Personality Disorders: Personality Disorders Definition of Personality? Definition of Personality Disorder Manifest across many life areas Inflexible Maladaptive Cause either significant impairment or distress to self or others


Personality Disorders: Personality Disorders Dimensions or Categories? DSM-IV Considers as Categories Axis II of the multiaxial system Not usually primary diagnosis Ten Specific Labels Cluster A: 'Odd / Eccentric' Cluster B: 'Dramatic / Emotional' Cluster C: 'Anxious / Fearful' Gender Bias in Diagnosis? High Rates of Comorbidity


Paranoid Personality Disorder: Paranoid Personality Disorder Excessively Mistrustful Excessively Suspicious Without Justification Treatment Options Few seek professional help on their own Treatment focuses on development of trust Cognitive therapy to counter negativistic thinking Lack good outcome studies showing that treatment is efficacious


Schizoid Personality Disorder: Schizoid Personality Disorder Extreme Social Detachment (Loner) Appear Aloof, Cold, Indifferent Limited Range of Emotions Treatment Options Few seek professional help on their own Focus on the value of interpersonal relationships, empathy, and social skills Treatment prognosis is generally poor Lack good outcome studies showing that treatment is efficacious


Schizotypal Personality Disorder: Schizotypal Personality Disorder Also Socially Isolated BUT Behavior is More Unusual Often Considered Odd or Bizarre Ideas of Reference Magical Thinking Illusions Apparent Connection to Schizophrenia Treatment Options Developing social skills Treatment also addresses comorbid depression Medical treatment is similar to that used for schizophrenia Treatment prognosis is generally poor


Antisocial Personality Disorder: Antisocial Personality Disorder Long Histories of Violating Cultural Norms Violating Rights of Others Impulsivity andamp; Aggressiveness Lack of Remorse Not Always Criminal Relation Between ASPD, Conduct Disorder, and Early Behavior Problems


Antisocial Personality: Antisocial Personality Treatment Few seek treatment on their own Antisocial behavior is predictive of poor prognosis, even in children Emphasis is placed on prevention and rehabilitation Often incarceration is the only viable alternative


Borderline Personality Disorder: Borderline Personality Disorder Unstable Relationships Love/Hate Behavior Avoid Abandonment Poor Self-Image Mood Swings, Feel Empty Impulsivity Substance Abuse, Sex, Suicidality


Borderline Personality Disorder: Borderline Personality Disorder Causes? Borderline personality disorder runs in families Early trauma and abuse seem to play some etiologic role Treatment Options Few good treatment outcome studies Antidepressant medications provide some short-term relief Dialectical behavior therapy is the most promising psychosocial approach


Histrionic Personality Disorder: Histrionic Personality Disorder Overly Dramatic Center of Attention Emphasis on Appearance Emotions are Shallow Seductive andamp; Provocative Treatment Options Few good treatment outcome studies Treatment focuses on attention seeking and long-term negative consequences Targets may also include problematic interpersonal behaviors Little evidence that treatment is effective


Narcissistic Personality Disorder: Narcissistic Personality Disorder Grandiose Exaggerated Self-Importance Preoccupied with Attention Requires Admiration Little Empathy Highly Sensitive to Criticism Treatment Options Extremely limited treatment research Treatment focuses on grandiosity, lack of empathy, unrealistic thinking Treatment may also address co-occurring depression Little evidence that treatment is effective


Avoidant Personality Disorder: Avoidant Personality Disorder Sensitive to Other’s Opinions Avoid Social Relationships Extreme Low Self-Esteem Takes Few Risks Socially Inhibited andamp; Anxious Treatment Options Several well-controlled treatment outcome studies exist Treatment is similar to that used for social phobia Treatment targets include social skills and anxiety


Dependent Personality Disorder: Dependent Personality Disorder Excessive Reliance on Others Submissive andamp; Passive Cling to Relationships Fear Abandonment Can’t Make Decisions Treatment Options Research on treatment efficacy is lacking Therapy typically progresses gradually Treatment targets include skills that foster independence


Obsessive-Compulsive Personality Disorder: Obsessive-Compulsive Personality Disorder NOT same thing as OCD Fixation on Doing Things 'Right' Preoccupation with Orderliness and Perfectionism Control Details and Rules Seen as Rigid and Stubborn Treatment Options Data supporting treatment are limited Treatment may address fears related to the need for orderliness Other targets include rumination, procrastination, and feelings of inadequacy


Problems with PDs: Problems with PDs The Causes of Personality Disorders Are Difficult to Pinpoint Treatment of Personality Disorders Is Often Difficult Often comorbidity Egosyntonic (vs. Egodystonic)