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Personality Disorders

What is personality?persoality

  • Personality is a set of uniquely expressed characteristics that influence our behaviors, emotions, thoughts, and interactions
  • Particular characteristics – called traits – lead us to react in fairly predictable ways as we move through life
  • Personality is also flexible, allowing us to learn and adapt to new environments
  • For those with personality disorders, however, that flexibility is usually missing

What is Personality Disorder:

  • An enduring, rigid pattern of inner experience and outward behavior that impairs sense of self, emotional experience, goals, and capacity for empathy and/or intimacy
  • The rigid traits of people with personality disorders often lead to psychological pain for the individual or others

A class of mental disorders characterized by rigid, long-term patterns of inflexible and maladaptive behavior that keep a person from functioning appropriately in society

There are 10 specific types of personality disorders. Common to all personality disorders is a long-term pattern of behavior and inner experience that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood, and causes distress or problems in functioning. Without treatment, the behavior and experience is inflexible and usually long-lasting. The pattern is seen in at least two of these areas:

  • Way of thinking about oneself and others
  • Way of responding emotionally
  • Way of relating to other people
  • Way of controlling one’s behavior

The APA identifies 10 specific personality disorders are grouped into three categories called “clusters”.

Cluster A: odd or eccentric behavior

  • Paranoid personality disorder: a pattern of distrust and suspiciousness where others’ motives are seen as mean or spiteful. People with paranoid personality disorder often assume people will harm or deceive them and are reluctant to confide in others or become close to them.
  • Schizoid personality disorder: a pattern of detachment from social relationships and a limited range of emotional expression. A person with schizoid personality disorder typically does not seek close relationships, chooses solitary activities and appears indifferent to praise or criticism from others.
  • Schizotypal personality disorder: a pattern of acute discomfort in close relationships, distortions in thinking or perception, and eccentric behavior. A person with schizotypal personality disorder may have odd beliefs or magical thinking, odd or peculiar behavior or speech, or may incorrectly attribute meanings to events.

Cluster B: dramatic, emotional or erratic behavior

  • Antisocial personality disorder: a pattern of disregarding or violating the rights of others. A person with antisocial personality disorder may not conform to social norms, may repeatedly lie or deceive others, or may act impulsively.
  • Borderline personality disorder: a pattern of instability in personal relationships, emotional response, self-image and impulsivity. A person with borderline personality disorder may go to great lengths to avoid abandonment (real or perceived), have recurrent suicidal behavior, display inappropriate intense anger or have chronic feelings of emptiness.
  • Histrionic personality disorder: a pattern of excessive emotion and attention seeking. A person with histrionic personality disorder may be uncomfortable when he/she is not the center of attention, consistently use physical appearance to draw attention or show rapidly shifting or exaggerated emotions.
  • Narcissistic personality disorder: a pattern of need for admiration and lack of empathy for others. A person with narcissistic personality disorder may have a grandiose sense of self-importance, a sense of entitlement, take advantage of others or lack empathy.

Cluster C: anxious or fearful behavior

  • Avoidant personality disorder: a pattern of social inhibition, feelings of inadequacy and extreme sensitivity to criticism. A person with avoidant personality disorder may be unwilling to get involved with people unless he/she is certain of being liked, be preoccupied with being criticized or rejected, or may view himself/herself as being inferior or socially inept.
  • Dependent personality disorder: a pattern of needing to be taken care of and submissive and clingy behavior. A person with dependent personality disorder may have difficulty making daily decisions without reassurance from others or may feel uncomfortable or helpless when alone because of fear of inability to take care of himself or herself.
  • Obsessive-compulsive personality disorder: a pattern of preoccupation with orderliness, perfectionism and control. A person with obsessive-compulsive personality disorder may be preoccupied with details or schedules, may work excessively to the exclusion of leisure or friendships, or may be inflexible in morality and values. (This is NOT the same as obsessive compulsive disorder)

Diagnosis of a personality disorder requires a mental health professional looking at long-term patterns of functioning and symptoms. For a person under 18 years old to be diagnosed, the symptoms must have been present for at least a year. Some people with personality disorders may not recognize a problem. Also, people often have more than one personality disorder. An estimated 9 percent of U.S. adults have at least one personality disorder (APA, 2016) .

