personality disorders. definitions personality trait –a stable, recurring pattern of human...

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Personality Disorders

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Page 1: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Personality Disorders

Page 2: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Definitions

• Personality trait– a stable, recurring pattern of human behavior

• Personality type– a constellation of personality traits– recognizable as a frequent and familiar

combination

Page 3: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Definitions

• Personality disorder– a constellation of personality traits that are

• Inflexible

• Maladaptive

• lead to difficulties in work or interpersonal relations, subjective distress, and usually both. (Global Criteria)

Page 4: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Why Should We Care?

…as doctors

Page 5: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Presentation

• In Medical Settings– doctor-patient relationship– Noncompliance– Difficulty coping

• Hospitalization

• Disability

• medical restrictions

Page 6: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Presentation

• In the Family– Marital conflicts– Sexual dysfunction– Child rearing– Domestic violence

Page 7: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Presentation

• Within the individual– Anxiety– Depression– External problems/losses

• resulting from maladaptive behavior• Divorce• job loss• legal troubles• poor outcome from a medical condition• When circumstances prevent living according to usual

personality style

Page 8: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Comorbidity

Page 9: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Making a Personality Diagnosis

• Collateral sources

• Social and developmental history

• Personality tests (ex. MMPI)

• current strengths and weaknesses

Page 10: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Speculations on Etiology

Page 11: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

DSM-IV Personality disorders

PCategoricalPArranged by clusters

Page 12: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

The Clusters

PA: OddPB: DramaticPC: Anxious

Page 13: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

A: The Odd Cluster

PParanoidPSchizoidPSchizotypal

Page 14: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

B: The Dramatic Cluster

PNarcissisticPAntisocialPBorderlinePHistrionic

Page 15: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

C: The Anxious Cluster

PAvoidantPObsessive-CompulsivePDependent

Page 16: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

The Odd Cluster

Page 17: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Paranoid Personality Disorder

• Paranoid personality

• mistrustful of everyone

• but still able to test reality

Page 18: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Schizoid personality

• lacks intimate relationships

• frightened by closeness

• incapable of warmth

• Anxious about any closeness

Page 19: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Schizotypal personality

• odd and eccentric ideas

• influence daily behavior

• but not psychotic

Page 20: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

The Anxious Cluster

Page 21: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Avoidant personality

• Social inhibition

• Feelings of inadequacy

• Hypersensitivity to criticism

Page 22: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Obsessive-Compulsive Personality

• preoccupied w/ work/duty

• not enjoying life

• Often rigid and inflexible

Page 23: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

The Dependent Personality

• clings to stronger person

• Submissive

• seeks help/advice

• anxious when having to make decision

Page 24: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

24

The Dramatic Cluster

• Narcissistic

• Antisocial

• Borderline

• Histrionic

Page 25: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Narcissistic personality

• Exaggerated sense of self-importance, Unrealistic fantasies, Wants recognition for being special

• Arrogant, Entitled, Requires admiration• Exploitative, Unempathic towards others• Envious of others• Unconcerned about effect on others

Page 26: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Antisocial personality

• the "psychopath“

• violates laws/social conventions

• Dishonest

• unconcerned about effect on others

Page 27: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Borderline personality

• emotionally intense

• unstable

• impulsive behavior

• self-destructive

• inner emptiness

• intolerance of being alone

Page 28: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Histrionic personality

• Dramatic

• attention-seeking

• caricature of femininity/masculinity

Page 29: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

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Treatment

Page 30: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Treatment: Psychotherapy

• Acute symptom focused– Ex. Dialectic behavioral therapy

• Fundamental– Focused on changing personality– Long term psychotherapy

Page 31: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Treatment: Pharmacotherapy

• Symptom Focused• Ex.

– Depression

– Anxiety

– Psychosis

• More fundamental treatment?– Forme frustre approach

Page 32: Personality Disorders. Definitions Personality trait –a stable, recurring pattern of human behavior Personality type –a constellation of personality traits

Treatment In Medical Settings

• Identify and treat problems acute symptoms– Separate medical diagnosis from behaviors