Study Notes on Personality Disorders: BPD, Histrionic & Narcissistic

Overview of Personality Disorders

  • This section discusses four main personality disorders: Borderline Personality Disorder (BPD), Histrionic Personality Disorder, Narcissistic Personality Disorder, and Antisocial Personality Disorder (previously discussed).

Borderline Personality Disorder (BPD)

  • Diagnosis: More commonly diagnosed in females (approx. 5.9% of the population).
  • Characteristics:
    • Intense emotional responses and difficulties in emotional regulation.
    • Instability in self-image and relationships.
    • Hyper-sensitivity to perceived abandonment.
  • Predecessors/Vulnerabilities:
    • History of abuse or abandonment.
    • Difficulties developing a secure sense of identity.
  • Emotional Behavior:
    • Emotional dependency on others; may engage in behaviors such as clinging when sensing withdrawal from others.
  • Impulsivity and Self-Destructive Behavior:
    • High incidence of self-destructive behaviors, with 75% of individuals attempting suicide.
    • Risky behaviors, including dangerous recreational activities.
  • Cultural References:
    • Mention of the film Girl Interrupted, highlighting a character representing BPD.
    • Discussion of Fatal Attraction, depicting extreme emotional responses associated with BPD.
  • Theoretical Perspectives:
    • Link to serotonin deficiencies and emotional memory storage in the brain (specifically the amygdala).
    • Object relations theory emphasizes poor early relationships and inadequate attachment leading to unstable self-image and relationship issues.
  • Treatment:
    • Dialectical Behavior Therapy (DBT), which aims to develop self-identity and emotional regulation skills.
    • Mood stabilizers may have mixed results.

Histrionic Personality Disorder

  • Diagnosis: More commonly diagnosed in females (approx. 1.84% of the population).
  • Characteristics:
    • Dramatic attention-seeking behavior and emotional instability.
    • May dress or act provocatively to draw attention, not necessarily for overt recognition.
  • Theoretical Perspectives:
    • Objectification leading to defining self-worth based on physical appearance emphasized during upbringing.
    • Discussion of cognitive treatment focusing on overcoming faulty self-perceptions and developing autonomous functioning.

Narcissistic Personality Disorder

  • Diagnosis: More commonly diagnosed in males.
  • Characteristics:
    • Exhibits grandiosity and an inflated sense of self-importance.
    • Tendency to ignore the needs of others and exploit individuals for personal gain.
    • Distinction between explicit self-esteem (how they present themselves) and implicit self-esteem (true self-evaluation).
    • Need for admiration illustrates the contradiction in self-view and dependency.
  • Theoretical Perspectives:
    • Link to Narcissus in mythology, serving as symbolic representation of the disorder.

Considerations Across Personality Disorders

  • Shared Elements: These disorders exhibit themes of emotional dysregulation, self-identity instability, and patterns of behavior that lead to difficulty in interpersonal relationships.
  • Importance of Early Relationships: Secure attachments in early childhood are crucial for healthy development; conversely, lack thereof enhances the risk of developing these disorders.
  • Suicide Risk: Particularly high among individuals with BPD, leading to an emphasis on treatment approaches that offer stability and support.

Closing Discussion

  • Explore possible overlaps with other mental health issues (e.g., depression, anxiety) and their role in exacerbating personality disorder symptoms.
  • Importance of intervention and treatment to enhance functioning and autonomy for individuals diagnosed with these personality disorders.