1. Personality Disorders

2. Features of Personality Disorders  Early onset  Evident at least since late adolescence  Stability  No significant period when not evident  Pervasive  Evident across a wide range of personal, social, and occupational situations  Clinically significant impairment  Personal distress or impairment in social and occupational functioning

3. Classifying Personality Disorders  Personality disorders are long-standing, maladaptive, inflexible ways of relating to the environment.  Diagnosed on AXIS-II of the DSM-IV.  Three categories:  Odd or eccentric behavior  Dramatic, emotional, or erratic behavior  Anxious or fearful behavior

4. Odd or Eccentric Behavior  Paranoid personality disorder  Suspicious or mistrusting of others  Hypersensitive  Schizoid personality disorder  Withdrawn and reclusive  Not interested in relationships with other  Schizotypal personality disorder  Odd ways of thinking, perceiving, communicating, and behaving  May be a weak form of schizophrenia

5. Dramatic, Emotional or Erratic Behavior  Histrionic Personality Disorder  Self-centered and manipulative  Have stormy relationships  Narcissistic Personality Disorder  Extreme sense of self-importance, yet with fragile self-esteem  Need for constant attention, lack of empathy for others

6. Dramatic, Emotional or Erratic Behavior (Continued)  Borderline Personality Disorder  Threaten and engage in self-destructive behavior  Impulsive  Unstable relationships, dependency on and manipulation of others  Antisocial Personality Disorder  Chronic behavior that violates others’ rights and which began before the age of 15  Likely to be reckless and sexually promiscuous  Lack of remorse for hurting others

7. Anxious or Fearful Behavior  Avoidant Personality Disorder  Low-self esteem  Worry about negative evaluation by others, but desire affection and relationships  Avoid social interaction  Dependent Personality Disorder  Lack confidence in ability to function independently  Subordinate their needs to wishes of others to maintain relationship  Obsessive-Compulsive Personality Disorder  Extreme perfectionism  Rigid approach to doing things  Lack of ability to express warm emotions

8. Risk Factors for Personality Disorders  Genetic vulnerability  Disturbed early relationship with parent  Some have been physically or sexually abused  “Splitting” - Failure to integrate positive and negative experiences that occur between individual and other people

9. Features of Borderline Personality Disorder

10. Treatment of Borderline Personality Disorder  Identify its most distinctive features  Psychodynamic therapy (largely ineffective)  Cognitive- behavioral therapy (Dialectical Behavior Therapy)  Biological – Medication  Combination of approaches is most effective  Long-term prognosis is poor, though some improve  Risk for alcoholism  High suicide risk – 8 to 10% commit suicide; far more attempt suicide or engage in parasuicidal behaviors.

11. Characteristics of Antisocial Subjects

12. Risk factors for Antisocial Personality Disorder  Family history – Heredity  Neurochemistry- Low levels of serotonin  Brain activity – Low arousal levels  Low anxiety levels  Childhood history of conduct disorder  Poor socialization  Deficits in moral development

13. Treatment of Antisocial Personality Disorder  Traditional psychotherapy not effective  Highly structured, residential treatment, especially in correctional settings, can be effective.  Structured community alternatives to prison have some effect.  Prognosis is poor; generally patterns reduce in severity over time.