Personality Disorders the nature of personality disorders enduring and relatively stable predispositions traits inflexible they re disorders b c they re maladaptive causing distress and or impairment impairment can be judged by clinician even if client doesn t realize it categorical vs dimensional models of personality disorders we re learning in a categorical way but many argue that we should move towards a more dimensional approach in old DSMs personality disorders were on axis 2 but DSM 5 doesn t have multiaxial system DSM 5 has an alternative more dimensional model to the current categorical approach used in the DSM 5 with six personality disorder types reduced schizotypal antisocial borderline narcissistic avoidant obsessive compulsive includes a personality pathology severity scale levels of personality functioning new includes a 5 domain 25 facet pathological personality trait assessment new called the five factor model people are rated on a series of personality dimensions and the combination of these components describes why people are so different from each other can be applied to all patients not just those w personality disorders debate over whether personality disorders are extreme versions of otherwise normal personality variations dimensions problem of degree they feel the same things as the rest of us just to a greater degree or ways of relating that are different from psychologically healthy behavior categories problem of kind the kind of problems they have are different than the kind that regular people have many wanted to eliminate paranoid schizoid histrionic avoidant and dependent PDs from the DSM 5 b c of lack of research and significant overlap among the disorders overall affect 5 2 of population for anyone in an inpatient unit prevalence is 10 30 personality disorders are comorbid w other disorders and you see them coming up a lot on inpatient units begin in childhood but don t diagnose very young since personality is still developing run chronic course if left untreated many don t seek treatment early on b c they don t realize there is a personality disorder to describe what they re like or they aren t bothered by the disorder so info on the course of these disorders is lacking it is not uncommon for someone to meet criteria for a certain personality disorder and then years later meet criteria for a different personality disorder clinicians have gender biases when diagnosing disorders they are more likely to give males diagnosis of ASPD and are more likely to give females diagnosis of histrionic personality disorder embodiment of extreme stereotypically feminine traits overdramatization vanity seductiveness and overconcern with physical appearance branding someone with extremely feminine traits in histrionic personality disorder reflects society s inherent bias against females there is no macho personality disorder in which the individual possesses stereotypically masculine traits diagnosing a personality disorder look at outward behaviors and internal experiences look at what s normal or abnormal based on your culture different diagnoses based on different cultural norms a pattern of inner experience behavior that deviates from expectations of the individual s culture in 2 or more of the following ways cognition affect interpersonal functioning impulse control the pattern is inflexible and pervasive across a broad range of personal and social situations the pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood clinically significant distress or impairment biological contributions are often unclear clusters of PDs A Odd Eccentric B Dramatic Emotional or Erratic C Anxious or Fearful Cluster A causes paranoid personality disorder pervasive and unjustified mistrust and suspicion biological and psychological contributions are unclear theory early learning that people and world are dangerous you can t trust people around you at least 4 of the following suspects that others are exploiting harming or deceiving them everyone is out to get you preoccupation w doubts about loyalty trustworthiness of friends and associates reluctance to confide in others fears that info will be used against them reads hidden threatening meanings into benign events bears grudges is unforgiving perceives attacks on character or reputation and is quick to counterattack suspicious of fidelity of sexual partner self view vulnerable view of others adversaries threat everyone affect hostile anxious dysphoric beliefs core beliefs the world is threatening and I must protect myself I can only rely on myself and no one else strategy don t trust anyone social isolation take jobs where you can be socially isolated events that have nothing to do with them are interpreted as personal attacks ideas of reference think everything is about them very few would seek help on their own either they are seeking help for another problem or someone is pushing them to get treatment related to schizophrenia higher proportion of people in their family have schizophrenia than in families where no one has a personality disorder more common in men genetics plays a role in the disorder retrospective research suggests that early mistreatment or traumatic childhood experiences may play a role in the development of the disorder but this has to be taken w a grain of salt b c it is the patients themselves describing this some psychologists theorize that the reason these people have mistaken perceptions of people is b c their parents taught them to be careful about making mistakes and that they were different from others and this vigilance caused them to see signs that others were deceptive and malicious treatment developing trust engaging in exercises to feel vulnerable in a situation CBT dynamic therapy working to better understand trust however treatments are largely unsuccessful b c these people don t trust their therapists and may quit therapy schizoid personality disorder pervasive pattern of detachment from social relationships very limited range of emotions in interpersonal situations relationship btwn shyness in childhood and schizoid personality disorder in adulthood but cause is pretty much unknown little interest in any sensually pleasing experience even walking on a beach feeling sand in your toes some symptoms look similar to autism spectrum disorder parents with children of autism are more likely to have schizoid personality disorder abuse and