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Personality Disorders. What are PD’s?. Think of: The core construction of a person’s world Experiences and Behaviors remarkably outside the norm (for culture). Causes significant distress or impairment Starts in adolescence/early adulthood Pervasive across settings Not GMC or Substance.
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What are PD’s? • Think of: The core construction of a person’s world • Experiences and Behaviors remarkably outside the norm (for culture). • Causes significant distress or impairment • Starts in adolescence/early adulthood • Pervasive across settings • Not GMC or Substance
Incidence/Diagnosis • 10-15% of population • Varies based on disorder. Some prevalence uncertain • Diagnosed after the age of 18. • Consider all other diagnoses
Cluster A: The Odd/Eccentric Ones • Schizoid Personality Disorder • Primary feature: detached from others and restricted emotions. • Little desire for relationships, prefers solitary actions, may appear indifferent/cold/aloof. • Paranoid Personality Disorder • Primary feature: Distrust, suspiciousness about other’s motives. • Believes they are being exploited, reads hidden meaning, reacts quickly w/anger • Schizotypal Personality Disorder • Think Schizoid and then some • Decreased desire for relationships AND eccentricity. “Magical thinking,” ideas of reference, suspiciousness, • Sometimes seen as pre-morbid to Psychotic Disorders
Cluster B: The Dramatic, Emotional, or Erratic Ones • Antisocial Personality Disorder • Primary feature: complete disregard for others/rules (think: the sociopaths) • Includes violence, law violations, lying/cheating, lack of remorse. May appear as very charming or cocky and hostile. • The one disorder where symptoms must be present by the age of 15 (still cannot diagnose until 18). • Borderline Personality Disorder • Primary feature: Unstable relationships, self-image, and affect. Impulsivity. This stems from an unstable “sense of self” • Make frantic efforts to about being abandoned, very reactive in mood, idealization/devaluation, feelings of emptiness, frequent suicide attempts/cutting episodes.
Cluster B Continued • Narcissistic Personality Disorder • Primary feature: Grandiosity, need for admiration, lack of empathy. (stems from fragile ego) • Feel entitled, exaggerate talents, believes he/she is special, exploitive, envious of others (believes opposite), arrogant • Histrionic Personality Disorder • Primary feature: Excessive emotionality and attention seeking behavior (think: the drama queen) • These people want to be the center of attention at all costs. Feel uncomfortable when they are not (use sexuality, speech, theatrics, etc).
Cluster C: Anxious or Fearful Ones • Avoidant Personality Disorder • Primary feature: Pervasive social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluations • Preoccupied with fears of criticism, ridicule, etc that limits social interaction. • Dependent Personality Disorder • Primary feature: Excessive need to be taken care of leading to submissive, clinging behavior. • Can’t make choices, needs complete guidance, fails to take responsibility, lacks self-confidence in abilities. • Obsessive-Compulsive Personality Disorder • Primary feature: Preoccupation with orderliness, perfectionism, and control (think: Anal retentive) • Preoccupied with rules, perfection, work, etc to the point that tasks aren’t completed. May be miserly and unwilling to share tasks with others.
PD NOS • Don’t meet criteria for a specific disorder, but distress is apparent. • The mixed personality • A disorder not listed in DSM-IV-TR but is under research
Causes/Treatment • Contention • Genetics vs. environmental factors. • Research is not consistent • Psychoanalytic theory prevalent • Challenging to treat • Long term • Some “resolve” on own • Personality testing is beneficial
