Exam 4 Study Guide X Ch 9 XI Ch 14 XII Ch 18 Topic X Ch 9 Personality Disorders Person vs Situation Debate o An individual is effected by Person influences includes personality Situation influences Which is it Both Nature temperament nurture Global Stable Internal Specific Unstable External environment personality characteristics What is Personality o Personality Enduring patterns of behaviors feelings and o Fundamental Attribution Error The tendency to thoughts over time and situations attribute undesirable behavior of others to their personality global stable internal factors o Self Serving Bias Attribute the cause of your undesirable behaviors to situation specific unstable external factors Where does Personality come from o Temperament A person s most basic characteristic styles of relating to the world especially those evident during 1st year of life Easy Less reactive more control Difficult More reactive less control Slow to Warm Up self explanatory Bio psychosocial Model of Personality o Biological Influences Genetically determined temperament Autonomic nervous system reactivity Brain activity o Psychological Influences Learned responses Expectations Childhood experiences The Big 5 Five Factor Model o Social cultural Influences Interpretations 1 O Openness to Experience 2 C Conscientiousness Fantasy Aesthetics Feelings Actions Ideas Values Competence Order Dutifulness Achievement striving Self Discipline Deliberation 3 E Extraversion 4 A Agreeableness Warmth Gregariousness Assertiveness Activity Excitement seeking Positive Emotions Trust Straightforwardness Altruism Compliance Modesty Tender mindedness 5 N Neuroticism Anxiety Anger Hostility Depression Self consciousness Impulsiveness Vulnerability Rated on a dimension low to high Personality Disorders are very low and one s environment o Exaggerations of normal personality traits very high or o Rigid inflexible maladaptive patterns of relating to oneself o More subtle o Most are less incapacitating than many other disorders o Most often untreated It s their personality hard for them to o Best viewed on a continuum dimensional even though see it as a problem DSM defines them categorically DSM General Criteria for PDs o Enduring pattern of inner experience behavior o Deviates markedly from the expectations of the individual s o Manifested in two or more of the following areas culture 1 Cognition e g about self others 2 Emotional Responses 3 Interpersonal Functioning 4 Impulse Control o Inflexible pervasive across a range of situations o Clinically significant distress themselves and or in others o Stable and of long duration onset in adolescence o Not better explained by another type of mental disorder or impairment Problems Controversy Regarding PDs o Diagnostic reliability is low Low level of agreement between professionals Categories are not as clearly defined or objective as most others o Tremendous overlap among categories Categories are not mutually exclusive o Problems in making categorical judgments If dimensional those on the threshold might need help but not get it because they didn t make the cut o Questions remain about stability over time Why are there fewer diagnoses over time Personality is supposed to be consistent over time Some cultures have different values than others E g o Not clear that they are culturally universal Level of extroversion o Little evidence to show that they can be treated successfully Why are PDs crucial o Disrupt functioning Social Interpersonal Occupational Educational Happiness Well Being Perhaps predispositions Perhaps early manifestations o May be predictive of other disorders o Make treatment of co morbid disorders more difficult Paranoid o Cluster A Odd eccentric behavior schizophrenia PD Clusters in DSM IV spectrum disorders Distrust Suspiciousness of others Detachment from social relationships don t Restricted range of expression of emotions Schizoid want them Schizotypal Discomfort with close relationships Cognitive and perceptual distortions Eccentricities of behavior o Cluster B Dramatic emotional and erratic problems Antisocial of others Disregard for frequent violation of the rights Lack of remorse Low reactivity thrill seekers Impulsive Aggressive No known treatment Borderline Instability of interpersonal relationships Self image including identity disturbance Emotions Low impulse control Self injury suicidal behavior is common Excessive emotionality Excessive attention seeking Grandiosity Need for admiration Lack of empathy Histrionic Narcissistic o Cluster C Anxious fearful behavior Avoidant Dependent Social inhibition Feelings of inadequacy Hypersensitivity to negative evaluation Excessive need to be taken care of Submissive clingy behavior Preoccupation with orderliness perfectionism Obsessive Compulsive at the expense of flexibility Dimensional Approach Look at Table 9 3 o Provides a more complete description of each person o Useful with patients who fall on boundaries between o Useful with patients who present combinations of disorders o Two part process disorders 1 Clinician makes judgment regarding impairment in Problems with persons view of self and others Difficulties maintaining interpersonal personality function as defined by Identity Self direction relationships Empathy Intimacy exhibits 2 Specify what kind of personality problem the person Uses ratings of pathological personality traits Generally follows 5 factor model Labeled differently More specific facets included under each domain Includes 25 core traits Dimensional vs Categorical o Primary emphasis on ratings of maladaptive traits o Traits replace diagnostic criteria for each PD in categorical o Retains some continuity 6 of 10 specific types of PDs from o Other 4 categorical types replaced with PDTS Personality system categorical system Disorder Trait Specified system Must exhibit impairment in self or interpersonal Must exhibit one or more pathological personality Avoids need to assign more than one type of PD function traits PDs are difficult to treat because o Personality is supposed to be stable enduring nature o Person doesn t recognize that they have a problem Ego syntonic Consistent with whom you are o Interpersonal difficulties interfere with the therapeutic relationship o Very little research evidence on treatment efficacy Hard for them to relate with the therapist Except perhaps Borderline Building Blocks of Personality Symptoms in PDs o Motives Refers to goals and desires Conscious or
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