Classifying Personality Disorders

A personality disorder typically becomes recognizable in adolescence or early adulthood

  • These are among the most difficult psychological disorders to treat
  • Many sufferers are not even aware of their personality problems
  • It has been estimated that 9% to 13% of all adults may have a personality disorder

It is common for a person with a personality disorder to also suffer from another disorder, a relationship called comorbidity

  • Whatever the reason for this relationship, research indicates that the presence of a personality disorder complicates a person’s chances for a successful recovery from other psychological problems

personality disorder

This DSM listing is called a categorical approach

  • It assumes that:
  • Problematic personality traits are either present or absent
  • A personality disorder is either displayed or not
  • A person who suffers from a personality disorder is not markedly troubled by personality traits outside of that disorder
  • It turns out, however, that these assumptions are frequently contradicted in clinical practice

In fact, the symptom of the personality disorders overlap each other so much that it can be difficult to distinguish one from another

  • In addition, diagnosticians sometimes determine that particular individuals have more than one personality disorder
  • This lack of agreement has raised concerns about the validity (accuracy) and reliability (consistency) of these categories

As a result, many theorists have challenged the use of a categorical approach

  • They believe that these disorders differ more in degree than in type of dysfunction – called a dimensional approach
  • In a dimensional approach, each trait is seem as varying along a continuum extending from nonproblematic to extremely problematic

Given the inadequacies of a categorical approach and the enthusiasm for a dimensional one, the framers of DSM-5 initially proposed significant changes

  • This proposal was met with enormous concern and criticism in the clinical field, leading to a reversion back to the categorical approach
  • The newly proposed dimensional approach is now assigned “for further study”

Personality Disorder Types: Dramatic/Impulsive

Antisocial:

A disregard for social rules, norms, and cultural codes, charactized by

  • Impulsive behavior
  • Indifference to the rights and feelings of others
  • Beginning in childhood and continuing past age 18

Histrionic:

Excessive, dramatic, emotional reactions and attention seeking

  • often sexually provocative
  • highly impressionable and suggestible
  • out of touch with negative feelings

Narcissistic:

  • Grandiose fantasies or behavior, lack of empathy, and oversensitivity to evaluation; constant need for admiration from others; proud self-display

Borderline:

  • Pattern of severe instability of self-image, interpersonal relationships, emotions
  • often expressing alternating extremes of love and hatred toward the same person
  • High frequency of manipulative suicidal behavior

Personality Disorder Types: Anxious/Fearful

Avoidant:

  • Extreme social discomfort and timidity
  • feelings of inadequacy
  • fearfulness of being negatively evaluated

Dependent:

  • Extreme submissive and dependent behavior
  • Fears of separation from those who satisfy dependency needs

Obsessive-Compulsive:

  • Extreme perfectionism, orderliness, and inflexibility
  • preoccupied with mental and interpersonal control

Personality Disorder Types: Odd/Eccentric

Schizoid:

  • Indifference to social relationships and experience; displays a restricted range of expressed emotions

Schizotypal:

  • Odd thoughts, appearance, and behavior; extreme discomfort in social situations

Paranoid:

  • An unwarranted tendency to interpret the behavior of other people as threatening, exploiting, or harmful

Causes of Personality Disorders

Psychoanalytic:

Antisocial neurosis caused by a person having not properly developed the superego (the conscience)

Biological:

Created through genetics and physiological factors

Behavioral:
Learned via reinforcement; may be triggered by a loss or some other punishing event

Cognitive:

A person’s perceptions, thoughts, or self-statements cause feelings of worthlessness and inadequacy

Family Issues:

Caused from our surrounding culture, family, friends, and the presence or absence of a strong social-support network when dealing with negative factors

 

References:
Bernstein, D.A. & Nash, P.W. (2008). Essentials of psychology (4th ed.) Boston: Houghton Mifflin Company.
Comer, R.J. (2013). Abnormal Psychology (8th ed).  Worth Publishers
Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
Feldman, R. (2013). Essentials of understanding psychology (11th ed.). New York, NY: McGraw-Hill.
Friedman, H.S. & Schustack, M.W. (2012), Personality: classic theories and modern research (5th ed). Boston: Pearson Allyn & Bacon.
McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
Ryckman, R. M. (2013). Theories of personality (10th ed.). Mason, OH: Cengage Learning.
Sue,Sue, and Sue (2014).  Understanding Abnormal Behavior (10th Ed), Cengage Learning

 

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