Personality Disorders (Week 9 / Chap 13)

Question 1

Categorical versus dimensional

Answer 1

Categorical (DSM)
vs
Dimensional (Five Factor Model)

Question 2

What is Personality?
Five Factor Model (McCrae & Costa, 2008)

Answer 2

• 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

Question 3

Myers‐Briggs Personality Test

Answer 3

▪ 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!!)

Question 4

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

Answer 4

Personality disorder

Question 5

DSM‐5 divides personality disorders into three groups (clusters)

Answer 5

▪ Cluster A: odd or eccentric
▪ Cluster B: dramatic, emotional, erratic
▪ Cluster C: anxious, fearful

Question 6

Odd or Eccentric Personality Disorders

Answer 6

Cluster A

▪ Paranoid Personality Disorder
▪ Schizoid Personality Disorder
▪ Schizotypal Personality Disorder

Question 7

Dramatic, Emotional, Erratic Personality Disorders

Answer 7

Cluster B

▪ Antisocial Personality Disorder
▪ Borderline Personality Disorder
▪ Histrionic Personality Disorder
▪ Narcissistic Personality Disorder

Question 8

Anxious, Fearful Personality Disorders

Answer 8

Cluster C

▪ Avoidant Personality Disorder
▪ Obsessive‐Compulsive Personality Disorder
▪ Dependent Personality Disorder

Question 9

▪ 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

Answer 9

Paranoid Personality Disorder

(difference between this and paranoid ideation is that this is pervasive and more of a schema / modus operandi)

Question 10

▪ 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

Answer 10

Schizoid Personality Disorder

Question 11

▪ 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

Answer 11

Schizotypal Personality Disorder

Question 12

Psychotic type symptoms across Cluster A

Answer 12

SLIDE / TEXT

Question 13

Antisocial Personality DSM-5 Criteria

Answer 13

SLIDE/TEXT

Question 14

▪ 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

Answer 14

Antisocial Personality Disorder

Question 15

Psychopathic personalities

Answer 15

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

Question 16

Borderline Personality Disorder DSM-5 CRITERIA

Answer 16

SLIDE/TEXT

Question 17

▪ 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)

Answer 17

Borderline Personality Disorder

Question 18

▪ 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

Answer 18

Histrionic Personality Disorder

Question 19

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

Answer 19

Histrionic Personality Disorder

Question 20

▪ 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

Answer 20

Narcissistic Personality Disorder

Question 21

Narcissistic Personality Disorder: DSM-5

Answer 21

SLIDE / TEXT

Question 22

Avoidant Personality Disorder: DSM-5

Answer 22

SLIDE / TEXT

Question 23

▪ Clinical Description
– Interpersonally anxious, fear rejection, pessimistic about future
▪ Causes
– Born with difficult temperament, parental rejection, uncritical love
▪ Treatment
– CBT, systematic desensitization

Answer 23

Avoidant Personality Disorder

Question 24

OCD: DSM-5

Answer 24

SLIDE / TEXT

Question 25

▪ Clinical Description
– Rigidity, poor interpersonal relationships, quest for perfectionism
▪ Causes
– Genetics
▪ Treatment
– Relaxation techniques, CBT

Answer 25

Obsessive‐Compulsive Personality
Disorder

Question 26

Dependent Personality Disorder:DSM-5

Answer 26

SLIDE / TEXT

Question 27

▪ 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

Answer 27

Dependent Personality Disorder

Question 28

ive Factor Model and Personality Disorders

Answer 28

SLIDE / TEXT !!!! READ