Lab 10: Personality DisordersLab 10: Personality Disorders

Personality Disorders:

Axis II of the DSM - they are seen as Axis II of the DSM - they are seen as longstanding, pervasive and inflexible longstanding, pervasive and inflexible patterns of behaviour and inner experiencepatterns of behaviour and inner experience

Deviate from the expectations of the Deviate from the expectations of the persons culturepersons culture

Impair social and occupational functioningImpair social and occupational functioning Some, but not all, can cause emotional Some, but not all, can cause emotional

distressdistress

Video #2: Antisocial Personality vs Psychopathy

Does he meet criteria for Antisocial Does he meet criteria for Antisocial Personality Disorder?Personality Disorder?

Does he show any remorse or empathy Does he show any remorse or empathy when describing his offending?when describing his offending?

Does he meet criteria for being a Does he meet criteria for being a ‘psychopath’ ‘psychopath’

What are your overall impressions of this What are your overall impressions of this person?person?

DSM IV Criteria Antisocial Personality Disorder

A) Pervasive pattern of disregard for and violation A) Pervasive pattern of disregard for and violation of the rights of others occuring since 15yrs as of the rights of others occuring since 15yrs as indicated by 3 or more of the following:indicated by 3 or more of the following:

1) Failure to conform to social norms with respect 1) Failure to conform to social norms with respect fo lawful behaviours i.e repeatedly arrestedfo lawful behaviours i.e repeatedly arrested

2) Decietfulness2) Decietfulness 3) Impulsivity or failure to plan ahead3) Impulsivity or failure to plan ahead 4) Irritability and aggressiveness4) Irritability and aggressiveness 5) Reckless disregard for safety of self or others5) Reckless disregard for safety of self or others

APD criteria cont..

6) Constant irresponsibility6) Constant irresponsibility 7) Lack of remorse, indifferent or 7) Lack of remorse, indifferent or

rationalizing to having hurt othersrationalizing to having hurt others B) At least 18 years of ageB) At least 18 years of age C) Evidence of Conduct Disorder with C) Evidence of Conduct Disorder with

onset before 15 yrs of ageonset before 15 yrs of age D) Antisocial behaviours not only during D) Antisocial behaviours not only during

Schizophrenia or a manic episode.Schizophrenia or a manic episode.

Criteria for Psychopathy

No DSM criteriaNo DSM criteria Literature (Cleckly, Hare) indicates psychopaths Literature (Cleckly, Hare) indicates psychopaths

have a lack of both positive and negative have a lack of both positive and negative emotions, no sense of shame, positive feelings emotions, no sense of shame, positive feelings mearly an act, superficially charming, manipulates mearly an act, superficially charming, manipulates others for personal gain, lack of negative others for personal gain, lack of negative emotions, don’t learn from mistakes, no empathy emotions, don’t learn from mistakes, no empathy or consideration of others, acts for the thrill of it.or consideration of others, acts for the thrill of it.

Similar but inflated elements of APD diagnosisSimilar but inflated elements of APD diagnosis

Hare’s PCL-R item groupings

Factor 1: Interpersonal or AffectiveFactor 1: Interpersonal or Affective- Glibness or superficial charmGlibness or superficial charm- Grandiose sense of self-worthGrandiose sense of self-worth- Pathological LyingPathological Lying- Conning or manipulativeConning or manipulative- Lack of remorse or guiltLack of remorse or guilt- Shallow affectShallow affect- Callous or lack of empathyCallous or lack of empathy- Failure to accept responsibility for actionsFailure to accept responsibility for actions

Hare’s PCL-R cont…

Factor 2: Social DevienceFactor 2: Social Devience Proneness to boredomProneness to boredom Parasitic lifestyleParasitic lifestyle Poor behavioural controlsPoor behavioural controls Early behavioural problemsEarly behavioural problems Lack of realistic long-term goalsLack of realistic long-term goals ImpulsivityImpulsivity IrresponsiblityIrresponsiblity Juvenile delinquencyJuvenile delinquency Revocation of conditional releaseRevocation of conditional release

Hare’s PCL-R cont….

Additional ItemsAdditional Items- Promiscuous sexual behaviourPromiscuous sexual behaviour- Many short-term marital relationshipsMany short-term marital relationships- Criminal versatilityCriminal versatility

Video Clip #2: Antisocial Personality Disorder

What criteria does this person meet for APD?What criteria does this person meet for APD? What impact has this man’s personality had on his What impact has this man’s personality had on his

life?life? What early experiences seem significant as What early experiences seem significant as

possible predisposing/precipitating factors?possible predisposing/precipitating factors? Does this man seem remorseful when describing Does this man seem remorseful when describing

his offending?his offending? What differences do you see between this clip and What differences do you see between this clip and

the one shown previously?the one shown previously?

Party full of People exhibiting Personality Disorders

What type of personality disorder does each What type of personality disorder does each person at the party show?person at the party show?

What does this exercise show about What does this exercise show about stereotyping?stereotyping?

You might know some people like this – You might know some people like this – can you explain the continuim approach to can you explain the continuim approach to personality?personality?

Possible Diagnosis of People at the Party

Donna – Histrionic Personality DisorderDonna – Histrionic Personality Disorder William – Schizotypal Personality DisorderWilliam – Schizotypal Personality Disorder Sherry – Borderline PDSherry – Borderline PD Winston – Narcissistic PDWinston – Narcissistic PD Peter – Obsessive Compulsive PDPeter – Obsessive Compulsive PD Doreen – Paranoid PDDoreen – Paranoid PD Margie – Avoidant PDMargie – Avoidant PD Harold – Schizoid PDHarold – Schizoid PD

Case: Blood is Thicker Than Water

Dependent PD – described as lacking self Dependent PD – described as lacking self confidence and self reliance, passively confidence and self reliance, passively allow other to take responsibility of allow other to take responsibility of decisions for them, intense need to be taken decisions for them, intense need to be taken care of, feel uncomfortable when alone, care of, feel uncomfortable when alone, preocupied with fears of being left alone to preocupied with fears of being left alone to take care of themselves, unable to make take care of themselves, unable to make demands on others.demands on others.

Case: Blood is Thicker than Water

In what way is this person expriencing In what way is this person expriencing social or occupational disruptions in social or occupational disruptions in functioning?functioning?

What about this set of symptoms is What about this set of symptoms is pervasive, longstanding and inflexible?pervasive, longstanding and inflexible?

Is it causing the person emotional distress?Is it causing the person emotional distress? Does his behaviour deviate from what is Does his behaviour deviate from what is

expected in your culture?expected in your culture?

Case – The Workaholic

Compulsive PD – perfectionist, preoccupied Compulsive PD – perfectionist, preoccupied with details, rules and schedules, often pay with details, rules and schedules, often pay so much attention that they fail to finish so much attention that they fail to finish projects, work rather than pleasure projects, work rather than pleasure orientated, have difficulty making decisions orientated, have difficulty making decisions and allocating time in case they make a and allocating time in case they make a mistake, stubborn and demanding, serious, mistake, stubborn and demanding, serious, rigid, formal and inflexible, usually miserly rigid, formal and inflexible, usually miserly or stingy, can’t throw things away.or stingy, can’t throw things away.

Case - Workaholic

In what way is this person expriencing In what way is this person expriencing social or occupational disruptions in social or occupational disruptions in functioning?functioning?

What about this set of symptoms is What about this set of symptoms is pervasive, longstanding and inflexible?pervasive, longstanding and inflexible?

Is it causing the person emotional distress?Is it causing the person emotional distress? Does his behaviour deviate from what is Does his behaviour deviate from what is

expected in your culture?expected in your culture?