Personality Disorders PSYCHOLOGY MHS 2013 Personality Traits you

Personality Disorders PSYCHOLOGY MHS 2013

Personality Traits (you know this part already) n ways of thinking, feeling, and behaving that are stable across time and situations n considered to be a disorder when n Traits break cultural rules are maladaptive: hurt self / others) Cause impairment / distress

The Diagnostic Question n Are people with personality disorders qualitatively different from people without? OR Are people with PD individuals who have extreme versions of otherwise normal traits? Answer: n Think of PD as extreme positions on one or more personality dimensions

Course: how does it work out? n n thought to originate in childhood and continue into adulthood believed to be relatively stable, difficult to treat

Conduct Disorder: n Aggression to people and animals n n Destruction of Property n n n deliberately sets fires with intention to cause damage deliberately destroys other's property Deceitfulness, lying, or stealing n n bullies, often initiates physical fights is physically cruel to people or animals forces someone into sexual activity has broken into someone's building, house, or car lies to obtain goods, favors or avoid obligations steals items without confronting a victim (e. g. shoplifting) Serious violations of rules n n often stays out at night despite parent objections runs away from home, truant from school

Conduct Disorder (Cont. ) n Prior to age 15 n Comorbid with: n n n mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems Problems present for all kids involved in substance abuse… but the problems go away after substance abuse stops.

Classifying PDs: 3 groups n Classifies in 3 clusters: n n Cluster A Odd/Eccentric Cluster B Dramatic/Erratic Cluster C Anxious/Fearful Test-retest reliability (diagnostic stability) n ½ of those initially diagnosed with PD did not receive same diagnosis 1 year later (Shea et al. , 2002)

DSM-IV-TR Personality Disorders n n n n n Paranoid PD Schizotypal PD Antisocial PD Borderline PD Histrionic PD Narcissistic PD Avoidant PD Dependent PD Obsessive-Compulsive PD

A) Paranoid PD (distrustful) n Suspicious of others – reluctant to confide Questions loyalty Expects to be mistreated / exploited Sees hidden messages in benign comments Blames others when things go wrong n No hallucinations n n

A) Schizoid PD (‘loners’) n Avoids close interpersonal relationships n n Few or no close friends Detached, distant… called ‘loners’ No apparent need of friends, sex Focus on inner / solitary activities n Rarely report strong emotions n Anhedonia (no pleasure from activities) n Seem to be missing the “human part”

A) Schizotypal PD n n Interpersonal difficulties similar to schizoid Odd beliefs or magical thinking n Superstitious n Telepathic n Illusions n Feels the presence of a force or person not actually present. n Odd/eccentric behavior or appearance n Wears strange clothes n Talks to self Distant cousin of schizophrenia? highly heritable n

B) Antisocial PD (psychopath, sociopath) l Pervasive disregard for the rights of others since age 15 n n n l Conduct disorder before age 15 n l Lies Aggression Impulsiveness Violates the law Irresponsible Lack of remorse Truancy, running away, lying, theft, arson, destruction of property Substance abuse common co-morbid disorder

ASPD and Emotion n Low levels of skin conductance – sweat: Sympathetic NS: evidence of lack of fear/anxiety n Skin conductance reactivity at age 3 predicted APD at age 28 (Glenn et al. , 2007) Difficult to avoid beh. that leads to punishment : Show less SCR to other’s distress n Lack empathy

B) Borderline PD l l Emotional reactivity Unstable, stormy, intense relationships Frantic efforts to avoid abandonment Impulsive, self-damaging behaviors l Unstable sense of self Anger control problems Chronic feelings of emptiness l Recurrent suicidal gestures l l

BPD n Genetic component n n n n Highly heritable Role in impulsivity and emotional dysregulation Decreased function of serotonin Frontal lobe dysfunction Increased activation of amygdala Socio-Environmental Causes? Parental separation Verbal and emotional abuse during childhood

B) Histrionic PD (hysterical) n Excessive emotional displays n n n Craves attention, victim stance Seeks re-assurance, praise n n “dramatic” behaviour easily influenced by others Emotionally shallow despite strong emotions Very concerned with physical attractiveness Seductive, provocative, “life of the party”

B) Narcissistic PD n Grandiose view of self n n Preoccupied with fantasies of success Self-centered n Demands attention and adulation n Feelings of entitlement and arrogance Envious of others n Little concern for needs and well being of others n n Lacks empathy Hypersensitive to criticism Seeks out high-status partners

C) Avoidant PD n Avoids interpersonal situations n Fears criticism or rejection n Hesitant about involvement with others n Wants to be certain of acceptance n Restrained and inhibited in interpersonal situations n Fears ridicule n Feelings of inadequacy n Avoids taking risks or trying new activities n Doesn’t want to risk embarrassment

C) Dependent PD n n n Lack of self confidence Excessive reliance on others Intense need to be cared for Uncomfortable when alone Behavior focused on maintaining relationships Quickly initiates new relationship if current one fails

C) Obsessive-Compulsive Personality Disorder n n n A perfectionist Preoccupied with rules, details, & organization Rigid and inflexible n Overly focused on work n Little time for leisure, family, & friends n Tendency to hoard n Difficulty discarding worthless items n Reluctant to delegate Moral inflexibility Does not have the obsessions/compulsions of OCD n n