Chapter 11 Abnormal Psych Book Notes 11 1a Aspects of Personality Disorder Personality Disorder an enduring maladaptive pattern for relating to the environment and self exhibited in a range of contexts that cause significant functional impairment or subjective distress Personality disorders are chronic they do not come and go but originate in childhood and continue throughout adulthood Pervade every aspect of a person s life Will effect everything a person does including relationships employment may not be able to sustain a lasting relationship where a person lives Others may feel distressed by the personality disorder Antisocial personality disorder show blatant disregard for the rights of others and exhibit no remorse Many tend to do poorly in treatment Characteristic traits are ingrained and inflexible Axis 2 is for personality disorders exclusively Can only be diagnosed on axis 1 axis 2 or both axes A diagnosis on both axis 1 and 2 indicates that a person has both a current disorder axis 1 and a more chronic problem personality disorder 11 b Categorical and Dimensional Models People with personality disorders however display problem characteristics over extended periods and in many situations Difficulty than can be one of degree rather than kind in other words the problems of people with personality disorders may just be extreme versions of the problems many of us experience temporarily such as being shy or suspicious Problems of degree and problems of kind are described in terms of dimensions instead of categories Debate over whether they are extreme behaviors of normal behavior or ways dimensions of relating that are different from psychologically healthy behavior categories Society views us in categories female and dimensions maleness or femaleness There is no somewhat when it comes to personality disorders Categorical models are convenient Five Factor Model Big Five Using categories leads clinicians to reify them view disorders as real things People can be rated on a series of personality dimensions and the combination of 5 components describes why people are so different Five Factors Extroversion talkative assertive and active versus silent passive and reserved Agreeableness kind trusting and warm versus hostile selfish and mistrustful Conscientiousness organized thorough and reliable versus careless negligent and unreliable Neuroticism even tempered versus nervous moody and temperamental Openness to Experience imaginative curious and creative versus shallow and imperceptive On each dimension people are rated high low or somewhere in between There are individual differences across cultures 11 1c Personality Disorder Clusters Three groups clusters Cluster division is based on resemblance Cluster A Odd or Eccentric Paranoid schizoid and schizotypal personality disorders Cluster B Dramatic Emotional or Erratic Antisocial borderline histrionic and narcissistic personality disorders Cluster C Anxious or Fearful Cluster A Avoidant dependent and obsessive compulsive personality disorders Paranoid Personality Disorder the strong tendency to mistrust the motives of others leading to a high degree of suspiciousness Schizoid personality disorder characterized by social detachment and a lack of emotional expression not due to social anxiety Schizotypal Personality Disorder social and interpersonal difficulties that are due to social anxiety but also involves distorted views of the world and unusual behavior Cluster B Cluster C Antisocial Personality Disorder characterized by behavior that shows limited regard for other people Borderline Personality Disorder characterized by a high level of unstable relationships and emotional outbursts poor self image and a difficulty controlling impulses Histrionic Personality Disorder The tendency to display flamboyant emotions with the goal of seeking attention Narcissistic Personality Disorder Pervasive belief that the individual is better than everyone else which leads to attention seeking and a lack of concern for others Avoidant personality disorder characterized by strong feelings of inadequate which can result in inhibition in social situations and sensitivity to any negative feedback Dependent Personality Disorder A strong need to be cared for by others including patterns of submissiveness and fear of separation Obsessive Compulsive Personality Disorder Characterized by a desire for being perfect both mentally and interpersonally a need for orderliness and reduced flexibility and openness 11 d Statistics and Development Personality disorders are found in 0 5 percent to 2 5 percent of the general population 10 30 percent of all individuals served in impatient settings and 2 10 percent of those individuals in outpatient settings 1 in 10 adults in the US may have diagnosable personality disorder worldwide about 6 percent of adults may have at least one personality disorder Gender differences are not apparent Originate in childhood and continue into adult years So ingrained that onset is difficult to pinpoint Gaps in knowledge of about 1 2 of personality disorders People with borderline personality disorder are characterized by their volatile and unstable realtionships tend to have persistent problems early in adulthood with frequent hospitlizations unstable personal relationships severe depression and suicidal gestures 10 percent attempt suicide with BPD 6 percent succeed in their attempts Symptoms gradually improve if their survive to their 30s Elderly with BPD may be disruptive in nursing homes and have difficulty making plans Antisocial personality disorder display characteristic disregard for the rights and feelings of others tend to continue their destructive behaviors of lying and manipulation through adulthood Some tend to burn out after the age of about 40 and engage in fewer criminal activities 11 1e Gender Differences BPD is diagnosed more often in females who make up about 75 percent of the indentified cases Histrionic and Dependent Personality disorders are identified by clinicians more often in women but according to more recent studies may have more equal diagnoses in men and women Histrionic personality disorder being biased as a woman disorder and antisocial personality disorder is labeled as a men s disorder Criterion gender bias assessment gender bias 11 1f Comorbidity 10 percent of the population with a personality disorder People tend to be diagnosed with more than one personality disorders Comorbidity condition in which