What is Personality?Personality is the ways we act, think and feel that make each of us unique.Personality trait is a complex pattern of behavior, thought and feeling considered stable across time. (stable develops in childhood/adolescence)One of the leading theories of personality is the five-factor model which posits that everyone’s personality is organized along five broad dimensions or factors of personality.“The Big 5” – negative emotionality, extraversion, openness to experience, agreeableness, and conscientiousness.Personality traits in the five-factor model appear to be strongly influenced by genetics.Personality DisordersA long-standing pattern of maladaptive behaviors, thoughts, and feelings.Highly comorbid (substance abuse and depression)Getting info about a person’s life in order to diagnose is very difficultDifferential DiagnosisMost people experience “way of seeing” as normal…When would an individual with a personality disorder present for treatment?Diagnostic SummaryMajor DepressionGeneralized Anxiety DisorderParanoid Personality DisorderPersonality Disorder ClustersCluster A: odd-eccentricbehavior/thinkingParanoid personality disorderSchizoid personality disorderSchizotypal personality disorderCluster B: dramatic-emotional behavior and interpersonal relationshipsAntisocial personality disorderHistrionic personality disorderBorderline personality disorderNarcissistic personality disorderCluster C: anxious-fearful emotions and chronic self-doubtDependent personality disorderAvoidant personality disorderObsessive-compulsive personality disorderCluster A: The Odd-EccentricThe behavior of people with odd-eccentric personality disorder is similar to that of people with schizophrenia, but these people retain their grasp on reality to a greater degree than do people who are psychotic.May be paranoid, speak in odd and eccentric ways that make them difficult to understand, have difficulty relating to other people, and have unusual beliefs or perceptual experience that fall short of delusions and hallucinations.No delusions, hallucinations, other severe symptoms.Some researchers consider this group of personality disorders to be part of the schizophrenia spectrum these disorders may be precursors to schizophrenia in some people or may even be milder versions of schizophrenia.Often occur in people with first-degree relatives who have schizophrenia.Difficult to treat personality disorders because one of the hallmarks of paranoid is being mistrustful – even paranoid about the therapist’s attempt to be helpful.Cluster A DisordersParanoid Personality DisorderSchizoid Personality DisorderSchizotypal Personality DisorderParanoid Personality DisorderPervasive distrust and suspiciousness of others. They are hypervigilant for evidence confirming their suspicions. Often penetrate observers of situations, noting details most other people miss. Sensitive to criticism.Motives interpreted as malevolent because they misinterpret situations in line with their suspicions. Resistant to rational arguments against their suspicions and may consider the fact that another person is arguing with them as evidence that the person is part of a conspiracy against them.Onset by early adulthood.Present in a variety of contexts.Some withdraw to protect themselves while others become aggressive and arrogant.Differential Diagnosis:Distinct from similar disorders characterized by a period of persistent psychotic symptoms (e.g. delusions and hallucinations).Schizophrenia paranoid typeMood disorder with psychotic featuresPrevalence and Course0.5 – 5.6% of general populationIn treatment, 3x more men than womenChronic courseParanoid PD inevitably contributes to other disordersFamily History StudiesSomewhat more common in families of people with schizophreniaTwin and adoption studies have not been doneCognitive TheoryParanoid PD result from:Underlying belief that people are malevolent and deceptiveLack of self-confidence about being able to defend oneselfDifficult to treat, because therapy/therapists are interpreted in line with paranoid beliefs.Schizoid Personality DisorderLack the desire to form interpersonal relationships and are emotionally cold in their interactions with others.Other people describe them as aloof, reclusive and detached or as dull, uninteresting, and humorless.People diagnosed with this disorder show little emotion in interpersonal interactions. They view relationships with others as unrewarding, messy, and intrusive.Pervasive detachment from social relationships and restricted range of expression in interpersonal settings.Onset by early adulthoodPresent in a variety of contextsPrevalence:Very rare, 0.4-1.7% lifetime prevalence3x more men than womenBiology:Indirect evidence of relationship to SchizophreniaTwin studies indicate personality traits associated with schizoid personality are heritableTreatment:Psychosocial treatments focus on increasing social skills, social contacts, and affective awarenessSchizotypal Personality DisorderTend to be socially isolated, to have a restricted range of emotions, and to be uncomfortable in interpersonal interactions.As children, people who develop schizotypal personality disorder are passive, socially unengaged, and hypersensitive to criticism.Pervasive social and interpersonal deficitsAcute discomfort and reduced capacity for close relationshipsCognitive or perceptual distortions and eccentricitiesOnset in early adulthoodPresent in a variety of contextsThe distinguishing characteristics of schizotypal personality disorder are the oddities in cognition, which generally fall into four categories:Paranoia or suspiciousness, ideas of reference (random events related to them), odd beliefs and magical thinking, illusions that are short of hallucinations.People diagnosed with schizotypal personality disorder tend to have speech that is tangential, circumstantial, vague, or overelaborate.May have inappropriate emotional responses and behaviors are odd.Neuropsychological tests show deficits in working memory, learning, and recall similar to those shown by people with schizophrenia.Retain basic contact with realityPrevalence:0.6 – 5.2% lifetime prevalence2x more women than menBiologyStudies suggests genetic relationship between schizotypal PD and schizophrenia.Much more common in first degree relatives of people with schizophrenia.Schizotypal PD may be a milder form of Schizophrenia.Problems in their ability to sustain their
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