CHAPTER 7
Personality Disorders
OBJECTIVES:
a.) To define the Personality disorder
b.) To give the importance of having a knowledge in Personality
Disorder
c.) To distinguish the different types of Personality
❖ Diagnosing Personality Disorders
A personality disorder is characterized by maladaptive personality traits that
begin by young adulthood and continue through adulthood; these traits are relatively
inflexible, are expressed across a wide range of situations, and lead to distress or
impaired functioning. A personality disorder affects three areas of functioning: affect,
behavior (including social behavior), and cognition.
DSM-IV-TR Personality Clusters
Cluster A personality disorders are characterized by odd or eccentric behaviors that have
elements related to those of schizophrenia. Cluster B personality disorders are
characterized by emotional, dramatic, or erratic behaviors that involve problems with
emotional regulation. Cluster C personality disorders are characterized by anxious or
fearful behaviors.
The neuropsychosocial approach explains how personality disorders
develop by highlighting the interactions among three sorts of factors:
• Neurological factors involve the effects of genes on temperament.
• Psychological factors include temperament, operant conditioning, and
dysfunctional beliefs.
• Social factors include insecure attachment that can result from childhood abuse or
neglect.
Treatments for personality disorders include medications for comorbid
symptoms, CBT or psychodynamic therapy, and family education and therapy, as well as
couples, interpersonal, and group therapy.
❖ Odd/Eccentric Personality Disorders
A Paranoid personality disorder refers to personality disorder
characterized by persistent and pervasive mistrust and suspiciousness,
accompanied by a bias to interpret other people’s motives as hostile.
Schizotypal personality disorder is viewed as a milder form of
schizophrenia. Many of the factors that give rise to schizophrenia also appear to
give rise to schizotypal personality disorder: genes and the prenatal environment;
problems with attention, memory, and executive function as well as an impaired
theory of mind; and physical abuse or neglect in childhood, insecure attachment,
and discrimination.
Psychological Factors in Odd/Eccentric Personality Disorders
People with odd/eccentric personality disorders are reluctant participants in
treatment. Treatment may address fundamental issues, such as isolation and
suspiciousness. Treatment for schizotypal personality disorder may include antipsychotic
medication (although at lower doses than used for psychotic disorders), CBT, social skills
training, and family therapy.
❖ Dramatic/Erratic Personality Disorders
Antisocial personality disorder refers to a personality disorder
characterized by a persistent disregard for the rights of others.
Conduct disorder refers to a psychological disorder that typically arises in childhood and
is characterized by the violation of the basic rights of others or of societal norms that are
appropriate to the individual’s age.
The term psychopath (or sociopath, which was used in the first DSM) has often been
used to refer to someone with symptoms of antisocial personality disorder. These two
terms are not exactly the same, however As illustrated in Figure 13.6, the diagnosis of
antisocial personality disorder is broader (i.e., less restrictive, because there are fewer
criteria) than the diagnosis of psychopathy.
Psychopathy and antisocial personality disorder are thought to arise from
feedback loops among various factors, including genes and temperament, lack of
empathy, classical and operant conditioning, abuse or neglect or inconsistent
discipline in childhood, parents’ criminal behavior, and attachment style. Treatment
for psychopathy has generally not been successful; treatment for antisocial
personality disorder focuses on modifying specific behaviors and has some degree
of success, at least temporarily, in motivated individuals.
Borderline personality disorder is characterized by volatile emotions, an unstable self-
image, and impulsive behavior in relationships. People with this disorder have problems
with emotional regulation—which is probably related to their temperament—and may
engage in self-harming behaviors or try to commit suicide.
Factors that contribute to borderline personality disorder include the genetic and
neurological underpinnings of emotional dysregulation, a relatively low threshold for
emotional responsiveness, an easily changeable sense of self, cognitive distortions, and
a history of abuse, neglect, or feeling invalidated by others.
Treatment for borderline personality may include medication, CBT, DBT,
intensive psychodynamic therapy, and IPT.
The hallmark of histrionic personality disorder is attention seeking, usually
through exaggerated emotional displays. Symptoms may also include a sense of
boredom or emptiness and a low tolerance for frustration.
Narcissistic personality disorder is characterized by a grandiose sense of
self-importance and a constant desire for praise and admiration. People with this disorder
may also feel a sense of entitlement, behave arrogantly, and have difficulty understanding
other people’s points of view.
❖ Fearful/Anxious Personality Disorders
The predominant characteristic of people with avoidant personality
disorder is social inhibition—extreme shyness—that usually stems from feeling
inadequate and being overly sensitive to negative evaluation. People with avoidant
personality disorder are often characterized as shy, isolated, timid, or lonely.
The hallmark of avoidant personality disorder is social inhibition, which usually stems
from feeling inadequate and being overly sensitive to negative evaluation. Although
similar to social phobia, avoidant personality disorder has criteria that are more pervasive
and involve a more general reluctance to take risks.
Dependent personality disorder is characterized by submissive and clingy behaviors,
based on fear of separation; these behaviors are intended to elicit attention, reassurance,
and decision making from other people. People with dependent personality disorder are
chronically plagued by self-doubt and consistently underestimate their abilities; in fact,
they may not know how to function independently.
Obsessive-compulsive personality disorder is characterized by preoccupations with
perfectionism, orderliness, and self-control and by low levels of flexibility and efficiency.
These rigid personality traits may lead these people to have difficulty prioritizing and
making decisions, and they are often intolerant of emotional or “illogical” behavior in
others.
