Personality Disorders

1
Chapter 16

• Personality Disorders

Slides Handouts by Karen Clay Rhines,
Ph.D. Seton Hall University
2
Who Are You?

• In five words or less, describe your personality

3
Personality

• What is personality?
• Unique and long-term pattern of inner experience
  and outward behavior
• Consistent
• Traits
• These traits may be inherited, learned, or both
• Flexible
• What is a personality disorder?

4
Classifying Personality Disorders

• Impairments in social or occupational
  functioning, or personal distress
• Adolescence or early adulthood
• Undesirable or problematic behavior?
• Difficulty classifying
• Co-morbidity

5
What Problems Are Posed by the DSM Categories?

• Validity and reliability
• Differentiation b/ Axis I and Axis II
• Overlap
• Distinguishing b/ normal and abnormal behavior
• Sexist

6
Classifying Personality Disorders

• The DSM-IV identifies ten personality disorders
  and separates these into three categories or
  clusters
• Odd or eccentric behavior
• Dramatic, emotional, or erratic behavior
• Anxious or fearful behavior

7
Odd Personality Disorders

• Paranoid Personality Disorder
• Schizoid Personality disorder
• Schizotypal Personality Disorder

8
Paranoid Personality Disorder

• Characterized by deep suspicion or mistrust of
  others
• Not delusional
• Avoidance of relationships
• Hypersensitivity, vigilance, and caution

9
Treatments for Paranoid Personality Disorder

• People with paranoid personality disorder do not
  typically see themselves as needing help
• Object relations therapists
• Behavioral and cognitive therapists
• Drug therapy

10
Schizoid Personality Disorder

• Characterized by persistent avoidance of social
  relationships and limited emotional expression
• Extreme social withdrawal prevents them from
  seeking treatment

11
Treatments for Schizoid Personality Disorder

• Cognitive therapists
• Behavioral therapists
• Group therapy
• Drug therapy

12
Schizotypal Personality Disorder

• Characterized by a range of interpersonal
  problems, odd (even bizarre) ways of thinking and
  perceiving, and behavioral eccentricities
• Ideas of reference and/or bodily illusions
• Attention problems
• Isolation
• Most severe of the three in this cluster

13
Treatments for Schizotypal Personality Disorder

• Reconnect
• Recognize limitations
• Antipsychotic drugs

14
Dramatic Personality Disorders

• Antisocial personality disorder
• Borderline personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder

15
Antisocial Personality Disorder

• Psychopaths or sociopaths
• Persistently disregard and violate others rights
• Have to be at least 18 years of age to receive
  this diagnosis
• Caucasians/African Americans
• Men/Women
• Conduct disorder/Attention-deficit hyperactivity
  disorder

16
Treatments for Antisocial Personality Disorder

• About 25 of all people with antisocial
  personality disorder receive treatment for it,
  yet no treatment appears to be effective
• Cognitive therapists
• Little or no impact on the disorder

17
Borderline Personality Disorder

• Instability, including major shifts in mood, an
  unstable self-image, unstable relationships, and
  impulsivity
• Their impulsive, self-destructive behavior can
  include
• Alcohol and substance abuse
• Reckless behavior, including driving and unsafe
  sex
• Cutting themselves
• Suicidal actions and threats

18
Borderline Personality Disorder

• Almost 2 of the general population are thought
  to suffer from this disorder
• Close to 75 of those diagnosed are women
• The course of the disorder varies

19
Treatments for Borderline Personality Disorder

• It appears that psychotherapy can eventually lead
  to some degree of improvement for people with
  this disorder
• Not easy!!
• Psychodynamic Cognitive-behavioral
  Dialectical behavior therapy
• Group therapy
• Antidepressant, antibipolar, antianxiety, and
  antipsychotic drugs
• Combination of drug therapy and psychotherapy

20
Histrionic Personality Disorder

• Extremely emotional and continually seek to be
  the center of attention
• Once believed to be more common in women than in
  men
• 2 of adults have this personality disorder,
  with males and females equally affected

21
Treatments for Histrionic Personality Disorder

• Cognitive therapists
• Psychodynamic therapy and group therapy
• Drug therapy

22
Narcissistic Personality Disorder

• Generally grandiose, need much admiration, and
  feel no empathy for others
• Seldom interested in the feelings of others
• Less than 1 of adults display narcissistic
  personality disorder
• Up to 75 of these are men
• Normal teenagers

23
Treatments for Narcissistic Personality Disorder

• One of the most difficult personality patterns to
  treat
• None of the major treatment approaches have had
  much success

24
Anxious Personality Disorders

• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive-Compulsive Personality Disorder

25
Avoidant Personality Disorder

• Uncomfortable and restrained in social
  situations, overwhelmed by feelings of
  inadequacy, and extremely sensitive to negative
  evaluation
• Similar to social phobia

26
Treatments for Avoidant Personality Disorder

• People with avoidant personality disorder come to
  therapy seeking acceptance and affection
• Building trust
• Group and drug therapy

27
Dependent Personality Disorder

• Pervasive, excessive need to be taken care of
• Central feature difficulty with separation
• Feel distressed, lonely, and sad
• Depression and anxiety disorders
• Suicidal thoughts

28
Treatments for Dependent Personality Disorder

• In therapy, people with this disorder usually
  place all responsibility for their treatment on
  the clinician
• Accepting responsibility for themselves
• Couple or family therapy can be helpful often
  recommended

29
Treatments for Dependent Personality Disorder

• Treatment can be at least modestly helpful
• Psychodynamic therapy
• Cognitive therapists
• Antidepressant drug therapy
• Group therapy

30
Obsessive-Compulsive Personality Disorder

• So focused on order, perfection, and control that
  they lose all flexibility, openness, and
  efficiency
• Education, Marital status, and Employment status
• Gender
• Obsessive-compulsive personality disorder and
  obsessive-compulsive disorder

31
Treatments for Obsessive-Compulsive Personality
Disorder

• Unlikely to seek treatment unless they also are
  suffering from another disorder, most frequently
  anxiety or depression