Cluster B: Histrionic Personality Disorder

  • Exaggerated, shallow emotionality.
  • Seeks attention, reassurance, and praise.
  • Inappropriately sexual behavior.
  • Extreme focus on appearance.
  • Core beliefs:
    • Self: If I can't entertain people will abandon me
    • Other: If other people don’t respond to me they are rotten

Cluster B: Antisocial Personality Disorder (ASPD)

  • Disregard for and violation of others' rights.
  • Failure to conform to social norms.
  • Deceitfulness, impulsivity, aggressiveness.
  • Lack of remorse.
  • Early History:
    • Moral insanity: “Constitutionally deficient in moral faculties”
  • Learning and Performance Deficits
    • Incapable of profiting from reward/punishment
    • Deficits in acquiring fear response
    • Chronic low levels of arousal

Histrionic Personality Disorder: Cognitive-Behavioral Models

  • Core Beliefs:
    • Self: "If I can’t entertain people will abandon me."
    • Other: "If other people don’t respond to me, they are rotten."
  • Learning History:
    • Selective interpersonal reinforcement leads to attention-seeking.

ASPD: Learning Deficits and Novelty-Seeking

  • Early Learning Environment:
    • Passive/neglectful or overly harsh parenting.
    • Results in learning and performance deficits.
  • Deficits in Acquiring Learning Responses:
    • Incapable of profiting from reward/punishment.
  • Deficits in Acquiring Fear Responses:
    • Slow to develop conditioned responses to fear.
  • Chronic Low Levels of Arousal:
    • Aversive state leads to sensation-seeking.

Healthy vs. Pathological Narcissism

  • Healthy Narcissism:
    • Balanced self-view.
    • Seeks validation moderately.
    • Drives growth and achievement without harming others.
  • Positive Associations:
    • Achievement motivation, self-esteem.
    • Autonomy subtype: creativity, empathy, individualism.
  • Pathological Narcissism:
    • Grandiose: Conceited, domineering, inflated self-image.
  • Grandiose :Externalize negative life events, have little insight into their behavior
    • Vulnerable: Fragile, hypersensitive, prone to narcissistic injury.
    • Emotional states characterized by shame, anxiety, depression, and feelings of inadequacy

Borderline Personality Disorder (BPD)

  • Instability in emotion, cognition, behavior, self, and relationships.
  • Profound fear of abandonment.
  • Early Learning Factors:
    • Maternal/paternal absences, discord, foster care, violence.
    • Invalidating early attachment environment.
  • Genetic Factors:
    • Predisposing traits inherited (anxiety, mood disorders, impulsivity).

BPD: "Good Enough Mothering"

  • Winnicott's concept:
    • Caregiver responds to needs, provides safety, allows emotional expression.
  • Connects to Linehan's view:
    • BPD arises from invalidating environments where feelings are ignored/criticized.

BPD: Genetic Factors

  • Twin Studies:
    • Monozygotic twins: 70% concordance.
    • Dizygotic twins: 35% concordance.
  • Inherited Traits:
    • Anxiety, mood problems, impulsivity, emotional instability.

Cluster C: Anxious-Fearful

  • Avoidant Personality Disorder:
    • Social inhibition, inadequacy, sensitivity to criticism.
  • Dependent Personality Disorder:
    • Helplessness, submissiveness, reassurance-seeking.
  • Obsessive-Compulsive Personality Disorder (OCPD):
    • Preoccupation with orderliness, perfectionism, control.
    • At the expense of flexibility, openness, efficiency