Personality disorder Flashcards
Criteria for personality disorder diagnosis
An enduring disturbance characterized by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., ability to develop and maintain close and mutually satisfying relationships, ability to understand others’ perspectives and to manage conflict in relationships).
The disturbance has persisted over an extended period of time (e.g., lasting 2 years or more).
The disturbance is manifest in patterns of cognition, emotional experience, emotional expression, and behaviour that are maladaptive (e.g., inflexible or poorly regulated).
The disturbance is manifest across a range of personal and social situations (i.e., is not limited to specific relationships or social roles), though it may be consistently evoked by particular types of circumstances and not others.
The symptoms are not due to the direct effects of a medication or substance, including withdrawal effects, and are not better accounted for by another mental disorder, a Disease of the Nervous System, or another medical condition.
The disturbance is associated with substantial distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.
when should personality disorder not be diagnosed
if the patterns of behaviour characterizing the personality disturbance are developmentally appropriate (e.g., problems related to establishing an independent self-identity during adolescence) or can be explained primarily by social or cultural factors, including socio-political conflict.
severe personality disorder characteristics
All general diagnostic requirements for Personality Disorder are met. There are severe disturbances in functioning of the self (e.g., sense of self may be so unstable that individuals report not having a sense of who they are or so rigid that they refuse to participate in any but an extremely narrow range of situations; self view may be characterised by self-contempt or be grandiose or highly eccentric). Problems in interpersonal functioning seriously affect virtually all relationships and the ability and willingness to perform expected social and occupational roles is absent or severely compromised. Specific manifestations of personality disturbance are severe and affect most, if not all, areas of personality functioning. Severe Personality Disorder is often associated with harm to self or others, and is associated with severe impairment in all or nearly all areas of life, including personal, family, social, educational, occupational, and other important areas of functioning.
Negative affectivity
low self-esteem, low self-confidence, a tendency to the strong experience of negative emotions—an empirically interesting and well-validated feature that is even, as you may remember from before, an inheritor of something seen in infants.
Detachment
a tendency towards social and emotional detachment from others in a rigid way. This is similar to what has been called schizoid character in previous classifications.
Dissociality
this is an enduring clinical phenomenon related to harmful behaviour towards others and often a lack of empathy related to it
Disinhibition
a tendency towards impulsiveness and recklessness.
Anankastia
a tendency towards rigid insistence on order, cleanliness, abiding by rules to their letter—which has long been seen as an area of clinical interest. This is an inheritor of what was part of obsessive-compulsive personality disorder and what was called in early psychoanalytic work the anal-retentive character.
The Borderline pattern
the most clinically useful, and something to consider in detail.
Cluster A disorders were characterised by severe problems of basic interpersonal trust.
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Paranoid Personality Disorder
related to a severe tendency to see malign motives in others.
Schizoid Personality Disorder
related to gross social and emotional detachment.
Schizotypal Personality Disorder
related to the use of a vivid fantasy life and the development of a highly odd manner likely as a hangover from significant disturbance in early relationships.
Cluster B disorders
were characterised by problems of impulse control and emotion regulation.
borderline personality disorder
histrionic personality disorder
narcissistic personality disorder
antisocial personality disorder
Borderline Personality Disorder
characteristically involved the loss of an ability to manage emotions in situations where one felt one would be abandoned by an important person, with that feeling of being abandoned being very easily aroused. This would be associated with suicidal behaviour to manage such emotions in many cases, as well as a gross instability of one’s identity.
Narcissistic Personality Disorder
related to someone being extremely self-important and selfish in their interactions as a way of covering over extremely deficient self-esteem.
Histrionic Personality Disorder
related to the dramatic yet shallow show of emotion, as well as the use of interpersonal seductiveness, to manage a disturbance of identity.
Antisocial Personality Disorder
characteristically involves repeated violent or criminal behaviour with most likely at least some impairment of ordinary remorsefulness.
cluster c disorders
Cluster C disorders were essentially characterised by the abnormal management of anxiety.
obsessive avoidant and depressant anxiety disorder
Obsessive-Compulsive Personality Disorder
that problem of over-rigidity and reliance on management of one’s environment and order in relationships and routine to prevent overwhelming anxiety.
Avoidant Personality Disorder
involved an ingrained tendency to manage anxiety simply by gross avoidance of anxiety-provoking situations, usually leading to a piling-up of problems.
Dependent Personality Disorder
involved avoiding anxiety by delegating any major responsibility for oneself or one’s decisions to someone else or to others in general.
Dissociality trait
Self-centeredness. Self-centeredness in individuals high on Dissociality is manifested in a sense of entitlement, believing and acting as if they deserve—without further justification—whatever they want, preferentially above what others may want or need, and that this ‘fact’ should be obvious to others. Self-centeredness can be manifested both actively/intentionally and passively/unintentionally. Active—and usually intentional—manifestations of self-centeredness include expectation of others’ admiration, attention-seeking behaviours to ensure being the center of others’ focus, and negative behaviours (e.g., anger, ‘temper tantrums,’ denigrating others) when the admiration and attention that the individual expects are not granted. Typically, such individuals believe that they have many admirable qualities, that their accomplishments are outstanding, that they have or will achieve greatness, and that others should admire them. Passive and unintentional manifestations of self-centeredness reflect a kind of obliviousness that other individuals matter as much as oneself. In this aspect of Dissociality, the individuals’ concern is with their own needs, desires, and comfort, and those of others simply are not considered.
Lack of empathy. Lack of empathy is manifested as indifference to whether one’s actions inconvenience others or hurt them in any way (e.g., emotionally, socially, financially, physically, etc.). As a result, individuals high on Dissociality are often deceptive and manipulative, exploiting people and situations to get what they want and think they deserve. This may include being mean and physically aggressive. In the extreme, this aspect of Dissociality can be manifested as callousness with regard to others’ suffering, and ruthlessness in obtaining one’s goals, such that these individuals may be physically violent with little to no provocation and may even take pleasure in inflicting pain and harm. Note that this aspect of Dissociality does not necessarily imply that individuals high on Dissociality do not cognitively understand the feelings of others, only that they are not concerned about them and instead are likely to use this understanding to exploit others.
