Personality Disorders (Week 9 / Chap 13) Flashcards
Categorical versus dimensional
Categorical (DSM)
vs
Dimensional (Five Factor Model)
What is Personality?
Five Factor Model (McCrae & Costa, 2008)
- Personality traits statistically boil down to 5 reliable factors
- No relation to DSM5 personality disorders “categories”
O.C.E.A.N
- Openess
- Conscientuousness
- Extroversion
- Agreeableness
- Neuroticism
Myers‐Briggs Personality Test
▪ Widely used but not by
psychologists
▪ Not supported
▪ Appeal in generic descriptions,
capitalizing on the Barnum Effect
– Viewing vague personality
descriptions as specific to them
(e.g., “Aries, you are going to have a
gangbuster of a day!!)
Persistent pattern of emotions, cognitions, behaviour resulting in
enduring emotional distress for affected person and others
▪ Distress may (or not) be subjective
▪ Causes difficulties with work and relationships
Personality disorder
DSM‐5 divides personality disorders into three groups (clusters)
▪ Cluster A: odd or eccentric
▪ Cluster B: dramatic, emotional, erratic
▪ Cluster C: anxious, fearful
Odd or Eccentric Personality Disorders
Cluster A
▪ Paranoid Personality Disorder
▪ Schizoid Personality Disorder
▪ Schizotypal Personality Disorder
Dramatic, Emotional, Erratic Personality Disorders
Cluster B
▪ Antisocial Personality Disorder
▪ Borderline Personality Disorder
▪ Histrionic Personality Disorder
▪ Narcissistic Personality Disorder
Anxious, Fearful Personality Disorders
Cluster C
▪ Avoidant Personality Disorder
▪ Obsessive‐Compulsive Personality Disorder
▪ Dependent Personality Disorder
▪ Clinical Description
– Suspicious, mistrustful, argumentative, complain, quiet, hostile towards others, suicidal
▪ Causes
– Genetics (Kendler et al., 2015)? Relatives with schizophrenia
– Mistreatment in childhood – be vigilant against those who could cause harm
– Schema of being on guard – vigilance and confirmatory bias
– Cultural: second language, immigration, hearing impairments, prisoners – prone to
interpret ambiguity in a suspicious way, e.g., people laughing must be laughing at you
▪ Treatment
– Rare to see someone present for treatment
– Cognitive therapy to change mistaken assumptions about others
Paranoid Personality Disorder
(difference between this and paranoid ideation is that this is pervasive and more of a schema / modus operandi)
▪ Clinical Description
– Detachment from social relationships, no desire to enjoy closeness with others, cold, aloof
▪ Causes
– Childhood shyness, abuse and neglect, low density dopamine receptors –
aloofness also found in those with schizophrenia
▪ Treatment
– Rare for them to present for treatment
– Social skills training
Schizoid Personality Disorder
▪ Clinical Description
– Social deficits, psychotic‐like symptoms, paranoia, “magical thinking,”
hypersensitive to criticism as children
▪ Causes
– Genetics – lots of overlap with schizophrenia?
– left hemisphere damage – memory and learning deficits in some?
▪ Treatment
– Antipsychotic medication – they are more likely to seek treatment for
depression or anxiety
– CBT, social skills training and social support combined with medication, but
studies are needed
Schizotypal Personality Disorder
Psychotic type symptoms across Cluster A
SLIDE / TEXT
Antisocial Personality DSM-5 Criteria
SLIDE/TEXT
▪ Clinical Description
– Aggressive, lying, cheating, no remorse, substance abuse, unnatural death in boys with this disorder
▪ Causes
– Gene‐environment interaction: kids with convict moms offend in their adopted homes but less so if they spent less time in an interim foster situation
– Underarousal of cortex? U‐shaped distribution, theta in wake
– Defective x chromosome (gets canceled out by the y in girls*)
– Fearlessness: less reactivity to shocks? (inherent underarousal and fearlessness, arousal system dysfunction?)
– They are impervious to reward information – they don’t stop when reward is unlikely
– Coercive parenting: yell at kid and then back down when kid escalates
– Trauma leads to turning‐off emotions
▪ Treatment
– Don’t usually seek treatment
– Parenting training for prevention – rewards prosocial behaviours
Antisocial Personality Disorder
Psychopathic personalities
Antisocial Personality Disorder:
1. Failure to conform to law
2. Deceit/lying
3. Impulsivity
4. Irritable/aggressive
5. Reckless disregard for safety of
others
6. Failure to maintain work or
honor financial obligations
7. Lack of remorse
Psychopathy (Hare, 1970) (Psychopathy Checklist Test)
1. Glibness/superficial charm
2. Grandiose sense of self‐worth
3. Pathological lying
4. Conning/manipulation
5. Callous/lack of empathy
Borderline Personality Disorder DSM-5 CRITERIA
SLIDE/TEXT
▪ Clinical Description
– Turbulent relationships, fear abandonment, self‐mutilating behaviours, no
control over emotions
▪ Causes
– Genetics: higher concordance with monozygotic twins
– Early trauma (76‐91% reporting trauma); 20‐40% have no reported trauma
– Invalidating parental styles “you’re not hungry”
– There is an attentional bias for words like abandonment, emptiness
▪ Treatment
– Antipsychotic and antidepressants, dialectical behaviour therapy (DBT)
Borderline Personality Disorder
▪ Unlike narcissists (who also
need to be the centre of
attention), they want to be
the centre of attention to
fit in.
▪ Unlike narcissists, they and
do not require others to
admire/validate them to
feed their inflated sense of
self
Histrionic Personality Disorder
Clinical Description
– Dramatic, theatrical, self‐centred, seek constant reassurance
– Hugging, excessive emotional displays, vain, impressionistic
▪ Causes
– Overlap with antisocial personality disorder – sexist notion that women are HPD
(wandering uterus) and men are antisocial – both appear as charming and
manipulative to get what they want
▪ Treatment
– Improving problematic interpersonal relationships
Histrionic Personality Disorder
▪ Clinical Description
– Unreasonable sense of self‐importance, grandiosity, no compassion for others,
envious, arrogant
▪ Causes
– Failure of empathic “mirroring” in parents?
– Lots of overlap with psychopathy
▪ Treatment
– They don’t present for treatment, sometimes for depression
or anxiety
– Coping strategies, CBT
Narcissistic Personality Disorder
Narcissistic Personality Disorder: DSM-5
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Avoidant Personality Disorder: DSM-5
SLIDE / TEXT
▪ Clinical Description
– Interpersonally anxious, fear rejection, pessimistic about future
▪ Causes
– Born with difficult temperament, parental rejection, uncritical love
▪ Treatment
– CBT, systematic desensitization
Avoidant Personality Disorder
OCD: DSM-5
SLIDE / TEXT
▪ Clinical Description
– Rigidity, poor interpersonal relationships, quest for perfectionism
▪ Causes
– Genetics
▪ Treatment
– Relaxation techniques, CBT
Obsessive‐Compulsive Personality
Disorder
Dependent Personality Disorder:DSM-5
SLIDE / TEXT
▪ Clinical Description
– Interpersonally dependent, anxious
▪ Causes
– Disruptions in early childhood lead to fears of abandonment
▪ Treatment
– Developing confidence; ensuring patient does not over‐depend on therapist
Dependent Personality Disorder
ive Factor Model and Personality Disorders
SLIDE / TEXT !!!! READ
