Personality Disorders PSYCH 3830
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This 5 page Class Notes was uploaded by Margaret Bloder on Wednesday March 30, 2016. The Class Notes belongs to PSYCH 3830 at Clemson University taught by Pam Alley in Winter 2016. Since its upload, it has received 8 views. For similar materials see Abnormal Psychology in Psychlogy at Clemson University.
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Date Created: 03/30/16
Personality Disorders (first added in the DSM-3) A person’s personality is their pattern of characteristic traits, coping styles, and ways of interacting with the social environment. A Personality Disorder is an enduring pattern of traits, coping styles, and ways of interacting that is so inflexible and maladaptive that the individual’s ability to function adaptively and in compliance with society’s norms is significantly impaired. General Diagnostic Criteria for a Personality Disorder An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in 2 (or more) of the following areas: o Cognition o Affectivity (how one experiences/expresses their emotions) o Interpersonal functioning o Impulse control The enduring pattern is inflexible and pervasive across a broad range of personal and social situations The enduring pattern leads to clinically significant distress or impairment in functioning The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood (relatively early onset) Personality Disorders: Cluster A People with these disorders often seem odd or eccentric with unusual behavior ranging from distrust and suspiciousness to social detachment Schizotypal: o Odd thought patterns, odd perceptual processes, most strongly related to schizophrenia, dually coded o More common in males Schizoid: o Very impaired social relationships, don’t form attachments, no interest in establishing relationships, “loner” o More common in males Paranoid: o Suspicious, mistrusting, blameless, always on guard, difficult to get along with o More common in males Diagnostic Criteria for Paranoid Personality Disorder A pervasive pattern of behavior which begins by early adulthood and is present in a variety of contexts, as indicated by 4 (or more) of the following: o Suspects that others are exploiting, harming, or deceiving him or her o Is preoccupied with unjustified doubts about the trustworthiness of others o Is reluctant to confide in others because of unwarranted fears o Reads hidden demeaning or threatening meanings into benign remarks or events o Persistently bears grudges o Perceives attacks on his or her character and is quick to react angrily o Has recurrent suspicions regarding fidelity of significant other Personality Disorders: Cluster B Individuals with these disorders share a tendency to be dramatic, emotional, and erratic Histrionic (used to be called hysterical): o Very dramatic, very entitled, overly concerned with their appearance, irritable if they aren’t getting enough attention o Equal in males and females Antisocial: o Lacks moral compass, violates social norms, often times they lie, tend to manipulate, feel entitled o Have a history of conduct problems as a child o Dually coded in the DSM-5 o More common in males Borderline: o Very impulsive, inappropriately angry, drastic mood shifts, easily bored, more likely to self-mutilate (cut themselves, commit suicide) o More common in females Narcissistic: o Grandiosity (think they are the most important and their needs should be met), very preoccupied with getting attention, not empathetic o Relatively rare o More common in males Diagnostic Criteria for Narcissistic Personality Disorder A pervasive pattern of behavior which begins by early adulthood and is present in a variety of contexts, as indicated by 5 (or more) of the following: o Has a grandiose sense of self-importance o Is preoccupied with fantasies of unlimited success, power, or beauty o Believes that he or she is “special” and can only be understood by other high-status people o Requires excessive admiration o Has a sense of entitlement o Is interpersonally exploitative o Lacks empathy o Is often envious of others or believes that others are envious of him or her o Shows arrogant, haughty behaviors or attitudes Personality Disorders: Cluster C Individuals with these disorders demonstrate anxiety and fearfulness Avoidant: o Super shy, very sensitive to being rejected, very insecure in establishing relationships o Equal in males and females Dependent: o Extreme difficulty separating relationships, subordinate their needs to the other person, tend to be indecisive, want someone by their side o Example: in an abusive relationship, need to get out of it, but can’t o Equal in males and females Obsessive-Compulsive: o Very concerned about following rules, pay attention to details, perfectionistic, difficulty relaxing or having fun o Different from obsessive-compulsive disorder o More common in males Diagnostic Criteria for Obsessive-Compulsive Personality Disorder A pervasive pattern of behavior which begins by early adulthood and is present in a variety of contexts, as indicated by 4 (or more) of the following: o Is preoccupied with details, rules, lists, or order o Shows perfectionism that interferes with task completion o Is excessively devoted to work to the exclusion of leisure activities o Is over conscientious and inflexible about matters of morality o Is unable to discard worthless objects o Is reluctant to delegate tasks or work with others o Adopts a miserly spending style toward both self and others o Shows rigidity and stubbornness Differential Diagnosis A. Personality Disorder vs. Clinical Disorder In a personality disorder, symptoms appear in adolescence or early adulthood and behavior is long-lasting, stable, doesn’t come & go B. Distinguishing between the 10 personality disorders Hard to distinguish Often times diagnosed with more than one (high comorbidity) “Unspecified personality disorder”: meets general diagnostic criteria, but doesn’t meet specific criteria within a cluster C. Personality Disorder vs. Personality Trait A personality disorder meets the general and specific criteria and is long term. A personality trait waxes and wanes (comes and goes) Course and Treatment Relatively stable over time o More likely to remit with age/time: Borderline and antisocial personality disorder o Least likely to remit with age: Obsessive-compulsive and schizotypal personality disorder Medication not so much used (doesn’t seem to help) Cluster C seems to be more responsive to treatment than Cluster A (most resistant to treatment) Typically do not seek out counseling because they don’t think anything is wrong with them Research shows that avoidant personality disorder might be responsive to cognitive behavioral therapy Borderline personality disorder has received the most attention because they are most likely to harm themself. Models for Personality Disorders 1. Categorical Model (was first added in the DSM-III): The categorical model considers each of the personality disorders to be qualitatively different syndromes. Though the personality disorders are clustered based on similarities in features, each disorder maintains a set of criteria and symptoms that are not the same as any of the others. Each white box represents one of the ten personality disorders, which are grouped into Clusters A, B, and C. 2. Dimensional Model: The dimensional model uses a continuum to describe a personality trait. Each continuum possesses a positive, resilient expression of the trait on one end, and a negative, maladaptive expression of the trait on the other end. There are many different personality traits, and thus, many different continuums. Every person falls somewhere on each continuum. (Ex: emotional stability: positive trait expression would be emotionally stable and negative trait expression would be not emotionally stable [anxious depressed]) 3. Alternative Hybrid Model (in the appendix of DSM-5, might be in DSM-6): The alternative hybrid model combines elements from both the categorical model and the dimensional model. This model identifies only six personality disorders, which are represented below by the white boxes. The continuums insides the boxes represent the specific personality traits, which are pathologically expressed in each personality disorder. Only 6 personality disorders, not 10 2 specific criteria: 1) The degree of dysfunction (mild, moderate, etc.) 2) Individual falls along a continuum
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