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Page 1: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Personality DisordersPersonality Disorders

Definition of Personality?Definition of Personality? Definition of Personality DisorderDefinition of Personality Disorder

Manifest across many life areasManifest across many life areas InflexibleInflexibleMaladaptiveMaladaptiveCause either significant impairment or Cause either significant impairment or

distress to self distress to self or othersor others

Page 2: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Personality DisordersPersonality Disorders

Dimensions or Categories?Dimensions or Categories? DSM-IV DSM-IV

Consided as Categories (not dimensions)Consided as Categories (not dimensions) Axis II of the multiaxial systemAxis II of the multiaxial system

Not usually primary diagnosisNot usually primary diagnosis Ten Specific LabelsTen Specific Labels

Cluster A: “Odd / Eccentric”Cluster A: “Odd / Eccentric” Cluster B: “Dramatic / Emotional”Cluster B: “Dramatic / Emotional” Cluster C: “Anxious / Fearful”Cluster C: “Anxious / Fearful”

High Rates of ComorbidityHigh Rates of Comorbidity Gender Bias in Diagnosis?Gender Bias in Diagnosis?

Page 3: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest
Page 4: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Paranoid Personality DisorderParanoid Personality Disorder

Excessively Mistrustful Excessively Mistrustful Excessively SuspiciousExcessively Suspicious Without JustificationWithout Justification Treatment Options Treatment Options

Few seek professional help on their ownFew seek professional help on their own Treatment focuses on development of trustTreatment focuses on development of trust Cognitive therapy to counter negativistic thinkingCognitive therapy to counter negativistic thinking Lack good outcome studiesLack good outcome studies

Page 5: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Schizoid Personality DisorderSchizoid Personality Disorder

Extreme Social Detachment (Loner) Extreme Social Detachment (Loner) Appear Aloof, Cold, IndifferentAppear Aloof, Cold, Indifferent Limited Range of EmotionsLimited Range of Emotions Treatment Options Treatment Options

Few seek professional help on their ownFew seek professional help on their own Focus on the value of interpersonal relationships, Focus on the value of interpersonal relationships,

empathy, and social skillsempathy, and social skills Treatment prognosis is generally poorTreatment prognosis is generally poor Lack good outcome studiesLack good outcome studies

Page 6: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Schizotypal Personality Schizotypal Personality DisorderDisorder

Also Socially Isolated Also Socially Isolated BUT Behavior Is More Unusual BUT Behavior Is More Unusual Often Considered Odd or BizarreOften Considered Odd or Bizarre

Ideas of ReferenceIdeas of Reference Magical ThinkingMagical Thinking IllusionsIllusions

Apparent Connection to Schizophrenia (but be careful!)Apparent Connection to Schizophrenia (but be careful!) Treatment Options Treatment Options

Developing social skillsDeveloping social skills Treatment also addresses comorbid depressionTreatment also addresses comorbid depression Medical treatment is similar to that used for schizophreniaMedical treatment is similar to that used for schizophrenia Treatment prognosis is generally poorTreatment prognosis is generally poor

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Antisocial Personality DisorderAntisocial Personality Disorder

Long Histories ofLong Histories of Violating Cultural NormsViolating Cultural Norms Violating Rights of OthersViolating Rights of Others Impulsivity & AggressivenessImpulsivity & Aggressiveness Lack of Remorse, Conscience, EmpathyLack of Remorse, Conscience, Empathy

Not Always CriminalNot Always Criminal Relation Between ASPD, Conduct Disorder, and Relation Between ASPD, Conduct Disorder, and

Early Behavior ProblemsEarly Behavior Problems

Page 8: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Antisocial PersonalityAntisocial Personality

Neurobiological TheoriesNeurobiological Theories Underarousal, Fearlessness, & Behavioral Inhibition Underarousal, Fearlessness, & Behavioral Inhibition

Treatment Treatment Few seek treatment on their ownFew seek treatment on their own Antisocial behavior is predictive of poor prognosis, Antisocial behavior is predictive of poor prognosis,

even in childreneven in children Emphasis is placed on prevention and rehabilitationEmphasis is placed on prevention and rehabilitation Often incarceration is the only viable alternative Often incarceration is the only viable alternative

Page 9: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Borderline Personality DisorderBorderline Personality Disorder

Unstable RelationshipsUnstable Relationships Love/Hate BehaviorLove/Hate Behavior Fear of AbandonmentFear of Abandonment

