Lab 10: Personality Disorders Lab 10: Personality Disorders

Personality Disorders: Axis II of the DSM - they are seen as longstanding, pervasive and inflexible patterns of behaviour and inner experience Axis II of the DSM - they are seen as longstanding, pervasive and inflexible patterns of behaviour and inner experience Deviate from the expectations of the persons culture Deviate from the expectations of the persons culture Impair social and occupational functioning Impair social and occupational functioning Some, but not all, can cause emotional distress Some, but not all, can cause emotional distress

Video #2: Antisocial Personality vs Psychopathy Does he meet criteria for Antisocial Personality Disorder? Does he meet criteria for Antisocial Personality Disorder? Does he show any remorse or empathy when describing his offending? Does he show any remorse or empathy when describing his offending? Does he meet criteria for being a ‘psychopath’ Does he meet criteria for being a ‘psychopath’ What are your overall impressions of this person? What are your overall impressions of this person?

DSM IV Criteria Antisocial Personality Disorder A) Pervasive pattern of disregard for and violation of the rights of others occuring since 15yrs as indicated by 3 or more of the following: A) Pervasive pattern of disregard for and violation of the rights of others occuring since 15yrs as indicated by 3 or more of the following: 1) Failure to conform to social norms with respect fo lawful behaviours i.e repeatedly arrested 1) Failure to conform to social norms with respect fo lawful behaviours i.e repeatedly arrested 2) Decietfulness 2) Decietfulness 3) Impulsivity or failure to plan ahead 3) Impulsivity or failure to plan ahead 4) Irritability and aggressiveness 4) Irritability and aggressiveness 5) Reckless disregard for safety of self or others 5) Reckless disregard for safety of self or others

APD criteria cont.. 6) Constant irresponsibility 6) Constant irresponsibility 7) Lack of remorse, indifferent or rationalizing to having hurt others 7) Lack of remorse, indifferent or rationalizing to having hurt others B) At least 18 years of age B) At least 18 years of age C) Evidence of Conduct Disorder with onset before 15 yrs of age C) Evidence of Conduct Disorder with onset before 15 yrs of age D) Antisocial behaviours not only during Schizophrenia or a manic episode. D) Antisocial behaviours not only during Schizophrenia or a manic episode.

Criteria for Psychopathy No DSM criteria No DSM criteria Literature (Cleckly, Hare) indicates psychopaths have a lack of both positive and negative emotions, no sense of shame, positive feelings mearly an act, superficially charming, manipulates others for personal gain, lack of negative emotions, don’t learn from mistakes, no empathy or consideration of others, acts for the thrill of it. Literature (Cleckly, Hare) indicates psychopaths have a lack of both positive and negative emotions, no sense of shame, positive feelings mearly an act, superficially charming, manipulates others for personal gain, lack of negative emotions, don’t learn from mistakes, no empathy or consideration of others, acts for the thrill of it. Similar but inflated elements of APD diagnosis Similar but inflated elements of APD diagnosis

Hare’s PCL-R item groupings Factor 1: Interpersonal or Affective Factor 1: Interpersonal or Affective - Glibness or superficial charm - Grandiose sense of self-worth - Pathological Lying - Conning or manipulative - Lack of remorse or guilt - Shallow affect - Callous or lack of empathy - Failure to accept responsibility for actions

Hare’s PCL-R cont… Factor 2: Social Devience Factor 2: Social Devience Proneness to boredom Proneness to boredom Parasitic lifestyle Parasitic lifestyle Poor behavioural controls Poor behavioural controls Early behavioural problems Early behavioural problems Lack of realistic long-term goals Lack of realistic long-term goals Impulsivity Impulsivity Irresponsiblity Irresponsiblity Juvenile delinquency Juvenile delinquency Revocation of conditional release Revocation of conditional release

Hare’s PCL-R cont…. Additional Items Additional Items - Promiscuous sexual behaviour - Many short-term marital relationships - Criminal versatility

Video Clip #2: Antisocial Personality Disorder What criteria does this person meet for APD? What criteria does this person meet for APD? What impact has this man’s personality had on his life? What impact has this man’s personality had on his life? What early experiences seem significant as possible predisposing/precipitating factors? What early experiences seem significant as possible predisposing/precipitating factors? Does this man seem remorseful when describing his offending? Does this man seem remorseful when describing his offending? What differences do you see between this clip and the one shown previously? What differences do you see between this clip and the one shown previously?

Party full of People exhibiting Personality Disorders What type of personality disorder does each person at the party show? What type of personality disorder does each person at the party show? What does this exercise show about stereotyping? What does this exercise show about stereotyping? You might know some people like this – can you explain the continuim approach to personality? You might know some people like this – can you explain the continuim approach to personality?

Possible Diagnosis of People at the Party Donna – Histrionic Personality Disorder Donna – Histrionic Personality Disorder William – Schizotypal Personality Disorder William – Schizotypal Personality Disorder Sherry – Borderline PD Sherry – Borderline PD Winston – Narcissistic PD Winston – Narcissistic PD Peter – Obsessive Compulsive PD Peter – Obsessive Compulsive PD Doreen – Paranoid PD Doreen – Paranoid PD Margie – Avoidant PD Margie – Avoidant PD Harold – Schizoid PD Harold – Schizoid PD

Case: Blood is Thicker Than Water Dependent PD – described as lacking self confidence and self reliance, passively allow other to take responsibility of decisions for them, intense need to be taken care of, feel uncomfortable when alone, preocupied with fears of being left alone to take care of themselves, unable to make demands on others. Dependent PD – described as lacking self confidence and self reliance, passively allow other to take responsibility of decisions for them, intense need to be taken care of, feel uncomfortable when alone, preocupied with fears of being left alone to take care of themselves, unable to make demands on others.

Case: Blood is Thicker than Water In what way is this person expriencing social or occupational disruptions in functioning? In what way is this person expriencing social or occupational disruptions in functioning? What about this set of symptoms is pervasive, longstanding and inflexible? What about this set of symptoms is pervasive, longstanding and inflexible? Is it causing the person emotional distress? Is it causing the person emotional distress? Does his behaviour deviate from what is expected in your culture? Does his behaviour deviate from what is expected in your culture?

Case – The Workaholic Compulsive PD – perfectionist, preoccupied with details, rules and schedules, often pay so much attention that they fail to finish projects, work rather than pleasure orientated, have difficulty making decisions and allocating time in case they make a mistake, stubborn and demanding, serious, rigid, formal and inflexible, usually miserly or stingy, can’t throw things away. Compulsive PD – perfectionist, preoccupied with details, rules and schedules, often pay so much attention that they fail to finish projects, work rather than pleasure orientated, have difficulty making decisions and allocating time in case they make a mistake, stubborn and demanding, serious, rigid, formal and inflexible, usually miserly or stingy, can’t throw things away.

Case - Workaholic In what way is this person expriencing social or occupational disruptions in functioning? In what way is this person expriencing social or occupational disruptions in functioning? What about this set of symptoms is pervasive, longstanding and inflexible? What about this set of symptoms is pervasive, longstanding and inflexible? Is it causing the person emotional distress? Is it causing the person emotional distress? Does his behaviour deviate from what is expected in your culture? Does his behaviour deviate from what is expected in your culture?