Exam 4: Personality Disorders Flashcards
what is personality?
set of unique characteristics that influence our behaviors, emotions, thoughts, and interactions
-enduring characteristics - called traits - lead us to react in predictable ways
traits
hypothetical constructs used to explain individual differences in response to a given situation and individual consistency across different situations
what is a personality disorder?
-enduring, rigid, or extreme patterns of inner experience and outward behavior that impair sense of self, emotional experience, goals and capacity for empathy or intimacy
when does a personality disorder typically become recognizable?
in adolescence or early adulthood
-these are among the most difficult psychological disorders to treat
what percentage of adults may have a personality disorder?
9-13% of adults
The DSM-5 identifies 10 personality disorders separated into 3 groups or clusters. What are these 3 groups?
- odd or eccentric behavior
- dramatic, emotional, or erratic behavior
- anxious or fearful behavior
odd or eccentric behavior
- paranoid
- schizoid
- schizotypal
dramatic, emotional, or erratic behavior
- antisocial
- borderline
- narcissistic
- histrionic
anxious or fearful behavior
- avoidant
- dependent
- obsessive-compulsive
the classifying of personality disorders uses what approach?
categorical approach
classifying personality disorders
- the symptoms of personality disorders overlap each other so much that it can be difficult to distinguish from one another
- individuals may have more than one personality disorder
- some theorists believe that personality disorders differ more in DEGREE than in type of dysfunction - called a DIMENSIONAL approach
dimensional approach
some theorists believe that personality disorders differ more in degree than in type of dysfunction
Odd personality disorders
- paranoid, schizoid, and schizotypal personality disorders
- people w/ these disorders display behaviors similar to, but not as extensive as, schizophrenia
- behaviors include extreme suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving, which leave the person isolated
- some clients believe that these disorders are actually related to schizophrenia and thus call them schizophrenia-spectrum disorders
- people w/ these disorders rarely seek treatment
what is another name for odd personality disorders?
schizophrenia-spectrum disorders
paranoid personality disorder
- characterized by deep distrust/suspicion of others
- inaccurate but not delusional
- people often remain cold and distant
- unable to recognize their own mistakes and are extremely sensitive to criticism
- they often blame others for the things that go wrong in their lives and repeatedly bear grudges
treatments for paranoid personality disorder
- few people come to treatment willingly
- those in treatment often distrust and rebel against their therapists
- behavioral/cognitive therapists try to help clients control anxiety and improve interpersonal skills
- cognitive therapists also try to restructure clients maladaptive assumptions and interpretations
schizoid personality disorder
- characterized by persistent avoidance of social relationships and limited emotional expression
- do not have close ties w/ other people/ genuinely prefer to be alone
- often seen as flat, cold, humorless, or dull
- thoughts tend to be vague and empty
treatments for schizoid personality disorder
- social withdrawal prevents most from entering therapy; they seem to not care about treatment & make limited progress at best
- cognitive-behavioral therapists try to help people experience more + emotions & more satisfying social interactions
- cognitive end focuses on thinking about emotions
- behavioral end focuses on the teaching of social skills (individually or in group therapy)
schizotypal personality disorder
- range of interpersonal problems, extreme discomfort in close relationships, odd (even bizarre) ways of thinking, and behavioral eccentricities
- difficulty keeping attention focused; conversation typically digressive & vague, even sprinkled w/ loose associations
- tend to drift aimlessly and lead unproductive lives, choosing undemanding jobs in which they are not required to interact w/ other people
how do theorists explain schizotypal personality disorder?
- causal factors in schizotypal personality disorder may be similar to those involved in schizophrenia
- for example, researchers have begun to link schizotypal personality disorder to high dopamine activity
treatments for schizotypal personality disorder
- cognitive-behavioral therapists try to teach clients to objectively evaluate their thoughts and perceptions and provide social skills training
- antipsychotic drugs may be somewhat helpful in reducing certain thought problems
Dramatic personality disorders
- antisocial, borderline, histrionic, and narcissistic personality disorders
- the behaviors are so emotional or erratic that it is almost impossible for them to have satisfying relationships
- these personality disorder s are more commonly diagnosed than the others
- only antisocial and borderline personality disorders have received much study
- causes of these disorders are not well understood
how common are dramatic personality disorders?
- these are more diagnosed than others
- only antisocial and borderline personality disorders have received much study
antisocial personality disorder
- previously referred to as psychopaths/sociopaths
- persistent disregard for rules and other persons rights
- personality disorder most linked to adult criminal behavior
- people w/ this disorder are likely to lie repeatedly, be reckless, and impulsive
- have little regard for other individuals, and can be cruel, sadistic, aggressive, and violent
- 4 times more common in men than women
what is the ratio of antisocial personality disorder for men & women
4x more common in men than women
how do theorists explain antisocial personality disorder?
- behaviorists argue that antisocial symptoms are learned through modeling or reinforcement
- a # of studies suggest biological factors: lower levels of serotonin, impacting impulsivity & aggression
- deficient functioning in frontal lobes of brain
- lower levels of anxiety/arousal, leading them to be more likely than others to take risks and seek thrills
treatments for antisocial personality disorder
- treatments typically not effective
- major obstacle is the individuals lack of desire to change
- most have been forced into treatment
- some cognitive therapists try to guide clients to think about moral issues and the needs of others
- atypical antipsychotic drugs have been tried but w/ little evidence of efficacy
borderline personality disorder
- immense emotional and behavioral instability
- behaviors can include alcohol/substance abuse, reckless behavior (including driving and unsafe sex), self-injurious or self-mutilation behavior, suicidal threats/actions
- frequently form intense conflict-ridden relationships
- women w/ BPD are 3 times more likely than men
how do theorists explain borderline personality disorder?