Poor Self-ImagePoor Self-Image Mood Swings, Feel EmptyMood Swings, Feel Empty

ImpulsivityImpulsivity Substance Abuse, Sex, SuicidalitySubstance Abuse, Sex, Suicidality

Self-mutilationSelf-mutilation

Page 10: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Borderline Personality DisorderBorderline Personality Disorder

Runs in familiesRuns in families Early trauma and abuse seem to play some roleEarly trauma and abuse seem to play some role Treatment Options Treatment Options

Few good treatment outcome studiesFew good treatment outcome studies Antidepressant medications provide some short-term Antidepressant medications provide some short-term

reliefrelief Dialectical behavior therapy is the most promising Dialectical behavior therapy is the most promising

psychosocial approachpsychosocial approach

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Histrionic Personality DisorderHistrionic Personality Disorder

Overly DramaticOverly Dramatic Center of AttentionCenter of Attention Emphasis on AppearanceEmphasis on Appearance Emotions are ShallowEmotions are Shallow Seductive & ProvocativeSeductive & Provocative Treatment Options Treatment Options

Few good treatment outcome studiesFew good treatment outcome studies Treatment focuses on attention seeking and long-term negative Treatment focuses on attention seeking and long-term negative

consequencesconsequences Targets may also include problematic interpersonal behaviorsTargets may also include problematic interpersonal behaviors Little evidence that treatment is effectiveLittle evidence that treatment is effective

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Narcissistic Personality DisorderNarcissistic Personality Disorder

Grandiose Sense of SelfGrandiose Sense of Self Exaggerated Self-ImportanceExaggerated Self-Importance

Preoccupied with AttentionPreoccupied with Attention Requires AdmirationRequires Admiration Little EmpathyLittle Empathy Highly Sensitive to CriticismHighly Sensitive to Criticism Treatment Options Treatment Options

Focuses on grandiosity, lack of empathy, unrealistic thinkingFocuses on grandiosity, lack of empathy, unrealistic thinking Treatment may also address co-occurring depressionTreatment may also address co-occurring depression Little evidence that treatment is effectiveLittle evidence that treatment is effective

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Avoidant Personality DisorderAvoidant Personality Disorder Sensitive to Other’s OpinionsSensitive to Other’s Opinions Avoid Social RelationshipsAvoid Social Relationships Extreme Low Self-EsteemExtreme Low Self-Esteem Takes Few RisksTakes Few Risks Socially Inhibited & AnxiousSocially Inhibited & Anxious Treatment Options Treatment Options

Several well-controlled treatment outcome studies existSeveral well-controlled treatment outcome studies exist Treatment is similar to that used for social phobia Treatment is similar to that used for social phobia Treatment targets include social skills and anxietyTreatment targets include social skills and anxiety

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Dependent Personality DisorderDependent Personality Disorder

Excessive Reliance on OthersExcessive Reliance on Others Submissive & PassiveSubmissive & Passive Rely on Others to Make Even Minor DecisionsRely on Others to Make Even Minor Decisions

Fear AbandonmentFear Abandonment ClingyClingy

Treatment Options Treatment Options Research on treatment efficacy is lackingResearch on treatment efficacy is lacking Therapy typically progresses gradually Therapy typically progresses gradually Treatment targets include skills that foster Treatment targets include skills that foster

independenceindependence

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Obsessive-Compulsive Obsessive-Compulsive Personality DisorderPersonality Disorder

NOTNOT same thing as OCD same thing as OCD Fixation on Doing Things “The Right Way”Fixation on Doing Things “The Right Way” Preoccupation withPreoccupation with

PerfectionismPerfectionism ControlControl Orderliness, Details, and RulesOrderliness, Details, and Rules

Obsessions and Compulsions Are RareObsessions and Compulsions Are Rare Treatment Options Treatment Options

Data supporting treatment are limitedData supporting treatment are limited Treatment may address fears related to the need for orderlinessTreatment may address fears related to the need for orderliness Other targets include rumination, procrastination, and feelings of Other targets include rumination, procrastination, and feelings of

inadequacyinadequacy

Page 16: Personality Disorders Definition of Personality? Definition of Personality? Definition of Personality Disorder Definition of Personality Disorder  Manifest

Problems with Personality DisordersProblems with Personality Disorders

The Causes of Personality Disorders Are The Causes of Personality Disorders Are Difficult to Pinpoint Difficult to Pinpoint

Treatment of Personality Disorders Is Treatment of Personality Disorders Is Often Difficult Often Difficult

Often Comorbid IssuesOften Comorbid Issues Egosyntonic (vs. Egodystonic)Egosyntonic (vs. Egodystonic)


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