Lecture 6: Personality Disorders Flashcards
personality disorder
enduring, the rigid pattern of inner experience and outward behavior that repeatedly impairs a person’s sense of self, emotional experiences, goals, capacity for empathy and intimacy
comorbidity
if a person suffers from 2 or more disorders
“odd” personality disorders
- paranoid personality disorder
- schizoid personality disorder
- schizotypal personality disorder
paranoid personality disorder
marked by a pattern of distrust and suspiciousness of others
- believe that everyone intends them harm so they avoid close relationships and remain cold and distant
- unable to recognize their own mistakes and are very sensitive to criticism
- often bare grudges and blame others for what goes wrong in their lives
psychodynamic explanation of paranoid personality disorder
people see the environment as hostile as a result of parents’ persistent and unreasonable demands
cognitive-behavioral explanation of paranoid personality disorder
people hold broad maladaptive assumptions (e.g. “people are evil”)
biological explanation of paranoid personality disorder
genetic causes
treatment of paranoid personality disorder
- distrust against therapists; few come to treatment willingly; therapy has limited effects
- object relations therapists: focus on what they view as a deep wish for a satisfying relationship
- cognitive-behavioral therapy
- antipsychotic drug therapy – limited help
schizoid personality disorder
featuring persistent avoidance of social relationships and little expression of emotion
- genuinely prefer to be alone and are generally unaffected by praise or criticism
- viewed as cold, humorless, or dull
psychodynamic explanation of schizoid personality disorder
roots in an unsatisfied need for human contact resulting from parenting
cognitive-behavioral explanation of schizoid personality disorder
suffer from deficiencies in thinking
treatment of schizoid personality disorder
- people with schizoid personality disorder tend to remain emotionally distant from therapists, seem not to care about treatment, and make limited progress at best
- cognitive-behavioral therapy
- group therapy
schizotypal personality disorder
characterized by extreme discomfort in close relationships, very odd patterns of thinking and perceiving, and behavioral eccentricities
- are anxious around others and can feel very lonely
- emotions appear inappropriate, flat, or humorless
- struggle to maintain focus
- conversations are vague and confusing
explanations of schizotypal personality disorder
- often linked to family conflict and psychological disorders
- defects in attention and short-term memory
biological explanation of schizotypal personality disorder
high activity of dopamine, enlarged brain ventricles, smaller temporal lobes and loss of gray matter
treatment of schizotypal personality disorder
- reconnecting with the world and recognizing their limits
- cognitive-behavioral therapy
- antipsychotic drugs
“dramatic” personality disorders
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
antisocial personality disorder
marked by a general pattern of disregard for and violation of other people’s rights
- usually lie repeatedly, careless with money, impulsive, irritable, aggressive, reckless, self-centered, and have trouble maintaining close relationships
- think of their victims as weak and deserving of being harmed
- often arrested and higher rates of substance use disorders
psychodynamic explanation of antisocial personality disorder
beings with the absence of parental love during infancy, leading to a lack of basic trust
cognitive-behavioral explanation of antisocial personality disorder
modeling (imitating antisocial others), operant conditioning, attitudes that trivialize the importance of other people’s needs
biological explanation of antisocial personality disorder
genetics, low activity of serotonin, deficient functioning in brain structures that help people follow rules, respond to warnings with low brain and bodily arousal
treatment of antisocial personality disorder
- typically ineffective due to a lack of: conscience, desire to change, and respect for therapy
- cognitive-behavioral therapy and antipsychotic drugs are sometimes used with little success
borderline personality disorder
characterized by repeated instability in interpersonal relationships, self-image, and mood, and by impulsive behavior
- prone to bouts of anger and feelings of emptiness
- often form intense, conflict-ridden relationships
- think in black-and-white terms and easily feel rejected
- recurrent fears of abandonment and dramatic identity shifts
psychodynamic explanation of borderline personality disorder
early lack of acceptance by parents leads to loss of self-esteem, increased dependence, and inability to cope with separation
biological explanation of borderline personality disorder
genetic, lower brain serotonin activity, abnormal activity in certain structures
sociocultural explanation of borderline personality disorder
likely to emerge in cultures that change rapidly
biosocial explanation of borderline personality disorder
combination of internal forces and external forces
developmental psychopathological explanation of borderline personality disorder
inability to mentalize (=capacity to understand one’s own mental states and those of other people)
treatment of borderline personality disorder
- psychotherapy can lead to some improvement
- relational psychoanalytic therapy
- dialectical behavioral therapy (DBT)
- psychotropic drug treatment
relational psychoanalytic therapy
therapists take a supportive posture, focus primarily on therapist-patient relationship
dialetical behavioral therapy (DBT)
weekly individual therapy and group sessions, special emphasis on efforts at self-harm and suicide
histrionic personality disorder
characterized by a pattern of excessive emotionality and attention seeking
- tend to be vain, self-centered, and demanding
psychodynamic explanation of histrionic personality diosrder
had cold and controlling parents who left them feeling unloved and afraid of abandonment
- to defend themselves against fears of loss, they behave dramatically so that other people would act protectively
