Notes on Personality Disorders - Intro of Abnormal Psychology | PSYC 3082, Study notes of Psychology

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Chapter 11 Personality Disorders table of contents  Personality Disorders: An Overview • The Nature of Personality Disorders – Enduring and relatively stable predispositions (i.e., ways of relating and thinking) – Predispositions are inflexible and maladaptive, causing distress and/or impairment – Coded on Axis II of the DSM-IV and DSM-IV-TR • DSM-IV and DSM-IV-TR Personality Disorder Clusters – Cluster A – Odd or eccentric cluster (e.g., paranoid, schizoid, schizotypal) – Cluster B – Dramatic, emotional, erratic cluster (e.g., antisocial, borderline, histrionic, narcisstic) – Cluster C – Fearful or anxious cluster (e.g., dependent, avoidant, obsessive-compulsive) Cluster A: Schizoid Personality Disorder • Overview and Clinical Features – Pervasive pattern of detachment from social relationships – Very limited range of emotions in interpersonal situations • The Causes – Etiology is unclear – Preference for social isolation in schizoid personality resembles autism • 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 Cluster A: Schizotypal Personality Disorder • Overview and Clinical Features – Behavior and dress is odd and unusual – Most are socially isolated and may be highly suspicious of others – Magical thinking, ideas of reference, and illusions are common – Risk for developing schizophrenia is high in this group • The Causes – Schizoid personality – A phenotype of a schizophrenia genotype? – Left hemisphere and more generalized brain deficits • Treatment Options – Main focus is on developing social skills – Treatment also addresses comorbid depression – Medical treatment is similar to that used for schizophrenia – Treatment prognosis is generally poor Cluster B: Antisocial Personality Disorder • Overview and Clinical Features – Failure to comply with social norms and violation of the rights of others – Irresponsible, impulsive, and deceitful – Lack a conscience, empathy, and remorse • Relation Between Psychopathy and Antisocial Personality Disorder • Relation Between ASPD, Conduct Disorder, and Early Behavior Problems – Many have early histories of behavioral problems, including conduct disorder – Many come from families with inconsistent parental discipline and support – Families often have histories of criminal and violent behavior Neurobiological Contributions and Treatment of Antisocial Personality • Prevailing Neurobiological Theories – Underarousal hypothesis – Cortical arousal is too low – Cortical immaturity hypothesis – Cerebral cortex is not fully developed – Fearlessness hypothesis – Psychopaths fail to respond with fear to danger cues – Gray’s model of behavioral inhibition and activation • 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 Cluster B: Borderline Personality Disorder • Overview and Clinical Features – Patterns of unstable moods and relationships – Impulsivity, fear of abandonment, coupled with a very poor self- image – Self-mutilation and suicidal gestures are common – Most common personality disorder in psychiatric settings – Comorbidity rates are high • The 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 Cluster B: Histrionic Personality Disorder • Overview and Clinical Features – Patterns of behavior that are overly dramatic, sensational, and sexually provocative – Often impulsive and need to be the center of attention – Thinking and emotions are perceived as shallow – Common diagnosis in females • The Causes – Etiology is largely unknown – Is histrionic personality a sex-typed variant of antisocial personality? • 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 Cluster C: Dependent Personality Disorder • Overview and Clinical Features – Excessive reliance on others to make major and minor life decisions – Unreasonable fear of abandonment – Tendency to be clingy and submissive in interpersonal relationships • The Causes – Still largely unclear – Linked to early disruptions in learning independence • Treatment Options – Research on treatment efficacy is lacking – Therapy typically progresses gradually – Treatment targets include skills that foster independence Cluster C: Obsessive-Compulsive Personality Disorder • Overview and Clinical Features – Excessive and rigid fixation on doing things the right way – Tend to be highly perfectionistic, orderly, and emotionally shallow – Obsessions and compulsions, as in OCD, are rare • The Causes – Are largely unknown • 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 Summary of Personality Disorders • Personality Disorders – Long-standing, ingrained ways of thinking, feeling, and behaving • Disagreement Exists Over How to Categorize Personality Disorders – Categorical vs. dimensional, or some combination of both • DSM-IV and DSM-IV-TR Includes 10 Personality Disorder – Personality disorders fall in one of three clusters – Cluster A, B, or C • The Causes of Personality Disorders Are Difficult to Pinpoint • Treatment of Personality Disorders Is Often Difficult