ch10personalitydis

Organization of Personality Disorders

Odd or Eccentric Personality Disorders

Dramatic Personality Disorders

Anxious/Fearful Personality Disorders

Stable mood and low levels of impulsive urge.

Occasional thoughts of spontaneity in a socially adaptive way.

Acts different in different situations depending on the social context.


Odd or EccentricPersonality Disorders


Anxious/FearfulPersonalityDisorders

PersonalityDisorders:Causes andPrevention

PersonalityDisorders:Assessmentand Treatment

Emotions

Cognitions

Behaviors

Normal

Occasional mood swings and impulsive urges.

Occasional thoughts of spontaneous activity suchas stealing.

Acts inappropriately at times in work or social situations.







Emotions

Cognitions

Behaviors

NormalMild

Frequent mood swings and some impulsive urges butlittle impairment at work or with relationships.

Frequent odd thoughts or thoughts of dangerous activitysuch as harming self or others.

Problematic personality trait such as impulsivity or emotional reactivity shown in many situations.







Emotions

Cognitions

Behaviors

NormalMildModerate







Emotions

Cognitions

Behaviors

NormalMildModeratePersonality Disorder – Less Severe

Intense mood swings and impulsive urges with significant impairment at work or with relationships.

Intense thoughts of suicide, paranoia, abandonment,attention from others, vengeance, or work.

Problematic personality traits and dangerous behavior shown in almost all situations.







Emotions

Cognitions

Behaviors

NormalMildModeratePersonality Disorder – Less SeverePersonality Disorder – More Severe

Extreme mood swings and impulsive or aggressive urges that lead to self-harm, arrest, or violence.

Extreme and constant thoughts of suicide, paranoia,abandonment, attention from others, vengeance, or work.

Problematic personality traits and dangerous behavior shown in all situations with intense distress and impairment.







• Paranoid• Schizoid• Schizotypal







Personality Disorders9-15.7% of population

Odd or Eccentric Personality Disorders2.1% of population







Personality traits related to genetics:

Emotional expression

Suspiciousness

Cognitive distortion







Examples of Cognitions Associated with Odd or Eccentric

Schizoid, SchizotypalMy privacy is more important to me than is closeness to people

Schizoid, SchizotypalI shouldn’t confide in others

ParanoidI cannot trust other people

ParanoidOther people have hidden motives

ParanoidIt isn’t safe to confide in other people







Biological vulnerabilities/early predispositions: Genetic vulnerability (e.g., family history of schizophrenia); Neurobiological vulnerability (e.g., cognitive and perceptual deficits; dopaminergic dysfunction)

Early family problems: Adverse family environment (e.g., parentalAbuse, emotional withdrawal)

Stressful life events: Family conflict, abuse, trauma

Cognitive-stress and behavioral vulnerabilities: Cognitive schemas (e.g., distrust, autonomy); Personality traits (e.g., restricted expression, suspiciousness)

Possible odd/eccentric personality disorder







• Antisocial• Borderline• Histrionic• Narcissistic







Disregard for the safety of oneself or others

Chronic irresponsibility

Lack of remorse for having hurt or mistreated others

Repeated criminal acts that could result in arrest

Repeated lying, use of aliases, or conning

Impulsivity

Irritability and aggressiveness







Recurrent suicidal behavior or self-mutilating behavior

Dissociation or paranoid thoughts that occur in response to stress

Chronic feeling of emptiness

Extreme attempts to avoid real or imagined abandonment

Impulsivity that is potentially self-damaging

Anger control problems

Lack of a sense of self, or unstable self-image

Intense and unstable interpersonal relationships







Discomfort in situations where s/he is not the center of attention

Emotions that shift rapidly and do not seem “real”

Speech characterized by unsupported “impressions”

Very suggestible and easily influenced

Inappropriately provocative or sexually seductive interaction with others

Physical appearance is used to draw attention to oneself

Very dramatic behavior and expression of emotions

Relationships are considered much more intimate and closer than they actually are







Extreme sense of entitlement

Interpersonally exploitative

Lack of empathy for others

Extreme sense of self-importance

Preoccupation with (unrealistic) fantasies of greatness and importance

Belief that one’s “uniqueness” can only be understood by special or high-status people

Excessive need for admiration

Frequent envy or belief that others are envious of him or her

Arrogant behavior and attitude







Amygdala

Hypothalamus

Prefrontal cortex

Somatosensory cortex

Thalamus







Childhood maltreatment

Poor parental bonding

Cognitive beliefs







Biological vulnerabilities/early predispositions: Genetic vulnerability (e.g., family history of mood or impulsive disorders); Neurobiological vulnerability (e.g., impulsive aggression; affective instability; serotonergic or noradrenergic dysfunction)

Early family problems: Adverse family environment (e.g., child abuse, poor parental bonding, inconsistent parenting)


Cognitive-stress and behavioral vulnerabilities: Cognitive schemas (e.g., immediate gratification, dramatic); Personality traits (e.g., emotional dysregulation, impulsivity, callousness)

Possible dramatic personality disorder







Anxious/fearful Personality Disorders

• Avoidant• Dependent• Obsessive-

Compulsive







Avoidance of situations that may involve significant interpersonal contact because of fear of disapproval, criticism, or rejection

Reluctance to get involved with other people unless there is some degree of certainty that she or he will be liked

Restrained close relationships because of a fear of being embarrassed or ridiculed

Preoccupied with the thought of being criticized or rejected in social situations

Feelings of inadequacy cause him or her to be inhibited in new social situations

Believes self to be inept, unappealing, and inferior

Very risk-aversive and unlikely to engage in any new activities because of the fear of being embarrassed







Giving up responsibility for major areas of his or her life

Extreme difficulty in doing things independently because of a lack of self-confidence

Frequently feels helpless or uncomfortable and fears being unable to take care of oneself

Difficulty making simple decisions without advice and reassurance from others

Fears of loss of support or approval cause him or her to censor any disagreement with others

Desperate to get support and nurturance from others

Moves from relationship to relationship to ensure care and support

Greatly fears being left alone to take care of himself or herself







Personality traits related to anxious/fearful personality disorders

Behavioral inhibition

Tendency to anticipate harm

Excessive sensitivity to negative events

Heightened arousal

Tendency to see threat in benign events







Biological vulnerabilities/early predispositions: Genetic vulnerability (e.g., family history of anxiety disorders); Neurobiological vulnerability (e.g., anxiety or inhibition; noradrenergic or GABA dysfunction)

Early family problems: Adverse family environment (e.g., insecure attachment to parents; rejection by parents)


Cognitive-stress and behavioral vulnerabilities: Cognitive schemas (e.g., low self-esteem, ten to catastrophize); Personality traits (e.g., anxiousness, inhibition, submissiveness)

Possible anxious/fearful personality disorder







Medication

Ease anxiety and depression

Stabilize mood

Reduce psychotic symptoms

ch10personalitydis

Education

personality disorders9

problematic personality

autonomy personality

social situations

different situations

severeextreme mood swings

severeintense mood swings

intense thoughts of