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Personality Disorders

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Autumn Dickens

on 14 March 2013

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Transcript of Personality Disorders

Treatments Personality Disorders What are Personality Disorders? Avoidant Personality Disorder:

Individuals that suffer from this disorder show extreme social inhibition and introversion, leading to lifelong patterns of limited social relationships and reluctance to enter into social interactions.
This differs from Schizoid Personality Disorder in that individuals with Avoidant Personality Disorder do not enjoy their alone time.

Causal Factors:
Childhood emotional abuse, rejection, or humiliation from unaffectionate parents

Example: The Avoidant Librarian, Sally Abnormal Psychology
pRESENTATION Cluster B Disorders
Paranoid Personality Disorder:
Extremely suspicious and distrust of others
Preoccupied with doubts of others’ loyalty
Feel blameless, instead blame others for their mistakes
Easily bear grudges, feel angry, “on guard” , and chronically tense
Not psychotic: they are in clear line with reality Cluster A Personality Paranoid Personality Disorder:
Causal Factors:
Little is known, not a lot of research done
Modest genetic liability, but unclear
Psychosocial factors expected to play a role Erin Ludlow
Morgan Lund
Michelle Savarese
Erin Bellstein
Autumn Dickens Characteristics:
Interpersonal difficulties
Problems with their identity or sense of ‘self’
Classification:
Behavior must be pervasive and inflexible
Must be stable, extending over a long duration
Three Clusters: A, B, & C Schizoid Personality Disorder
Unable to form social relationships AND no desire
No close friends, classified as loners or introverts
Not emotionally reactive
Generally apathetic about life
Very low openness to expressing feelings Schizoid Personality Disorder
Causal Factors:
Little knowledge, not a lot of research
Modest heritability, but unclear
Related to core dysfunctional Beliefs Schizotypal Personality Disorder:

Excessively introverted, social and interpersonal deficits.
Have cognitive and perceptual distortions
Eccentric qualities
Highly personalized and superstitious thinking
May experience psychotic symptoms
Lack of ability to focus, dficits in working memory, and highly distractable Schizotypal Personality Disorder:

Causal Factors:
2% prevalence in general population
Moderate heritability
Genetically related to schizophrenia
In adolescence, may be associated with stressful life events Histrionic Personality Disorder:

Defined as: “excessive attention-seeking behavior and emotionality”
People with this disorder feel unappreciated if they aren’t the center of attention
They are seductive and manipulative, people tire of attending to them
They need other people to validate their self-worth 2%-3% of population, more common in women
There may be a genetic link to having this disorder because much of it is based on character traits
This disorder is an extreme version of two character traits: neuroticism and extroversion Narcissistic Personality Disorder

Defined as: “exaggerated sense of self-importance, a preoccupation with being admired, and a lack of empathy for the feelings of others”
Grandiosity, “a strong tendency to overestimate their abilities and accomplishments while underestimating the abilities and accomplishments of others,” is the most-used criterion for diagnosing someone with narcissistic personality disorder
They have a “sense of entitlement” and an “unwillingness to forgive others”Crave acclaim and recognition
Researchers think that grandiosity is a cover-up for low self-esteem
More problems arise for friends and family of narcissistic people than for the narcissist themselves They cannot see from others’ perspectives
If they do not receive the praise they desire they are retaliatory
Characterized by: “low agreeableness/high antagonism, low altruism, and tough-mindedness”
They show “high levels of fantasy-proneness, angry-hostility, and self consciousness”1% of population, more common in men
Little research has been done to confirm causal factors
One view is that narcissistic personality disorder is caused by neglectful parents that are devaluing or unempathetic
Another view is that it comes from “unrealistic parental overvaluation” Difference between Histrionic and Narcissistic:

“The histrionic tends to be more emotional and dramatic than the narcissistic, and whereas both may be promiscuous, the narcissistic is more dispassionately exploitative, while the histrionic is more overtly needy. Both will be exhibitionist, but the histrionic seeks attention, whereas the narcissistic seeks admiration.” Borderline Personality Disorder

Defined as: “behavior characterized by impulsivity and instability in interpersonal relationships, self-image, and moods”
This term was originally used to describe the middle-ground between neurotic and psychotic disorders
Then, it was related to schizotypal personality disorder — this is no longer the case
People with BDP exhibit “affective instability...unusually intense high emotions to environmental triggers...delayed recovery to a baseline emotional state...[and] high unstable self-image”
People with this have poor interpersonal relationships; they are often intense yet volatile
Higher levels of impulsivity
Leads to self-destructive behaviors Of the people suffering from borderline personality disorder, 8%-10% will complete suicide

