Personality disorders DSM-IV: “A Personality Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” Cluster ACluster BCluster C odd/eccentricdramatic/erraticanxious/fearful ParanoidAntisocialAvoidant SchizoidBorderlineDependent SchizotypalHistrionicObsessive-compulsive Narcissistic

Personality disorders: Diagnostic criteria for Narcissistic PD A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1.has a grandiose sense of self-importance (exaggerates achievements and talents, expects to be recognized as superior without commensurate achievement.) 2.is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love 3.believes that he or she is ‘special’ and unique and can only be understood by, or should associate with, other special or high-status people 4.requires excessive admiration 5.has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations 6.is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends 7.lacks empathy: is unwilling to recognize or identify with the feelings and needs of others 8.is often envious of others or believes that others are envious of him or her 9.shows arrogant, haughty behaviors or attitudes

Personality disorders: Diagnostic criteria for Antisocial PD A.A pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by 3 or more of the following: 1.failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest (destroying property, harassing others, stealing). 2.deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure 3.impulsivity or failure to plan ahead (making decisions on the spur of the moment) 4.irritability and aggressiveness, as indicated by repeated physical fights or assaults 5.reckless disregard for the safety of self or others 6.consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations 7.lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another B/C. At least 18 years old, with conduct disorder before age 15

Personality disorders: Questions and assumptions (Morey, Vanderbilt) 1.Personality disorders are evident early in life 2.Personality disorders are relatively stable over time 3.Personality disorders are relatively stable over situations 4.Personality disorders are ego-syntonic (i.e., not experienced as alien) 5.Personality disorders are distinguished by interpersonal disruption 6.Personality disorders represent extremes of normal personality

Personality disorders: Questions and assumptions 1. Personality disorders are evident early in life Antisocial PD criterion: There is evidence of Conduct Disorder (aggression, destruction of property, deceitfulness/theft, rule violations) before age 15 years. Childhood shyness and withdrawal is characteristic of Schizoid (detachment from social relationships and restricted range of expression of emotions in interpersonal settings) and Schizotypal (social and interpersonal deficits as well as cognitive or perceptual distortions and eccentricities of behavior) PD patients. In general, personality is stable over time in rank order, but less stable in mean levels.

... pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture Roberts & Mroczek, in press People become more socially dominant, agreeable, conscientious, and emotionally stable with age: principle of maturity

Personality disorders: Questions and assumptions 2.Personality disorders are relatively stable over time 3.Personality disorders are relatively stable over situations Personality is stable over time, and so are personality disorders: Treatment studies of Borderline PD (instability of interpersonal relationships, self-image, and affect, and marked impulsivity) found that 44-67% of patients still met criteria for the disorder at 7-15 years post-treatment and despite treatment. Personality is stable over situations when aggregated over many situations - but some criteria employ the if-then profile suggested by Mischel: Histrionic PD (excessive emotionality and attention-seeking): (1) is uncomfortable in situations in which he or she is not the center of attention Avoidant PD (social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation): (2) is unwilling to get involved with people unless certain of being liked

Personality disorders: Questions and assumptions 4.Personality disorders are ego-syntonic (i.e., not experienced as alien) 5.Personality disorders are distinguished by interpersonal disruption “They are often seeking evaluation at someone else’s request. Their presenting complaints often involve the behavior of other people, rather than their own experiences.” Cluster A: distrust and suspiciousness of others (Paranoid PD), detachment from social relationships (Schizoid PD), discomfort with and reduced capacity for close relationships (Schizotypal PD) Cluster B: disregard for and violation of the rights of others (Antisocial PD), instability of interpersonal relationships (Borderline PD), interaction with others characterized by inappropriately seductive or provocative behavior (Histrionic PD), is interpersonally exploitative (Narcissistic PD) Cluster C: social inhibition, unwilling to get involved with others (Avoidant PD), submissive clinging and fears of separation (Dependent PD), preoccupation with interpersonal control (Obsessive-Compulsive PD)

Personality disorders: Questions and assumptions 6.Personality disorders represent extremes of normal personality Personality “disorder” is based on an arbitrary cut point in a continuous distribution of normal personality (Widiger, UK). O: Schizotypal, Histrionic PD (high) Obsessive-Compulsive PD (low) C: Obsessive-Compulsive PD (high) Antisocial PD (low) E: Histrionic, Narcissistic PD (high) Schizoid, Schizotypal, Avoidant (low) A: Dependent PD (high) Antisocial, Narcissistic, Paranoid PD (low) N: Borderline, Avoidant PD, most others (high) Antisocial, Narcissistic PD (low)

Antisocial PD and Psychopathy Psychopaths: “Intraspecies predators who use charm, manipulation, intimidation, and violence to control others and to satisfy their own selfish needs.” Antisocial PD: 3% of men, 1% of women Psychopaths:1% of population, 15-25% of prison population All psychopathy is not created equal: “Factor 2” or secondary psychopathy overlaps with Antisocial PD Poor behavioral controls, impulsive, irresponsible Sexually promiscuous, many short-term relationships Early behavior problems and juvenile delinquency Lack of realistic, long-term goals Criminal versatility

Psychopathy “Factor 1” or primary psychopathy distinguishes psychopaths Grandiose self of self-worth Lack of remorse, guilt, empathy; callous Needs stimulation, prone to boredom Pathological liar, conner Glib, superficially charming Parasitic lifestyle Factor 2 associates (negatively) with SES, education, and IQ and (positively) with substance abuse, but Factor 1 does not Is there such a thing as a successful psychopath?

No sex diff’s Age r = -.19 No sex diff’s Age r = -.12

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