chapter ten personality disorders. clinical features of personality disorders personality disorders...
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Clinical Features of Personality Disorders
Personality disorders
•Chronic interpersonal difficulties
•Problems with identity or sense of self
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Clinical Features of Personality Disorders
DSM criteria include enduring behavior
pattern
Pervasive and inflexible
Stable and of long duration
Clinically significant distress or
impairment in functioning
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Clinical Features of Personality Disorders
Prevalence Ranges from 4.4% to
14.8%
About 75% comorbidity
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Difficulties in Diagnosing Personality Disorders
Diagnostic criteria not sharply defined
Diagnostic categories not mutually exclusive
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Difficulties in Diagnosing Personality Disorders
PDs may represent extreme levels of normal personality
traits
• Histrionic• Dependent• Obsessive-compulsive
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Difficulties in Studying the Causes of Personality Disorders
Limited research on
causal factors
Less amenability to thorough study
Retrospective approaches
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Classifying Personality Disorders
• Cluster A are people who are perceived as odd or eccentric
Includes paranoid, schizoid, and schizotypal personality disorders
Classifying Personality Disorders
Cluster B are people whose behavior is overly dramatic, emotional, or erratic
– Includes antisocial, borderline, histrionic and narcissistic personality disorders
Classifying Personality Disorders
Cluster C are people who often appear anxious or fearful
Includes avoidant, dependent, and obsessive-compulsive personality disorders
Paranoid Personality Disorder (Cluster A)
On guard for perceived attacks by others
Tendency to see self as blameless
Suspiciousness and mistrust of others
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Schizoid Personality Disorder (Cluster A)
Inability and lack of desire to form attachments to others
Impaired social relationships
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Schizotypal Personality Disorder (Cluster A)
Oddities of perception and speech that interfere with communication and social
interaction
Peculiar thought patterns
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Histrionic Personality Disorder(Cluster B)
Irritability and temper outbursts if attention seeking is frustrated
Overconcern with attractiveness
Self-dramatization
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Narcissistic Personality Disorder(Cluster B)
Lack of empathy
Self-promoting
Preoccupation with receiving attention
Grandiosity
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Antisocial Personality Disorder(Cluster B)
History of conduct problems as a child (diagnosis of Conduct Disorder)
Shameless manipulation of others
Deceitfulness
Inability to follow approved models of behavior
Lack of moral or ethical development
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The Clinical Picture in Psychopathy and Antisocial Personality Disorder
Inadequate conscience development
Irresponsible and impulsive behavior
Ability to impress and exploit others
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Causal Factors in Psychopathy and Antisocial Personality
Causal factors • Genetic influences• Low levels of fear; poor conditioning of fear• More general emotional deficits• Early parental loss• Parental rejection• Inconsistent discipline
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Figure 10.4: Family Context and Antisocial Behavior
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Treatments and Outcomes in Psychopathic and Antisocial Personality
Cognitive-behavioral treatments offer some promise
Treatment of psychopaths is
difficult
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Borderline Personality Disorder (Cluster B)
Attempts at self-mutilation or suicide
Chronic feelings of boredom
Drastic mood shifts
Inappropriate anger
Impulsiveness
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Figure 10.1: Multidimensional Diathesis-Stress Theory of Borderline
Personality Disorder
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Avoidant Personality Disorder(Cluster C)
Insecurity in social interaction and initiating relationships
Shyness
Hypersensitivity to rejection or social derogation
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Dependent Personality Disorder(Cluster C)
Indecisiveness
Subordination of needs to keep others involved in a relationship
Discomfort at being alone
Difficulty in separating in relationships
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Obsessive-Compulsive Personality Disorder (Cluster C)
Difficulty in relaxing and having fun
Lack of expressiveness and warmth
Perfectionism
Excessive concern with order, rules, and trivial details
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Treatments and Outcomes for Personality Disorders
Difficulties
Clients resistance to
change
Relationships formation
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Treating Borderline Personality Disorder
Antidepressant medications
(SSRIs)
Dialectical behavior
therapy (DBT)
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Treating Other Personality Disorders
Few controlled studies of treatment
Antipsychotic or antidepressant
medication
Schizotypal PD
Cognitive-behavioral treatment and
antidepressant medication
Avoidant PD
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