Personality Disorders and cluster A

Question 1

What is Personality

Answer 1

An individuals unique way of perceiving, experiencing, and interacting with the world around them AND the underlying internal causes of these actions

Question 2

What sets personality apart from regular old behavior?

Answer 2

1. A unique part of the individual
   2. Characteristics are stable over time
   3. A pattern of behaviors
   4. An explanation for behavior

Question 3

What is a personality disorder?

Answer 3

Personality disorders are characterized by:

	- Inflexible patterns of behavior and inner experience
	- Evident in most of the person's interactions
	- Differs from social and cultural expectations of appropriate behavior
	- Duration of years

Question 4

Can a personality really be disordered?

Answer 4

Personality disorders are diagnosed ONLY when they cause impairments in social or occupational functioning, or personal distress

• PDs typically become recognizable in adolescence or early adulthood
• **Often, the affected person does not regard his or her behavior as undesirable or problematic

Question 5

Personality Disorders

Answer 5

• Person is NOT diagnosed with a PD if they qualify for another diagnosis that better explains their symptoms
• However, people CAN be diagnosed with both a personality and another disorder
  - Referred to as “comorbidity”
• Other psychological disorders are common in PD sufferers

Question 6

Understanding Comorbidity

Answer 6

History of behavior very important in making correct diagnoses
-Ex: person with a long history of chaotic relationships (personality) has been depressed for 6 months (mood disorder)

• Presence of a PD makes treatment of another disorder more difficult, recovery less likely
• Relationship between personality and other disorders is unclear: one may make the other more likely to develop, or there may be a single factor influencing both

Question 7

The General Criteria for a Personality Disorder

Answer 7

A. Enduring pattern of inner experience and behavior appearing in at least 2 of these areas:
-Cognition (thoughts about self, others, the world)
-Affectivity (intensity, stability, appropriateness of emotions)
-Interpersonal functioning
-Impulse control
B. Pattern is inflexible and appears across a broad range of personal and social situations
C. Pattern causes clinically significant distress of impairment
D. Pattern has been stable since adolescence or early adulthood
E. Pattern is not better accounted for by another mental disorder
F. Pattern is not due to a substance or medical condition

Question 8

• Clusters: How we group the PDs

Answer 8

o A general way of putting PDs with similar symptoms together
 Cluster A: people who exhibit “odd” behaviors
• Paranoid, schizoid, schizotypal PDs
 Cluster B: People who seem dramatic, emotional, or erratic
• Antisocial, histrionic, narcissistic, borderline PDs
 Cluster C: People who seem anxious or fearful
• Avoidant, dependent, obsessive-compulsive PDs

Question 9

-Problems with the DSM PD Categories

Answer 9

o Some criteria cannot be observed directly and rely on clinician impressions
-Different opinions of the line between normal and disordered personalities
o Similarities of disorders within clusters can make classifications difficult
o Diagnoses are based on number of criteria, not a single or shared feature
- People with different personalities can receive the same diagnosis

Question 10

-Can we do better?

Answer 10

• They propose that we should think about PDs in terms of severity of particular traits rather than their presence or absence
  - Called the dimensional approach
• “Big 5”: theory that personality can be described by 5 traits: Openness (to experience), conscientiousness, extraversion, agreeableness, and neuroticism

Question 11

-Cluster A: “The odd cluster”

Answer 11

• The “Odd” personality disorders
  - People w/ these disorders show behaviors that are similar, but not as extreme, as those found in schizophrenia
  • Such as: extreme suspiciousness, social withdrawal, strange ways of thinking or perceiving
  • Person becomes isolated because of behaviors
  • Some clinicians, believe these disorders are related to schizophrenia

Question 12

Paranoid personality disorder (cluster A)

Answer 12

• Pervasive tendency to interpret actions of others as deliberately harmful, demeaning, or threatening
• Psychotic Features NOT present
  - No hallucinations = or bizarre delusions
  - Instead: Tendency toward suspiciousness, mistrust
• More likely in male

Question 13

• How do theorists explain paranoid PD?

Answer 13

• Psychodynamic: early interactions with demanding parents are to blame
• Cognitive: maladaptive assumptions such as “people are evil and will exploit you if given a chance”
• Biological: genetic causes (supported by twin studies)

Question 14

• Therapies for paranoid PD

Answer 14

• Object relations therapy: see beyond client’s anger, work on expressing underlying wishes for a satisfying relationship
• Behavioral and cognitive therapists: help client control anxiety and improve social skills
  - Cognitive therapists try to change client’s paranoid assumptions about others and the world
• Drug therapy provides only limited help

Question 15

-Schizoid Personality Disorder

Answer 15

• Extremely aloof nature, avoidance of interpersonal relationships
  • Tend to be loners with few or no friends
  • Don’t enjoy or desire relationships others
  • Little or no sexual contact or interest
  • Restricted range of emotional experiences

Question 16

• How do theorists explain schizoid personality disorder

Answer 16

• Psychodynamic theorists link schizoid personality disorder to an unsatisfied need for human contact
  
  • The parents of those with the disorder are believed to have been unaccepting or abusive of their children
• Cognitive theorists propose that people with schizoid personality disorder suffer from deficiencies in their thinking
  
  • Thoughts tend to be vague and empty
  • Trouble scanning the environment for cues

Question 17

-Therapy for schizoid personality disorder

Answer 17

• Extreme social withdrawal prevents most people with this disorder from entering therapy unless some other disorder makes treatment necessary
• Cognitive therapists are sometimes able to help people with this disorder experience more positive emotions and more satisfying social interactions
• Behavioral therapists have had some success in teaching social skills
• Group therapy useful when it offers a safe environment for social contact

Question 18

-Schizotypal Personality Disorder

Answer 18

• Odd patterns in thoughts, appearance, and behavior
• Great difficulty in interpersonal relationships due to severe anxiety
  -Conversation vague due to limited attention
  -Unusual beliefs such as magical thinking, superstitiousness, ideas of reference
  • Not severe enough to be called schizophrenia
  • May be a less severe form of schizophrenia

Question 19

-How do theorists explain schizotypal disorder?

Answer 19

• Similarity between symptoms of schizotypal personality disorder and schizophrenia has led researchers to hypothesize that similar facts are at work in both disorders
o Schizotypal symptoms are often linked to poor family communication and to psychological disorders in parents
o Researchers have also begun to link schizotypal personality disorder to some of the same biological factors found in schizophrenia
• Has also been linked to mood disorders

Question 20

• Therapy for schizotypal personality disorder

Answer 20

• Most Therapists agree on the need to help clients “reconnect” and recognize the limitations of their thinking and powers
o Cognitive therapists further try to teach clients to objectively evaluate their thoughts and perceptions
• Antipsychotic drugs appear to be helpful in reducing certain thought problems