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Abnormal Psychology

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Abnormal Psychology ­ PSY404
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Lesson 35
PERSONALITY DISORDERS
Personality refers to enduring patterns of thinking and behavior that define the person and distinguish
him or her from other people.
These enduring patterns are ways of expressing emotion as well as patterns of thinking about ourselves
and other people. When enduring patterns of behavior and emotion bring the person into repeated
conflicts with others, and when they prevent the person from maintaining close relationships with
others, an individual's personality may be considered disordered. Personality disorders are among the
most controversial categories in the diagnostic system for mental disorders.
1- They are difficult to identify reliably, their etiology is poorly understood, and there is relatively little
evidence to indicate that they can be treated successfully.
2- Although they are difficult to define and measure, but personality disorders are important in the field
of psychopathology.
Several observations support this argument.
 First, personality disorders are associated with significant social and occupational impairment.
 Second, the presence of pathological personality traits during adolescence is associated with an
increased risk for the subsequent development of other mental disorders.
 Third, in some cases, personality disorders actually represent the beginning stages of the onset of a
more serious form of psychopathology.
 Fourth, the presence of a co-morbid personality disorder can interfere with the treatment of a
disorder such as depression.
 The specific symptoms that are used to define personality disorders represent maladaptive
variations in several of the building blocks of personality.
 These include
1- Motives
2- Cognitive perspectives regarding the self and others
3- Temperament and personality traits.
 The authors of DSM-IV-TR have organized ten specific forms of personality disorder into three
clusters on the basis of broadly defined characteristics.
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The behavior of people who fit the subtypes in cluster A is typically odd, eccentric, or asocial. All
three types share similarity with the symptoms of schizophrenia.
The close association with schizophrenia, they are sometimes called schizophrenia spectrum disorders.
1- Paranoid Personality
 Paranoid personality disorder is characterized by the pervasive tendency to be inappropriately
suspicious of other people's motives and behaviors.
 Paranoid people do not trust anyone; they have trouble maintaining relationships with friends and
family members.
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Example
Client A was frequently complaining about her boss, co-workers, teachers, father and friends. She
watched everyone closely, did not accept food or medicine from anyone for the fear that it would
contain poison. She did not go out with friends and co-workers that they might kill her.
2- Schizoid Personality
 Schizoid personality disorder is defined in terms of a pervasive pattern of indifference to other
people, coupled with a diminished range of emotional experience and expression.
 These people are loners; they prefer social isolation to interactions with friends or family.
Example
Client B would follow her class mates to school but would hurry back to her hostel room where she
would stay alone most of the time and was completely uninterested in others.
3- Schizotypal Personality
Schizotypal personality disorder centers on peculiar patterns of behavior rather than on the
emotional restriction and social withdrawal that are associated with schizoid personality disorder.
People with this disorder may report bizarre fantasies and unusual perceptual experiences.
Example
Client A was a young man with vague complaints of stuttering, feeling of indifference towards one's
self and wanted to study stars. He had peculiar, odd language and perceptual experiences.
The cluster B includes Antisocial, Borderline, Histrionic, and Narcissistic Personality
disorders.
According to DSM-IV-TR, the cluster B disorders are characterized by dramatic, emotional, or erratic
behavior, and all are associated with marked difficulty in sustaining interpersonal relationships.
4- Antisocial Personality
Antisocial personality disorder is defined in terms of a persistent pattern of irresponsible and antisocial
behavior that begins during childhood or adolescence and continues into the adult years.
The pattern shows disregard for, and violation of the rights of others.
Once the person has become an adult, these difficulties include persistent failure to perform
responsibilities that are associated with occupational and family roles.
Example
Client D is a young man who has just knocked out a man with his beer bottle because he thinks that he
was insulted.
The same client has history of being kicked out of school, fighting with neighbors and he does what
pleases him not what is right or wrong.
5- Borderline Personality
 Borderline personality disorder is a diffuse category whose essential feature is a pervasive
pattern of instability in mood and interpersonal relationships.
 People with this disorder find it very difficult to be alone.
 They form intense, unstable relationships with other people and are often seen by others as
being manipulative.
Example
Client C is a man who has been thrown out of his father's house because of bad temper and
undependability. He is depressed to the point of suicidal feelings.
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6- Histrionic personality
 Histrionic personality disorder is characterized by a pervasive pattern of excessive emotionality
and attention seeking behavior.
