1. Personality Disorders
PSYCHOLOGY
MHS
2013
Novemb

2. Personality Traits (you know this part already)
ways of thinking, feeling, and behaving that are stable across time and situations
considered to be a disorder when
Traits break cultural rules
are maladaptive: hurt self / others)
Cause impairment / distress

3. The Diagnostic Question
Are people with personality disorders qualitatively different from people without? OR
Are people with PD individuals who have extreme versions of otherwise normal traits?
Answer:
Think of PD as extreme positions on one or more personality dimensions

4. Course: how does it work out?
thought to originate in childhood and continue into adulthood
believed to be relatively stable, difficult to treat

5. Conduct Disorder: Aggression to people and animals
bullies, often initiates physical fights
is physically cruel to people or animals
forces someone into sexual activity
Destruction of Property
deliberately sets fires with intention to cause damage
deliberately destroys other's property
Deceitfulness, lying, or stealing
has broken into someone's building, house, or car
lies to obtain goods, favors or avoid obligations
steals items without confronting a victim (e.g. shoplifting)
Serious violations of rules
often stays out at night despite parent objections
runs away from home, truant from school

6. Conduct Disorder (Cont.)
Prior to age 15
Comorbid with:
mood disorders,
anxiety, PTSD,
substance abuse,
ADHD, learning problems
Problems present for all kids involved in substance abuse… but the problems go away after substance abuse stops.

7. Classifying PDs: 3 groups
Classifies in 3 clusters:
Cluster A Odd/Eccentric
Cluster B Dramatic/Erratic
Cluster C Anxious/Fearful
Test-retest reliability (diagnostic stability)
½ of those initially diagnosed with PD did not receive same diagnosis 1 year later (Shea et al., 2002)

8. DSM-IV-TR Personality Disorders
Paranoid PD
Schizoid PD
Schizotypal PD
Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD
Avoidant PD
Dependent PD
Obsessive-Compulsive PD

9. A) Paranoid PD (distrustful)
Suspicious of others – reluctant to confide
Questions loyalty
Expects to be mistreated / exploited
Sees hidden messages in benign comments
Blames others when things go wrong
No hallucinations

10. A) Schizoid PD (‘loners’)
Avoids close interpersonal relationships
Few or no close friends
Detached, distant… called ‘loners’
No apparent need of friends, sex
Focus on inner / solitary activities
Rarely report strong emotions
Anhedonia (no pleasure from activities)
Seem to be missing the “human part”

11. A) Schizotypal PD Interpersonal difficulties similar to schizoid
Odd beliefs or magical thinking
Superstitious
Telepathic
Illusions
Feels the presence of a force or person not actually present.
Odd/eccentric behavior or appearance
Wears strange clothes
Talks to self
Distant cousin of schizophrenia?  highly heritable

12. B) Antisocial PD (psychopath, sociopath)
Pervasive disregard for the rights of others since age 15
Lies
Aggression
Impulsiveness
Violates the law
Irresponsible
Lack of remorse
Conduct disorder before age 15
Truancy, running away, lying, theft, arson, destruction of property
Substance abuse common co-morbid disorder

13. ASPD and Emotion
Low levels of skin conductance – sweat: Sympathetic NS: evidence of lack of fear/anxiety
Skin conductance reactivity at age 3 predicted APD at age 28 (Glenn et al., 2007)
Difficult to avoid beh. that leads to punishment :
Show less SCR to other’s distress
Lack empathy

14. B) Borderline PD Emotional reactivity
Unstable, stormy, intense relationships
Frantic efforts to avoid abandonment
Impulsive, self-damaging behaviors
Unstable sense of self
Anger control problems
Chronic feelings of emptiness
Recurrent suicidal gestures

15. BPD Genetic component Decreased function of serotonin
Highly heritable
Role in impulsivity and emotional dysregulation
Decreased function of serotonin
Frontal lobe dysfunction
Increased activation of amygdala
Socio-Environmental Causes?
Parental separation
Verbal and emotional abuse during childhood

16. B) Histrionic PD (hysterical)
Excessive emotional displays
“dramatic” behaviour
Craves attention, victim stance
Seeks re-assurance, praise
easily influenced by others
Emotionally shallow despite strong emotions
Very concerned with physical attractiveness
Seductive, provocative, “life of the party”

17. B) Narcissistic PD Grandiose view of self Self-centered
Preoccupied with fantasies of success
Self-centered
Demands attention and adulation
Feelings of entitlement and arrogance
Envious of others
Little concern for needs and well being of others
Lacks empathy
Hypersensitive to criticism
Seeks out high-status partners

18. C) Avoidant PD Avoids interpersonal situations
Fears criticism or rejection
Hesitant about involvement with others
Wants to be certain of acceptance
Restrained and inhibited in interpersonal situations
Fears ridicule
Feelings of inadequacy
Avoids taking risks or trying new activities
Doesn’t want to risk embarrassment

19. C) Dependent PD Lack of self confidence Excessive reliance on others
Intense need to be cared for
Uncomfortable when alone
Behavior focused on maintaining relationships
Quickly initiates new relationship if current one fails

20. C) Obsessive-Compulsive Personality Disorder
A perfectionist
Preoccupied with rules, details, & organization
Rigid and inflexible
Overly focused on work
Little time for leisure, family, & friends
Tendency to hoard
Difficulty discarding worthless items
Reluctant to delegate
Moral inflexibility
Does not have the obsessions/compulsions of OCD