1. Abnormal Psychology Oltmanns and Emery Chapter nine personality Disorders presented by: Mani Rafiee

2. SymptomsSymptoms DiagnosisDiagnosis FrequencyFrequency Alternative method in DSM 5Alternative method in DSM 5 Chapter Outline

3. Personality Disorders Personality refers to enduring patterns of thinking and behavior that define the personPersonality refers to enduring patterns of thinking and behavior that define the person Personality disorder:Personality disorder: When enduring patterns of behavior and emotion bring the person into repeated conflict with others When enduring patterns of behavior and emotion bring the person into repeated conflict with others and when they prevent the person from maintaining close relationships with others. and when they prevent the person from maintaining close relationships with others.

4. All of the personality disorders are based on exaggerated personality traits.All of the personality disorders are based on exaggerated personality traits. In order to qualify for a personality disorder diagnosis in DSM a person must fit the general definition of personality disorder (which applies to all 10 subtypes) and must also meet the specific criteria for a particular type of personality disorder.In order to qualify for a personality disorder diagnosis in DSM a person must fit the general definition of personality disorder (which applies to all 10 subtypes) and must also meet the specific criteria for a particular type of personality disorder. Overview

5. duration of the pattern - onset that can be traced back at least to adolescence or early adulthood.duration of the pattern - onset that can be traced back at least to adolescence or early adulthood. and the social impairmentand the social impairment deviates markedly from the expectations of the individual’s culture.”deviates markedly from the expectations of the individual’s culture.” evident in two or more of the following domains:evident in two or more of the following domains: cognition cognition emotional responses emotional responses interpersonal functioning interpersonal functioning impulse control impulse control Overview

6. controversial category in DSMcontroversial category in DSM They are difficult to identify reliablyThey are difficult to identify reliably their etiology is poorly understoodtheir etiology is poorly understood there is relatively little evidence to indicate that they can be treated successfully.there is relatively little evidence to indicate that they can be treated successfully. But it is very important in psychopathologyBut it is very important in psychopathologyOverview

7. Importance of personality disorders:Importance of personality disorders: significant social and occupational impairment.significant social and occupational impairment. risk for the subsequent development of other mental disorders & represent the beginning stages of the onset of a more serious form of psychopathology.risk for the subsequent development of other mental disorders & represent the beginning stages of the onset of a more serious form of psychopathology. the presence of a comorbid personality disorder can interfere with the treatment of a disorderthe presence of a comorbid personality disorder can interfere with the treatment of a disorderOverview

8. Most other forms of mental disorder, such as anxiety disorders and mood disorders, are ego-dystonic; that is, people with these disorders are distressed by their symptoms and uncomfortable with their situations.Most other forms of mental disorder, such as anxiety disorders and mood disorders, are ego-dystonic; that is, people with these disorders are distressed by their symptoms and uncomfortable with their situations. Personality disorders are usually ego-syntonic—the ideas or impulses with which they are associated are acceptable to the person.Personality disorders are usually ego-syntonic—the ideas or impulses with which they are associated are acceptable to the person. We might also say that they do not have insight into the nature of their own problems.We might also say that they do not have insight into the nature of their own problems. assessments based exclusively on self-report may have limited validity.assessments based exclusively on self-report may have limited validity.Overview

9. building blocks of personality :building blocks of personality : Social motivation Social motivation cognitive perspectives regarding the self and others cognitive perspectives regarding the self and others temperament and personality traits. temperament and personality traits.Symptoms

10. Social Motivation The concept of a motive refers to a person’s desires and goals.The concept of a motive refers to a person’s desires and goals. Two of the most important motivesTwo of the most important motives affiliation—the desire for close relationships with other peopleaffiliation—the desire for close relationships with other people power—the desire for impact, prestige, or dominancepower—the desire for impact, prestige, or dominanceSymptoms

11. Temperament and Personality Traits Temperament refers to a person’s most basic, characteristic styles of relating to the world, especially those styles that are evident during the first year of life.Temperament refers to a person’s most basic, characteristic styles of relating to the world, especially those styles that are evident during the first year of life. Experts disagree about the basic dimensions of temperament and personality.Experts disagree about the basic dimensions of temperament and personality. 5 factor model:5 factor model: The basic traits (also known as domains) included in this model are neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness.The basic traits (also known as domains) included in this model are neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness.Symptoms

12. The authors of DSM-IV-TR have organized ten specific forms of personality disorder into three clusters on the basis of broadly defined characteristics.The authors of DSM-IV-TR have organized ten specific forms of personality disorder into three clusters on the basis of broadly defined characteristics.Diagnosis

14. Cluster A: Paranoid, Schizoid, and Schizotypal Personality Disorders The behavior of people who fit the subtypes in this cluster is typically odd, eccentric, or asocial.The behavior of people who fit the subtypes in this cluster is typically odd, eccentric, or asocial. All three types share similarity with the symptoms of schizophrenia.All three types share similarity with the symptoms of schizophrenia.Diagnosis

15. Cluster B: Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders According to DSM these disorders are characterized by dramatic, emotional, or erratic behaviorAccording to DSM these disorders are characterized by dramatic, emotional, or erratic behavior all are associated with marked difficulty in sustaining interpersonal relationships. all are associated with marked difficulty in sustaining interpersonal relationships.Diagnosis

