Abnormal Psych ch 9 outline Personality disorder chronic interpersonal difficulties and problems with one s identity or self I Criteria for diagnosing a personality disorder a The person s pattern of behavior must be pervasive and inflexible as b well as stable and long of duration It must also cause clinically significant distress or impairment in functioning c Must be manifested in at least two of the following areas cognition affectivity interpersonal functioning or impulse control The DSM IV TR personality disorders are grouped in to three clusters on the basis of what were originally thought to be important similarities of features among the disorder within a given cluster a Cluster A Includes paranoid schizoid and schizotypal personality II disorders i People with these disorders often seem odd or eccentric with unusual behavior ranging from distrust to suspiciousness to social detachment b Cluster B Includes histrionic narcissistic antisocial and borderline personality disorders i i Individuals with these disorders share a tendency to be dramatic emotional and erratic c Cluster C Includes avoidant dependent and obsessive compulsive personality disorders In contrast to the other two clusters people with these disorders often show anxiety and fearfulness III Difficulties in diagnosing personality disorders a One problem is that diagnostic criteria for personality disorders are not as sharply defined as they are for most Axis I diagnostic categories b Agreement between the diagnoses made on the basis of different structured interviews or self report inventories is often rather low so there are substantial problems with the reliability and validity of diagnoses c Model most influential is the five factor model i In order to fully account for the myriad ways in which people with personality disorders differ it is necessary to measure the 6 subcomponents of each of the 5 personality traits IV Difficulties in Studying the Causes of Personality Disorders a One major problem is the high level of comorbidity among disorders i Makes it difficult to distinguish what causal factors are associated with which personality disorder b Another problem is that researchers have more confidence in prospective studies in which groups of people are observed before a disorder appears and are followed over a period of time to see which individuals develop problems and what causal factors have to be present V Cluster A Personality Disorders a Paranoid personality disorder people have a pervasive suspiciousness and distrust of others leading to numerous interpersonal difficulties i Tend to see themselves as blameless instead blaming others for their own mistakes and failures even to the point of ascribing evil motives to others ii Constantly tense constantly expecting trickery looking for clues to validate their expectation while ignoring all evidence to the contrary iii Bear grudges refuse to forgive perceived insults and slights and are quick to react with anger b Schizoid Personality disorder individuals are usually unable to form social relationships and usually lack much interest in doing so i Consequently they typically do not have good friends with the possible exception of a close relative ii Lack social skills have solitary interests and occupations iii Tend not to take pleasure in many activities including sexual activity and rarely marry iv Not very emotionally reactive show a general apathetic mood c Schizotypal Personality Disorder excessively introverted and have pervasive social and interpersonal deficits i Have cognitive and perceptual distortions as well as oddities and eccentricities in their communication and behavior ii Although contact with reality is usually maintained highly personalized and superstitious thinking is characteristic and under extreme stress may experience transient psychotic symptoms iii They often believe that they have magical powers and engage in magical rituals iv Other cognitive perceptual problems includes ideas of reference odd speech and paranoid beliefs v Genetic relationship to schizophrenia Other subtype that is not related to Schizophrenia is characterized by cognitive and perceptual deficits and is instead linked to a history of childhood abuse and early trauma VI Cluster B Personality Disorders a Histrionic personality disorder individuals tend to feel unappreciated if they are not the center of attention their lively dramatic and excessively extraverted styles often ensure that they can charm others in to attending to them i Behavior and appearance are often quite theatrical and emotional as well as sexually provocative and seductive ii They may attempt to control their partners through seductive behavior and emotional manipulation but they also show a good deal of dependence iii May be characterized as involving extreme versions of neuroticism and extraversion b Narcissistic personality disorder show an exaggerated sense of self importance a preoccupation with being admired and a lack of empathy for the feelings of others i Grandiosity is the most important and widely used diagnostic criterion for diagnosing narcissistic patients ii Strong tendency to overestimate their abilities and accomplishments while underestimating the abilities and accomplishments of others iii Because they believe they are so special they often think they can only be understood only by other high status people that they should associate with only such people iv Most researchers believe they actually have a fragile self esteem so their personality is their protective shield v They are unwilling or unable to take the perspective of others vi By the five factor model individuals with narcissistic personality disorder are characterized by low agreeableness high antagonism low altruism tough mindedness vii More frequently found in men c Antisocial personality disorder individuals continually violate and show disregard for the rights of others through deceitful aggressive or antisocial behavior typically without remorse or loyalty to anyone i Tend to be impulsive irritable and aggressive and to show a pattern of generally irresponsible behavior ii Pattern must have been occurring before the age of 15 and before the age of 15 the person must have had symptoms of conduct disorder d Borderline personality disorder individuals show a pattern of behavior characterized by impulsivity and instability in interpersonal relationships self image and moods i Affective instability