12/5/200711Can my personality be a disorder?!Chapter 11- Personality Disorders2A 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. 3Defining Personality• Personality 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.12/5/200724Defining Personality Disorders• The 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 C5Cluster 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 abandonment6Prevalence• Personality 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 difficult12/5/200737Cluster A Personality Disorders• People 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.8Jake has never been in serious trouble, but has a reputation for arguing with teachers and classmates. Jake enrolled in a local community college after high school, but flunked out- though never taking responsibility for his failing grades. He began to develop conspiracy theories about fellow students and professors, believing they worked together to see him fail. Jake bounced from job to job, each time complaining that his employer was spying on him while at work and home. At age 25, he became very preoccupied with theories about people who were out to harm him; he now insists that “experiments” were performed on him as a child by the CIA. During these “experiments”, he was drugged and a microchip was implanted into his ear to cause cancer.Is it all really a conspiracy?9Borderline 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.12/5/2007410• Sherry paraded into the party drunk and continued to drink throughout the night. Laughing and giggling, she flirted with many of the men and to two of them, she expressed her “deep affection.” Twice during the night she disappeared for almost a half an hour, each time with a different man. After a violent argument with one of them, because he took “too long” to her a drink, she locked herself in the bathroom and attempted to swallow a bottle of aspirin. Her friends encouraged her to go home, but she was afraid to be alone in her apartment.11Understanding BPD• A 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).12“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 arm• Self-injurious behaviors, like cutting are sometimes described as “tension-reducing” for hose who report feeling empty (Bohus et al., 2000).12/5/2007513Self-Injury• There 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).14Comorbidity• BPD 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).15A 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.• Researchers 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.12/5/2007616Always Onstage• Histrionic 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 limelight17Donna• Donna danced into the party and immediately became the center of attention. With sweeping gestures of her arms and dramatic displays of emotion, she boasted about