16. Cluster C: Avoidant, Dependent and Obsessive- Compulsive Personality Disorders The common element in all three disorders is presumably anxiety or fearfulness.The common element in all three disorders is presumably anxiety or fearfulness. This description fits most easily with the avoidant and dependent types.This description fits most easily with the avoidant and dependent types. In contrast, obsessive–compulsive personality disorder is more accurately described in terms of preoccupation with rules and with lack of emotional warmth than in terms of anxiety.In contrast, obsessive–compulsive personality disorder is more accurately described in terms of preoccupation with rules and with lack of emotional warmth than in terms of anxiety.Diagnosis

17. A Dimensional Perspective on Personality Disorders There are a lot of people with serious personality problems who do not fit the official DSM-IV-TR subtypes.There are a lot of people with serious personality problems who do not fit the official DSM-IV-TR subtypes. Another frequent complaint about the description of personality disorders is the considerable overlap among categories.Another frequent complaint about the description of personality disorders is the considerable overlap among categories. Many patients meet the criteria for more than one type.Many patients meet the criteria for more than one type.Diagnosis

18. A Dimensional Perspective on Personality Disorders It is cumbersome to list multiple diagnoses, especially when the clinician is already asked to list problems on both Axis I and Axis II.It is cumbersome to list multiple diagnoses, especially when the clinician is already asked to list problems on both Axis I and Axis II. Thus, many experts favor the development of an alternative classification system for PDs, one that would be based on a dimensional view of personality pathology.Thus, many experts favor the development of an alternative classification system for PDs, one that would be based on a dimensional view of personality pathology. One proposal is to use the five-factor model as the basic structure for a comprehensive description of personality problems.One proposal is to use the five-factor model as the basic structure for a comprehensive description of personality problems.Diagnosis

19. Prevalence in Community and Clinical Samples In studies that have examined community based samples of adults, the overall lifetime prevalence for having at least one Axis II disorder (any type) varies between 10 and 14 percent.In studies that have examined community based samples of adults, the overall lifetime prevalence for having at least one Axis II disorder (any type) varies between 10 and 14 percent. Among community samples, the highest prevalence rates are found for obsessive– compulsive personality disorder.Among community samples, the highest prevalence rates are found for obsessive– compulsive personality disorder. The other types vary in prevalence between 1 and 2 percent of the population.The other types vary in prevalence between 1 and 2 percent of the population.Frequency

20. Prevalence in Community and Clinical Samples (continued) The most obvious exception is narcissistic personality disorder, which appears to be the least common form, affecting only 0.2 percent of the population.The most obvious exception is narcissistic personality disorder, which appears to be the least common form, affecting only 0.2 percent of the population. The overall lifetime prevalence rate for antisocial personality disorder was 3 percent.The overall lifetime prevalence rate for antisocial personality disorder was 3 percent. At least 50 percent of people who meet the diagnostic criteria for one personality disorder also meet the criteria for another personality disorder.At least 50 percent of people who meet the diagnostic criteria for one personality disorder also meet the criteria for another personality disorder.Frequency

21. Copyright © Prentice Hall 2007 Prevalence in Community and Clinical Samples (continued) There is also extensive overlap between personality disorders and disorders that are diagnosed on Axis I of DSM-IV-TR.There is also extensive overlap between personality disorders and disorders that are diagnosed on Axis I of DSM-IV-TR. Approximately 75 percent of people who qualify for a diagnosis on Axis II also meet criteria for a syndrome such as major depression, substance dependence, or an anxiety disorder.Approximately 75 percent of people who qualify for a diagnosis on Axis II also meet criteria for a syndrome such as major depression, substance dependence, or an anxiety disorder.Frequency

22. Gender Differences The overall prevalence of personality disorders is approximately equal in men and women.The overall prevalence of personality disorders is approximately equal in men and women. Antisocial personality disorder is unquestionably much more common among men than among women.Antisocial personality disorder is unquestionably much more common among men than among women. Borderline personality disorder and dependent personality disorder may be somewhat more prevalent among women than men, but the evidence is not strong.Borderline personality disorder and dependent personality disorder may be somewhat more prevalent among women than men, but the evidence is not strong.Frequency

23. Stability of Personality Disorders over Time In one study the best predictor of an adult diagnosis of antisocial personality was conduct disorder in childhood.In one study the best predictor of an adult diagnosis of antisocial personality was conduct disorder in childhood. Another longitudinal study has collected information regarding the prevalence and stability of personality disorders among adolescents.Another longitudinal study has collected information regarding the prevalence and stability of personality disorders among adolescents.Frequency

24. Stability of Personality Disorders over Time (continued) Several studies have examined the stability of personality disorders among people who have received professional treatment for their problems, especially those who have been hospitalized for schizotypal or borderline disorders.Several studies have examined the stability of personality disorders among people who have received professional treatment for their problems, especially those who have been hospitalized for schizotypal or borderline disorders. Recovery rates are relatively high among patients with a diagnosis of borderline personality disorder.Recovery rates are relatively high among patients with a diagnosis of borderline personality disorder.Frequency

25. Culture and Personality In DSM-IV-TR, personality disorders are defined in terms of behavior that “deviates markedly from the expectations of the individual’s culture.”In DSM-IV-TR, personality disorders are defined in terms of behavior that “deviates markedly from the expectations of the individual’s culture.” The personality disorders may be more closely tied to cultural expectations than any other kind of mental disorder.The personality disorders may be more closely tied to cultural expectations than any other kind of mental disorder.Frequency