cognitive-behavioral explanation of histrionic personality disorder
self-focused and emotional, general assumption that they are helpless to care for themselves
sociocultural explanation of histrionic personality diosrder
produced in part by cultural norms and expectations
- the vain, dramatic behavior of the histrionic personality may be an exaggeration of femininity as our culture once defined it
treatment of histrionic personality disorder
- cognitive-behavioral therapy
- group therapy
- psychodynamic therapy with the aim of helping clients recognize their excessive dependency and become more self-reliant
narcissistic personality disorder
broad pattern of grandiosity, need for admiration, and lack of empathy
- expect constant attention and admiration, have a grandiose sense of self-importance, exaggerate their achievements and talents, appear interested in the feelings of others (rarely) and may take advantage of other people
psychodynamic explanation of narcissistic personality disorder
begins with cold parents, defending against feeling rejected and ashamed by telling themselves they are perfect
cognitive-behavioral explanation of narcissistic personality disorder
people are treated too positively, children acquire superior and grandiose attitudes
sociocultural explanation of narcissistic personality disorder
family values and social ideals in societies
- western cultures encourage self-expression, individualism, and competitiveness, and are likely to produce generations of narcissism
treatment of narcissistic personality disorder
- difficult to treat because clients cannot acknowledge weaknesses or incorporate feedback from others
- psychodynamic therapists aim to help clients recognize and work through their underlying insecurities
- cognitive-behaivoral therapists try to redirect the client’s focus onto the opinion of others and increase their ability to empathize
avoidant personality disorder
characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation
- avoid social contact due to a fear of criticism or rejection
- believe themselves to be inferior to others and seldom take risks
- yearn for intimate relationships but usually have few or no close friends
psychodynamic explanation of avoidant personality disorder
shame comes from childhood experiences such as bladder accidents repeatedly punished by parents, leading to the development of a negative self-image
cognitive-behavioral avoidant personality disorder
harsh criticism and rejection in childhood lead to the assumption that others in the environment will always judge them negatively and failure to develop effective social skills
treatment of avoidant personality disorder
- building trust is important – clients may fear rejection
- psychodynamic therapy
- cognitive-behavioral therapy
- group therapy
- drug therapy (antianxiety, antidepressant)
dependent personality disorder
characterized by a pattern of clinging and obedience, fear of separation and ongoing need to be taken care of
- struggle to make even small decisions for themselves
- difficulty with separation and feel devastated when a close relationship ends, quickly seeking out another relationship to fill the void
- lack confidence in their own ability and seldom disagree with others
psychodynamic explanation of dependent personality disorder
unresolved conflicts during infancy, early parental loss or rejection resulting in fear of abandonment, or overinvolved and overprotective parents resulting in fear of abandonment
cognitive-behavioral explanation of dependent personality disorder
unintentionally rewarded as a child when showing clinging behavior, punishing independence
- dichotomous thinking: “if i am to be dependent, i must be completely helpless” or “if i am to be independent, i must be completely alone”
treatment of dependent personality disorder
- treatment can be helpful
- help clients accept responsibility for themselves
- psychodynamic therapy
- cognitive-behavioral therapy
- group therapy
- antidepressant drug therapy for those who also have depression
obsessive-compulsive personality disorder
marked by such an intense focus on orderliness, perfectionism, and control that the person loses flexibility, oppeness, and efficiency
- set unreasonably high standards for themselves and others
- tend to be rigid in their morals, ethics, and values
Freudian: anal retentive explanation of obsessive-compulsive personality disorder
overly harsh toilet training and becoming fixated
psychodynamic explanation of obsessive-compulsive personality disorder
early struggles with parents over control and independence
cognitive-behavioral explanation of obsessive-compulsive personality disorder
propose that illogical thinking processes help keep it going
treatment of obsessive-compulsive personality disorder
- unlikely to seek treatment because they often do not believe there is anything wrong with them
- psychodynamic therapy – help clients recognize and accept their underlying insecurities and limitations
- cognitive-behavioral therapy
- SSRIs
big five
- neuroticism
- extroversion
- openness
- agreeableness
- conscientiousness
personality disorder – trait specified (PDTS)
those whose traits significantly impair their functioning
five groups of problematic traits
- negative affectivity
- detachment
- antagonism
- disinhibition
- psychoticism
negative affectivity
experience negative emotions frequently and intensively
- emotional lability, anxiousness, separation insecurity, perseveration, submissiveness, hostility, depressivity, suspiciousness, and strong emotional reactions
detachment
withdraw from other people and social interactions
- restricted emotional reactivity, depressivity, suspiciousness, withdrawal, anhedonia, and intimacy avoidance
antagonism
behave in ways that put them at odds with other people
- manipulativeness, deceitfulness, grandiosity, attention seeking, callousness, and hostility
disinhibition
behave impulsively without reflecting on potential future consequences
- irresponsibility, impulsivity, distractibility, risk-taking, and imperfection/disorganization
psychoticism
have unusual and bizarre experiences
- unusual beliefs and experiences, eccentricity, and cognitive and perceptual dysregulation