 People with this disorder thrive on being the center of attention and they want the spotlight on
them at all times.
 They are self-centered, vain, and demanding, and they constantly seek approval from others.
Example
Client C is an attractive woman with a lovely smile used by her to get the attention of people. Her habit
of trying to be the centre of attention is annoying to others. She is moody and seemed to over-
dramatize minor problems.
7- Narcissistic Personality
 The essential feature of narcissistic personality disorder is a pervasive pattern of grandiosity,
need for admiration, and inability to empathize with other people.
 Narcissistic people have a greatly exaggerated sense of their own importance.
 They are preoccupied with their own achievements and abilities.
Example
Client D is a lawyer of outward charm and good looks who has won the bar elections. He has written
books and has a media following. He is a man preoccupied by appearance, wealth, power and fame.
8- Avoidant Personality
 Avoidant personality disorder is characterized by a pervasive pattern of social discomfort, fear
of negative evaluation, and timidity.
 People with this disorder tend to be socially isolated when they are outside their own family
circle because they are afraid of criticism.
Example
Client D is a woman who has taken a job in night shift where she can have minimal contact. Off duty
she spends time alone, worrying less that she may behave stupidly.
9- Dependent Personality
 The essential feature of dependent personality disorder is a pervasive pattern of submissive and
clinging behavior.
 People with this disorder are afraid of separating from other people on whom they are
dependent for advice and reassurance.
 Often unable to make everyday decisions on their own, they feel anxious and helpless when
they are alone.
Example
Client A has lacked self confidence since childhood, relying on her mother to choose what to wear,
what friends to have, which courses and classes to study.
10- Obsessive­Compulsive Personality
 Obsessive­compulsive personality disorder (OCPD) is defined by a pervasive pattern of
orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility,
openness, and efficiency.
 People with this disorder set ambitious standards for their own performance that frequently are
so high as to be unattainable.
 The central features of this disorder may involve a marked need for control and lack of
tolerance for uncertainty.
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Obsessive­compulsive personality disorder should not be confused with obsessive­compulsive
disorder (OCD), a type of anxiety disorder. A pattern of intrusive, unwanted thoughts
accompanied by ritualistic behaviors is used to define OCD. The definition of obsessive­
compulsive personality disorder, in contrast, is concerned with personality traits, such as
excessively high levels of conscientiousness.
Example
Client A has a reputation of being careful and conscientious and careful.
He works long hours and brings a lot of money to the firm but he is humorless but takes a lot time in
procedural details in staff meetings.
The common element in all three disorders is presumably anxiety or fearfulness.
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. Like people with avoidant personality disorder,
they are easily hurt by criticism, extremely sensitive to disapproval, and lacking in self confidence. One
difference between them is that people who are avoidant have trouble initiating a relationship (because
they are fearful). People who are dependent have trouble being alone or separating from other people
with whom they already have a close relationship.
The Diagnosis
The diagnosis of Personality Disorders is not an easy and simple task because
1-There are a lot of people with serious personality problems who do not fit the official DSM-IV-TR
subtypes.
2-Another frequent complaint about the description of personality disorders is the considerable overlap
among categories.
3-Many patients meet the criteria for more than one type.
Thus, for diagnosis of personality disorders many experts favor the proposal to use the five-factor
model of personality as the basic structure for a comprehensive description of personality
problems.
4-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.
Gender Differences
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.
Almost nothing is known about the extent of potential gender differences for the other types of
personality disorder.
Borderline personality disorder and dependent personality disorder may be somewhat more prevalent
among women than men, but the evidence is not strong.
Stability of Personality Disorders over Time
Temporal stability is one of the most important assumptions about personality disorders.
Evidence for the assumption that personality disorders appear during adolescence and persist into
adulthood has, until recently, been limited primarily to antisocial personality disorder.
The rate of personality disorders was relatively high in this sample: Seventeen percent of the
adolescents received a diagnosis of at least one personality disorder.
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Viewed from a dimensional perspective, the maladaptive traits that represent the core features of the
disorders remained relatively stable between adolescence and young adulthood.
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.
