6/22/20091Can my personality be a disorder?!Chapter 11- Personality DisordersThink on your own…How would you describe your personality?Make a list of your personality characteristics. How would you describe yourself to a new friend?What is Personality?There are many characteristics of personality:‐ “George is shy”‐ “Karen is outgoing”‐ “Missy is such a drama queen”‐ “Jane has the personality of a wet-mop!” ‐ Dan is SO suspicious of everyone”6/22/20092A personality refers to a distinctive set of behavior patterns that make up our individuality.Our personality consists of traits that vary based on the situation. Defining PersonalityPersonality disorders are displayed in a wide range of social and personal contexts…are inflexible and cause significant impairment in functioning.People with personality disorders have a great difficulty dealing with other people.‐ They tend to be rigid, inflexible, and unable to respond to changes and demands of life.In other words, people with personality disorders behave in ways that do not fit with accepted social standards, and they are unable to adapt their behaviors to better suit their environments.6/22/20093The DSM-IV-TR provides the following definition of a personality disorder: “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (APA, 2000). In general, the personality disorders are characterized by rigid, extreme, and maladaptivepersonality traits. Defining Personality DisordersThe DSM IV defines 10 specific personality disorders, based on category. These disorders are different than most of the previously discussed disorders because they are classified as Axis II.‐ The DSM IV divides the personality disorders into 3 groups or clusters: A, B or CCluster A- Odd or Eccentric Disorders:‐ Paranoid- suspicious, distrustful, hostile attributions‐ Schizoid- interpersonally and emotionally cut-off, constricted, unresponsive (the loner)‐ Schizotypal- odd thoughts, feelings, behaviors, experiences, poor interpersonal functioningCluster B-Dramatic, Emotional or Erratic Disorders:‐ Histrionic- dramatic, attention-seeking, emotionally shallow‐ Narcissistic- inflated sense of self-importance, entitled, low empathy, hidden vulnerability‐ Antisocial- pattern of behaviors that disregard laws and norms and rights of others‐ Borderline- instability in thoughts, feelings, behavior and sense of selfCluster C- Anxious or Fearful Disorders:‐ Obsessive-Compulsive- rigid, controlled, perfectionistic‐ Avoidant- fear of negative evaluation and abandonment‐ Dependent- submissive, dependent on others for self-esteem, fear of abandonment6/22/20094PrevalencePersonality disorders are relatively common, found in 0.5% to 2.5% of the general population.The personality disorder forms as the personality itself is developing, making these maladaptive patterns ingrained into the sense of self.‐ Pinpointing the onset is also very difficultCluster A Personality DisordersPeople with paranoid personality disorder are excessively mistrusting and suspicious of others without justification.They assume that people are out to trick or harm them, and they tend to not confide in others. Even events that have nothing to do with them are seen as personal attacks (Phillips & Gunderson, 2000).‐ These people would view the neighbor’s dog barking or a flight delay as a deliberate attempt to annoy them.Paranoid Personality Disorder6/22/20095What is Schizoid Personality Disorder?Borderline Personality Disorder(Cluster B)Borderline Personality Disorder is characterized by a pervasive pattern of instability of personal relationships, self-image, affects, and control over impulses.People with this disorder are highly impulsive and have a fear of abandonment.6/22/20096Understanding BPDA person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day.BPD is one of the most common personality disorders; it is seen in every culture and affects 2-3% of the general population, mostly affecting young women (Gunderson, 2001).Borderline Personality Disorder“But, it’s a good pain…”People with BPD often engage in suicidal or self-mutilative behaviors:‐ Cutting, burning or punching themselves‐ Self-inflicted cigarette burns‐ Carving initials into their arm6/22/20097Self-injurious behaviors, like cutting are sometimes described as “tension-reducing” for hose who report feeling empty (Bohus et al., 2000).Self-InjuryThere is a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and completed suicide in severe cases.‐ A significant proportion succeed at suicide-6% (Stone, 1989).6/22/20098Reflections of a “cutter”ComorbidityBPD is often comorbid with many other mood disorders.‐ 24-74% have major depression‐ 4-20% have bipolar disorder‐ 25% of people with bulimia have BPD‐ And up to 67% of people with BPD are also diagnosed with at least one substance use disorder (Dulit, 1993).A link to abuse?Studies show that many, but not all individuals with BPD report a history of abuse, neglect, or separation as young children.‐ 40-71% of BPD patients report having been sexually abused.6/22/20099Clinical Discussion about Borderline Personality DisorderResearchers believe that BPD results from a combination of vulnerability to environmental stress as young children and a series of events that trigger the onset of the disorder as young adults.The Neurological Perspective6/22/200910Always OnstageHistrionic Personality Disorder involves a pervasive pattern of excessive emotionality and attention-seeking.People with this disorder are overly dramatic and often seem like they are acting. Often expressing their emotions in an exaggerated fashion.‐ Hugging someone they have just met or crying uncontrollably at a sad movie.‐ They also tend to be vain, self-centered, and uncomfortable when they are not in the limelightHistrionic Personality DisorderIs this disorder accurately diagnosed?There is a high rate of diagnosis among women, which has raised some questions about the nature of this disorder.Research has shown that there is some bias among psychologists and psychiatrists who tend to associate this disorder with women