- object-relations theorists propose a lack of early acceptance or abuse/neglect by parents
- research has found some support for this view, including a link to early sexual abuse
- some features of BPD have also been linked to biological abnormalities such as an overly reactive amygdala and an underactive prefrontal cortex
- close relatives of those w/ BPD are 5x more likely than the general population to have the disorder
treatments for Borderline personality disorder
- an integrative treatment called dialectical behavioral therapy (DBT) has received strong research support
- based largely on cognitive-behavioral treatment but borrows from humanistic & mindfulness approaches
- DBT is often supplemented by the clients participation in social skill-building groups
- various meds (for anxiety, depression, psychotic symptoms) have helped w/ BPD to achieve greater calm
Histrionic personality disorder
- extremely emotional and continually seek to be the center of attention
- often engage in attention-getting behaviors and are always on stage
- often described as vain, self-centered, demanding
- their behaviors to gain attention can be dramatic and self-destructive (as in suicidal threats)
how do theorists explain histrionic personality disorder?
- psychodynamic theorists propose that to defend against deep-seated fears of loss, individuals learn to behave dramatically, inventing crises that require people to act protectively
- behaviorists similarly argue that histrionic behaviors are acquired through modeling and reinforcement
- cognitive theorists propose faulty learning of expectations (fearing inability to care for oneself and hence desperately seeking attention from others)
treatments for histrionic personality disorder
- compared to other disorders, persons w/ histrionic personality disorder are more likely to seek treatment on their own
- cognitive therapists try to help them develop better, more deliberate ways of thinking and solving problems
- psychodynamic therapy and group therapy try to help clients deal w/ their dependency
- drug therapy is less successful, except to relieve the depression experienced by some patients
narcissistic personality disorder
- grandiose, need much admiration, feel no empathy w/ others
- exaggerate achievements & talents, seem arrogant
- seldom interested in feelings of others
- many take advantage of others to achieve their own ends
- symptoms overlap w/ antisocial personality disorder
treatments for narcissistic personality disorder
- one of the most difficult personality patterns to treat
- individuals w/ narcissism are unlikely to pursue treatment on their own
- none of the major treatment approaches have had much success
anxious personality disorders
- avoidant, dependent, obsessive-compulsive personality disorders
- display anxious and fearful behavior
- many of the symptoms are similar to those of anxiety and depressive disorders
- research is limited: but treatments for this cluster appear to be moderately helpful and better than for other personality disorders
avoidant personality disorder
- intensely uncomfortable in social situations, overwhelmed by feelings of inadequacy, extremely sensitive to negative evaluation
- similar to social anxiety disorder; many people w/ one disorder experience the other
- similarities between the 2 disorders include a fear of humiliation and low self-confidence
- a key difference: people w/ social anxiety disorder mainly fear social circumstances, whereas people w/ avoidant personality disorder tend to fear close social relationships
how do theorists explain avoidant personality disorder?
-theorists often assume that avoidant personality disorder has the same causes as anxiety disorders, including:
- early trauma
- conditioned fears
- upsetting beliefs
- biochemical abnormalities
treatments for avoidant personality disorder
- therapists tend to treat the disorder as they treat social phobia/anxiety
- group therapy formats, especially cognitive-behavioral groups, help by providing practice in social interactions (these treatments have had modest success)
- anti-anxiety and anti-depressant drugs are also sometimes useful
dependent personality disorder
- persons have a pervasive, excessive need to be taken care of; they are clingy, obedient, fearing separation from their care provider
- rely on others so much that they cannot make the smallest decision for themselves
- they are at risk for depression (including suicidal thoughts), anxiety, and eating disorders
how do theorists explain dependent personality disorder?
- object-relations theorists propose that early parental loss or rejection leads to lingering fears of abandonment
- other theorists argue that parents were overinvolved & overprotective, increasing their childrens dependency
- behaviorists emphasize failure to learn independent coping skills, and reinforcement of dependent behaviors
treatments for dependent personality disorder
- psychodynamic therapy focuses on many of the same issues as therapy for people w/ depression
- cognitive-behavioral therapists try to help clients challenge and change their assumptions of helplessness and provide assertiveness training
- antidepressant drug therapy has ben helpful for those whose disorder is accompanied by depression
obsessive-compulsive personality disorder
- people w/ obsessive-compulsive personality disorder (OCD) are so preoccupied w/ order, perfection and control that they lose all flexibility, openness, and efficiency
- compulsiveness: preoccupation w/ order and control
- obsessiveness: rumination, inability to reach decisions
- obsessive-compulsive personality disorder and obsessive-compulsive disorder (the anxiety disorder) may be closely related
how do we explain & treat obsessive-compulsive personality disorder?
- most explanations of obsessive-compulsive personality disorder borrow heavily from those of obsessive-compulsive (anxiety) disorder
- cognitive-behavioral treatments focus on challenging irrational fears
- behavioral treatments emphasize exposure and response prevention (ERP)
- some evidence indicates efficacy of SSRIs (selective serotonin reuptake inhibitors)
additional considerations
- gender & other cultural differences may be important in the development and diagnosis of some personality disorder
- e.g. histrionic, borderline, & antisocial personality disorders
- the DSM-5 proposes 5 underlying dimensions to personality disorders:
- negative affectivity, detachment, antagonism, disinhibition, and psychoticism