Self-mutilation is prevalent, and 70%-80% of women with BPD have analgesia (“the absence of the experience of pain in the presence of a theoretically painful stimulus”)

Up to 75% of people with BPD experience hallucinations and times when they seem out of touch with reality

BPD is commonly comorbid with Axis I disorders such as unipolar, bipolar, and anxiety disorders; it is also comorbid with other personality disorders

Genetics can be a causal factor
Patients with BPD often experienced trauma as a child, 90% of BPD patients reported some kind of child abuse Difficult to treat
Goals of treatment
Only enter treatment at the insistence of others, not because they see a need for change Adapting Therapeutic Techniques to Specific Personality Disorders

Hospitalization
Partial-hospitalization Treating Borderline Personality Disorder

Biological Treatments
Psychosocial Treatments
Dialectical Behavior Therapy
Psychodynamic psychotherapy Treating Other Personality Disorders

Cluster A and Cluster B
Schizotypal personality disorder
Cluster C Cluster C Personality Disorders Dependent Personality Disorder:

individuals that suffer from this disorder show an extreme need to be taken care of, which leads to clinging and submissive behavior. 1.5% of population suffers from this disorder

More prevalent in women than in men

Borderline Personality Disorder and Dependent Personality Disorder both share fear of abandonment

BPD and DPD differ in that individuals with BPD react to abandonment with emptiness or rage whereas individuals with DPD react with submissiveness and then urgently seek a new relationship Obsessive Compulsive Personality Disorder:

individuals that suffer from this disorder feel an extreme need for perfection and have an excessive concern with maintaining order and control.
The 3 symptoms of OCPD are: Perfectionism, Preoccupation with details, and Hoarding

Causal Factors:

individuals are predisposed to this if they have high levels of conscientiousness and/or high assertiveness and low compliance. Research also exemplifies modest genetic influence as well. Passive-Aggressive Personality Disorder:

individuals that suffer from this disorder show a persuasive pattern of passive resistance to demands in social or work situations, sometimes being highly critical or scornful of authority.

Depressive Personality Disorder:

individuals that suffer from this disorder show a pattern of depressive cognitions and behaviors that is pervasive in nature. General Sociocultural Causal Factors for Personality Disorders are not well understood and there is less variance across cultures than within cultures.

It is believed that some of these personality disorders have increased in American society over the years. Antisocial Personality Antisocial Personality Disorder is defined as being characterized by continual violation of and disregard for the rights of others through deceitful, aggressive or antisocial behavior, typically without remorse or loyalty to anyone. Psychopathy is a condition involving the features of antisocial personality disorder and such traits such as lack of empathy, inflates and arrogant self appraisal and glib and superficial charm. Psychopathy
There are two dimensions of psychopathy:
This involves the affective and interpersonal core of the disorder and reflects traits such as lack of remorse or guilt, lack of empathy, superficial charm, grandiose sense of self worth and pathological lying.
This dimension reflects behavior- the aspects of psychopathy that involve an antisocial, impulsive and socially deviant lifestyle such as the need for stimulation, poor behavior controls, irresponsibility and a parasitic lifestyle. Psychopathic Characteristics

Conscience development is severely retarded or non-existent
Often break the law impulsively and without regard for the consequences
A majority of psychopaths are charming and likeable with a disarming manner that easily wins over new friends.
Pathological liars
Manipulative
Exploitive Genetic influences
Genetic and temperamental, learning, and adverse environmental factors seem to be important in causing psychopathty and ASPD.

Recent studies on gene environment interactions and ASPD identified a candidate gene that seems to be very involved. The gene is known as Monoamine Oxidase-A gene, which is involved in the breakdown of neurotransmitters like norepinephrine,dopamine and serotonin-all neurotransmitters affected by the stress of maltreatment that can lead to aggressive behavior.

Researchers found that individuals with low MOA-A activity were far more likely to develop ASPD if they had experienced early maltreatment than were individuals with high MOA-A activity and early maltreatment and individuals with low levels of MAO-A activity without early maltreatment. Treatments

Cognitive-behavioral treatments have proven to be the most effective form of the treatment of ASPD.

Common targets of this treatment are:
Increasing self control
Increasing victim awareness
Teaching anger management
Changing antisocial attitudes
Curing drug addiction

Treatment of individuals with ASPD psychopathy is difficult, partly because they rarely see any need to change and tend to blame other people for their problems. Difference between DPD and APD is that dependent personalities do not want to separate from relationship because they deal with feelings of incompetency and need to be taken care of whereas avoidant personalities are afraid to even begin an initial relationship for fear of rejection and criticism.

Causal Factors:
Genetic influence on dependent personality traits
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