1. Personality Disorders

2. Personality Disorders
Long-standing patterns of thought, behavior, and emotions that are maladaptive for the individual or for people around him or her.

3. DSM-IV-TR Personality Disorders
Cluster A: Odd-Eccentric Personality Disorders
Symptoms similar to those for schizophrenia, including inappropriate or flat affect, odd thought and speech patterns, paranoia. People with these disorders maintain their grasp on reality, however.
Cluster B: Dramatic Emotional Personality Disorders
Manipulative, volatile, and uncaring in social relationships. Impulsive, sometimes violent behavior that show little regard for their own safety or the safety or needs of others
Cluster C: Anxious-Fearful Personality Disorders
Extremely concerned about being criticized or abandoned by others and thus have dysfunctional relationships with them.

4. Problems with the DSM-IV-TR Categories
Symptoms described are often only extreme versions of otherwise “normal” traits.
Overlap in the diagnostic criteria and the majority of people who are diagnosed with one disorder tend to meet the diagnostic criteria for at least one other personality disorder.
Diagnosing a personality disorder often requires information that is hard for a clinician to obtain.
Conceptualized as stable characteristics, yet they vary, so individuals go in and out of the diagnosis

5. Cluster A: The Odd-Eccentric Personality Disorders
Paranoid personality disorder Chronic and pervasive mistrust and suspicion of other people that is unwarranted and maladaptive.
Schizoid personality disorder Chronic lack of interest in and avoidance of interpersonal relationships, emotional coldness toward others.
Schizotypal personality disorder Chronic pattern of inhibited or inappropriate emotion and social behavior, aberrant cognitions, disorganized speech.
Weak
Strong
Relationship to Schizophrenia

6. Cluster B: Dramatic Emotional Personality Disorders
Antisocial personality disorder
Pervasive pattern of criminal, impulsive, callous, or ruthless behavior; disregard for rights of others; no respect for social norms. One of the most common of the personality disorders and one of the most difficult to treat.
Borderline personality disorder
Rapidly shifting and unstable mood, self-concept, and interpersonal relationships; impulsive.
Histrionic personality disorder
Rapidly shifting moods, unstable relationships, and intense need for attention and approval; dramatic, seductive behavior.
Narcissistic personality disorder
Grandiose thoughts and feelings of one’s own worth; obliviousness to others’ needs.

7. Cluster B: Dramatic Emotional Personality Disorders
Borderline Personality Disorder:
Clips from Marsha Linehan’s DVD
Clips from Fatal Attraction

8. Antisocial Personality Disorder
Video clips (World of Ab Psych video – Program 5, 18:45 – 37:00)
Pervasive pattern of disregard for and violation of the rights of others, as indicated by three or more of:
Failure to conform to social norms re: lawful behavior
Deceitfulness
Impulsivity / failure to plan ahead
Aggressiveness / irritability
Reckless disregard for safety of self or others
Consistent irresponsibility
Lack of remorse

9. Contributors to Antisocial Personality Disorder
Interactive model (biological – environmental)
Biological
Genetic predisposition (only a modest contribution)
Testosterone (evidence?)
Serotonin (low levels associated with impulsivity and aggression)
ADHD? (correlation vs. causation)
Executive functions (deficits in planful behavior) – structural hypofrontality?
Arousability (low): fearlessness and/or stimulation-seeking
Environmental factors (next slide)

10. Contributors to Antisocial Personality Disorder and Violence
Environmental factors (Patterson, 2008)
Patterson, G., (2008) in Perspectives on Psychological Science

11. Contributors to Violence
Violent behavior is controlled by its consequences.
Extensive training precedes the violent act. In the societal model (i.e., war), the training is planned, whereas in the individual model the training by parents and peers is inadvertent.

12. Contributors to Violence
In both domains, the training is such that the overlearned violent act becomes automatic. For example, the violent individual who physically assaults his wife has a prior history of thousands of reinforcers for a wide variety of antisocial behaviors.
Peers are thought to play a key role in providing reinforcers for violence related behaviors.

13. Prevention
Reducing the relative rate of reinforcement would be associated with reductions in violence. To date, there is empirical support for this assertion as it applies to individual acts.
Behavioral approaches to classroom management
Improving parenting skills/practices

14. Treatment of ASPD and/or violent offenders
Difficult… Why?
Most don’t seek treatment
Those that do have a long history of antisocial acts to “unlearn”
Victim empathy training

15. Cluster C: The Anxious-Fearful Personality Disorders
Avoidant personality disorder
Pervasive anxiety, a sense of inadequacy, and a fear of being criticized, which leads to the avoidance of social interactions and nervousness.
Dependent personality disorder: Pervasive selflessness, need to be cared for, fear of rejection, leading to total dependence on and submission to others. .
Obsessive-compulsive personality disorder Pervasive rigidity in one’s activities and interpersonal relationships, including emotional construction, extreme perfectionism, and anxiety about even minor disruptions in one’s routine.