Chapter 6: Personality disorders Flashcards
At what point are you diagnosed as having a personality disorder?
When your behaviour patterns become so inflexible or maladaptive that they cause personal distress or impair functioning in the social/occupational realms.
what are personality disorders?
Types of abnormal behaviour patterns involving excessively rigid patterns of behaviour or ways of relating to others that ultimately become self-defeating because their rigidity prevents adjustment to external demands
Ego syntonic
behaviour or feelings that are perceived as natural or compatible parts of the self
- someone with a personality disorder
- often don’t seek treatment because they think its just how they are
Ego Dystonic
behaviour or feelings that are perceived to be foreign or alien to one’s self identity
- someone who has experienced a trauma
- high anxiety
Cluster A personality disorders
Characterized by odd or eccentric behaviour
Types fo Cluster A personality disorders
Paranoid Personality
Schizoid personality
Schizotypal personality
Paranoid Personality Disorder
Cluster A (odd/eccentric)
characterized by persistent suspiciousness of the movies of others, but not to the point of holding clear-cut delusions
2.3-4.4%
more men than women
trust issues
anxious
want control
difficulty maintaining/making relationships
Schizoid Personality Disorder
Cluster A
Characterized by a persistent lack of interest in social relationships, flattened affect, and social withdrawal
social isolation is key feature
3.1%
more common in men
men will rarely date/marry; women more likely to date/marry due to social conventions/pressures (but women will be passive in accepting romantic advances and will not initiate relationships or develop strong attachments to their partners
asexual
rarely express emotions, are aloof and distant
But their emotions are not as shallow or blunted as they are in people with schizophrenia
Schizotypal Personality disorder
Cluster A
Characterized by eccentricities or oddities of thought and behaviour but WITHOUT clearly psychotic features
People who have difficulties forming close relationships and whose behaviour, mannerisms, and though patterns are peculiar or odd but not disturbed enough to merit a diagnosis of schizophrenia
slightly more common in males
3%
still want relationships
Cluster B disorders
dramatic, emotional, or erratic behaviour
Types of cluster B disorders
Antisocial personality disorder (and psychopathy)
borderline personality disorder
Histrionic personality disorder
narcissistic personality disorder
Antisocial personality disorder
Cluster B
chronic pattern of antisocial and irresponsible behaviour and lack of remorse
violate the rights of others, break laws
more common in men
prevalence: 1.7-3.7%
can’t be diagnosed until you’re 18 years old (under 19 you are diagnosed with a conduct disorder > violate rules, violence towards animals, bed-wetting)
Psychopathy
Cluster B
related to antisocial personality disorder
affective and interpersonal traits, such as shallow emotions, selfishness, arrogance, superficial charm, deceitfulness, manipulativeness, irresponsibility, sensation seeking, and a lack of empathy, anxiety, and remorse, combined with persistent violations of social norms. A socially deviant and nomadic lifestyle and impulsiveness
many people end up in jail
many businessmen display psychopathy
rates go down as you age, people learn adaptive techniques
only a minority of people with psychopathic personality become psychopaths
Factor 1: more stable
Factor 2: remit over their 40s and 50s
no racial or ethnic differences in rates of disorder
around the world, not culture bound
Psychophysiological and biological factors related to antisocial personality and psychopathy
- lack of emotional responsiveness
- craving for stimulation model
- lack of restraint on impulsivity
- limbic abnormalities (amygdala impacted)
Borderline personality disorder
Cluster B
pervasive pattern of instability in relationships, self image, and mood
lack of control over impulses
uncertain about their values, goals, loyalties, careers, choices of friends, and perhaps sexual orientations
cannot tolerate being aloe and will make desperate efforts to avoid feelings of abandonment
2% of populations
75% more common in women
ex. Hitler “all-ornothing” thinking characteristic of BPD
Histrionic personality disorder
Cluster B
ex. models/actresses
excessive need to be the centre of attention, and to receive reassurance, praise, and approval from others
Overly dramatic and emotional
more commonly diagnosed in women
1.84% prevalence in population
Narcissistic personality disorder
Cluster B
adoption of an inflated self-image, demands constant attention and admiration
one-sided relationships
concerned about success/power
brag about accomplishments and expects others to shower them with praise even if their accomplishments are ordinary
prevalence rate: 0-6.2% of community samples
more common in males
Cluster C
Anxious or fearful behaviour
Cluster C disorders
Avoidant personality
dependent personality disorder
Obsessive compulsive personality disorder
Avoidant personality disorder
Cluster C
avoidance of social relationships due too fears of rejection
loners isolation
unwilling to enter relationships without ardent reassurance or acceptance. As a result tend to have few close relationships outside of family
avoid group occupational or recreational activities
equally common in men and women
2.4% of general population
comorbidity with social phobias
Dependent personality disorder
Cluster C
difficulties making independent decisions and by overly dependent behaviour
excessive need to be taken care of by others
more frequent in women: diagnosis often applied to women who fear abandonment, tolerate husbands who openly cheat on them, abuse them or gamble away family resources
0.6%
Obsessive Compulsive personality disorder
cluster C
rigid ways of communicating with others
perfectionist tendencies
lack of spontaneity
excessive attention to details, need for orderliness
2.1-7.9%
2x more common in men
problems with classification
Undetermined reliability and validity
- gender bias
- just need 6/9
overlap among disorders
difficulty in distinguishing between variations in normal and abnormal behaviour
Psychodynamic perspective : Hans Kohut
Hans Kohut
- self: psychology: describes processes that normally lead to the achievement of a cohesive sense of self or in narcissistic personality a grandiose sense of self
Psychodynamic perspective: Otto Kernberg
splitting
- term used to describe inability of some persons (esp. those with borderline personalities) to reconcile the positive and negative aspects of themselves and others into a cohesive integration, resulting in sudden and radical shifts between strongly positive and strongly negative feelings
Psychodynamic perspective: Margaret Mahler
Symbiotic
- describe state of oneness that normally exists between a mother and infant which the infants identity is fused with the mothers
Separation-individuation
Learning perspectives
tend to focus on acquisition of behaviour than on the notion of enduring personality traits
Use maladaptive behaviour instead of personality traits
Family Perspectives
link a history of physical or sexual abuse or neglect in childhood to the development of personality disorders
Cognitive Behavioural perspectives
problem solving therapy focuses on helping people develop more effective problem solving skills
Biological perspectives
genetic factors
twin studies
neuropsychological factors
- Gray: reinforcement sensitivity theory (RST)
Sociocultural views
low income family, teenage parent family, lone parent family, low parental education, and family dysfunction are associated with vulnerability to one or more behavioural problems in young children
Psychodynamic approaches
become more aware of the root of the self-defeating behaviour pattern and learn more adaptive ways of relating to others
Behavioural approaches
change behaviour rather than personality
biological approaches
drug therapy does not work
Treatment: Canadian Treatment services
- psychotherapy should focus on reducing the extremeness of traits and bring them into client awareness
- given historical perspectives so that the patient can see how their behaviour is shaped by the past
- involves changes