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Table of Contents:
  1. ABNORMAL PSYCHOLOGY:PSYCHOSIS, Team approach in psychology
  2. WHAT IS ABNORMAL BEHAVIOR:Dysfunction, Distress, Danger
  3. PSYCHOPATHOLOGY IN HISTORICAL CONTEXT:Supernatural Model, Biological Model
  4. PSYCHOPATHOLOGY IN HISTORICAL CONTEXT:Free association, Dream analysis
  5. PSYCHOPATHOLOGY IN HISTORICAL CONTEXT:Humanistic Model, Classical Conditioning
  6. RESEARCH METHODS:To Read Research, To Evaluate Research, To increase marketability
  7. RESEARCH DESIGNS:Types of Variables, Confounding variables or extraneous
  8. EXPERIMENTAL REASEARCH DESIGNS:Control Groups, Placebo Control Groups
  9. GENETICS:Adoption Studies, Twin Studies, Sequential Design, Follow back studies
  10. RESEARCH ETHICS:Approval for the research project, Risk, Consent
  11. CAUSES OF ABNORMAL BEHAVIOR:Biological Dimensions
  12. THE STRUCTURE OF BRAIN:Peripheral Nervous System, Psychoanalytic Model
  13. CAUSES OF PSYCHOPATHOLOGY:Biomedical Model, Humanistic model
  14. CAUSES OF ABNORMAL BEHAVIOR ETIOLOGICAL FACTORS OF ABNORMALITY
  15. CLASSIFICATION AND ASSESSMENT:Reliability, Test retest, Split Half
  16. DIAGNOSING PSYCHOLOGICAL DISORDERS:The categorical approach, Prototypical approach
  17. EVALUATING SYSTEMS:Basic Issues in Assessment, Interviews
  18. ASSESSMENT of PERSONALITY:Advantages of MMPI-2, Intelligence Tests
  19. ASSESSMENT of PERSONALITY (2):Neuropsychological Tests, Biofeedback
  20. PSYCHOTHERAPY:Global Therapies, Individual therapy, Brief Historical Perspective
  21. PSYCHOTHERAPY:Problem based therapies, Gestalt therapy, Behavioral therapies
  22. PSYCHOTHERAPY:Ego Analysis, Psychodynamic Psychotherapy, Aversion Therapy
  23. PSYCHOTHERAPY:Humanistic Psychotherapy, Client-Centered Therapy, Gestalt therapy
  24. ANXIETY DISORDERS:THEORIES ABOUT ANXIETY DISORDERS
  25. ANXIETY DISORDERS:Social Phobias, Agoraphobia, Treating Phobias
  26. MOOD DISORDERS:Emotional Symptoms, Cognitive Symptoms, Bipolar Disorders
  27. MOOD DISORDERS:DIAGNOSIS, Further Descriptions and Subtypes, Social Factors
  28. SUICIDE:PRECIPITATING FACTORS IN SUICIDE, VIEWS ON SUICIDE
  29. STRESS:Stress as a Life Event, Coping, Optimism, Health Behavior
  30. STRESS:Psychophysiological Responses to Stress, Health Behavior
  31. ACUTE AND POSTTRAUMATIC STRESS DISORDERS
  32. DISSOCIATIVE AND SOMATOFORM DISORDERS:DISSOCIATIVE DISORDERS
  33. DISSOCIATIVE and SOMATOFORM DISORDERS:SOMATOFORM DISORDERS
  34. PERSONALITY DISORDERS:Causes of Personality Disorders, Motive
  35. PERSONALITY DISORDERS:Paranoid Personality, Schizoid Personality, The Diagnosis
  36. ALCOHOLISM AND SUBSTANCE RELATED DISORDERS:Poly Drug Use
  37. ALCOHOLISM AND SUBSTANCE RELATED DISORDERS:Integrated Systems
  38. SCHIZOPHRENIA:Prodromal Phase, Residual Phase, Negative symptoms
  39. SCHIZOPHRENIA:Related Psychotic Disorders, Causes of Schizophrenia
  40. DEMENTIA DELIRIUM AND AMNESTIC DISORDERS:DELIRIUM, Causes of Delirium
  41. DEMENTIA DELIRIUM AND AMNESTIC DISORDERS:Amnesia
  42. MENTAL RETARDATION AND DEVELOPMENTAL DISORDERS
  43. MENTAL RETARDATION AND DEVELOPMENTAL DISORDERS
  44. PSYCHOLOGICAL PROBLEMS OF CHILDHOOD:Kinds of Internalizing Disorders
  45. LIFE CYCLE TRANSITIONS AND ADULT DEVELOPMENT:Aging