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Clinical Features of Personality Disorders
Personality disorders
•Chronic interpersonal difficulties
•Problems with identity or sense of self
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Clinical Features of Personality Disorders
DSM criteria include enduring behavior
pattern
Pervasive and inflexible
Stable and of long duration
Clinically significant distress or
impairment in functioning
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Clinical Features of Personality Disorders
Prevalence Ranges from 4.4% to
14.8%
About 75% comorbidity
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Difficulties in Diagnosing Personality Disorders
Diagnostic criteria not sharply defined
Diagnostic categories not mutually exclusive
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Difficulties in Diagnosing Personality Disorders
PDs may represent extreme levels of normal personality
traits
• Histrionic• Dependent• Obsessive-compulsive
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Difficulties in Studying the Causes of Personality Disorders
Limited research on
causal factors
Less amenability to thorough study
Retrospective approaches
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Classifying Personality Disorders
• Cluster A are people who are perceived as odd or eccentric
Includes paranoid, schizoid, and schizotypal personality disorders
Classifying Personality Disorders
Cluster B are people whose behavior is overly dramatic, emotional, or erratic
– Includes antisocial, borderline, histrionic and narcissistic personality disorders
Classifying Personality Disorders
Cluster C are people who often appear anxious or fearful
Includes avoidant, dependent, and obsessive-compulsive personality disorders
Paranoid Personality Disorder (Cluster A)
On guard for perceived attacks by others
Tendency to see self as blameless
Suspiciousness and mistrust of others
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Schizoid Personality Disorder (Cluster A)
Inability and lack of desire to form attachments to others
Impaired social relationships
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Schizotypal Personality Disorder (Cluster A)
Oddities of perception and speech that interfere with communication and social
interaction
Peculiar thought patterns
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Histrionic Personality Disorder(Cluster B)
Irritability and temper outbursts if attention seeking is frustrated
Overconcern with attractiveness
Self-dramatization
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Narcissistic Personality Disorder(Cluster B)
Lack of empathy
Self-promoting
Preoccupation with receiving attention
Grandiosity
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Antisocial Personality Disorder(Cluster B)
History of conduct problems as a child (diagnosis of Conduct Disorder)
Shameless manipulation of others
Deceitfulness
Inability to follow approved models of behavior
Lack of moral or ethical development
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The Clinical Picture in Psychopathy and Antisocial Personality Disorder
Inadequate conscience development
Irresponsible and impulsive behavior
Ability to impress and exploit others
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Causal Factors in Psychopathy and Antisocial Personality
Causal factors • Genetic influences• Low levels of fear; poor conditioning of fear• More general emotional deficits• Early parental loss• Parental rejection• Inconsistent discipline
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Figure 10.4: Family Context and Antisocial Behavior
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Treatments and Outcomes in Psychopathic and Antisocial Personality
Cognitive-behavioral treatments offer some promise
Treatment of psychopaths is
difficult
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Borderline Personality Disorder (Cluster B)
Attempts at self-mutilation or suicide
Chronic feelings of boredom
Drastic mood shifts
Inappropriate anger
Impulsiveness
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Figure 10.1: Multidimensional Diathesis-Stress Theory of Borderline
Personality Disorder
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Avoidant Personality Disorder(Cluster C)
Insecurity in social interaction and initiating relationships
Shyness
Hypersensitivity to rejection or social derogation
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Dependent Personality Disorder(Cluster C)
Indecisiveness
Subordination of needs to keep others involved in a relationship
Discomfort at being alone
Difficulty in separating in relationships
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Obsessive-Compulsive Personality Disorder (Cluster C)
Difficulty in relaxing and having fun
Lack of expressiveness and warmth
Perfectionism
Excessive concern with order, rules, and trivial details
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Treatments and Outcomes for Personality Disorders
Difficulties
Clients resistance to
change
Relationships formation
challenges© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Treating Borderline Personality Disorder
Antidepressant medications
(SSRIs)
Dialectical behavior
therapy (DBT)
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
Treating Other Personality Disorders
Few controlled studies of treatment
Antipsychotic or antidepressant
medication
Schizotypal PD
Cognitive-behavioral treatment and
antidepressant medication
Avoidant PD
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
