Personality Disorders - Psychiatry - Lecture Slides, Slides of Psychology

Download Personality Disorders - Psychiatry - Lecture Slides and more Slides Psychology in PDF only on Docsity! Personality Disorders Docsity.com Definition of Personality • “Enduring patterns of perceiving, relating to, and thinking about the environment and oneself, which are exhibited in a wide range of important social and personal contexts” Docsity.com Problems with the PDs • Low levels of inter-rater reliability • Comorbidity with both Axis I and Axis II • Problems with classification system - Categorical vs. Dimensional System Docsity.com DSM-IV-TR Personality Disorders • Paranoid Personality Disorder • Schizoid Personality Disorder • Schizotypal Personality Disorder • Antisocial Personality Disorder • Borderline Personality Disorder • Histrionic Personality Disorder • Narcissistic Personality Disorder • Avoidant Personality Disorder • Dependent Personality Disorder • Obsessive-Compulsive Personality Disorder Docsity.com Cluster A: Odd or Eccentric • Paranoid PD – is a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent • Schizoid PD – is a pattern of detachment from social relationships and restricted range of emotional expression • Schizotypal PD – is a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behaviour Docsity.com Schizotypal Personality Disorder • peculiar patterns of thinking and behaviour • perceptual and cognitive disturbances • magical thinking • not psychotic – perhaps a distant “cousin” of schizophrenia Docsity.com Cluster B: Dramatic, Emotional, or Erratic • Antisocial PD – is a pattern of disregard for, and violation of, the rights of others • Borderline PD – is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity • Histrionic PD – is a pattern of excessive emotionality and attention seeking • Narcissistic PD – is a pattern of grandiosity, need for admiration, and lack of empathy Docsity.com Antisocial Personality Disorder • pattern of irresponsibility, recklessness, impulsivity beginning in childhood or adolescence (e.g., lying, truancy) • adulthood: – criminal behaviour – little adherence to societal norms, – little anxiety – conflicts with others – callous/exploitive Docsity.com Quote of the day “I’m the most cold-hearted son of a b---- you will ever meet” – Ted Bundy Docsity.com Borderline Personality Disorder • marked instability of mood, relationships, self-image • intense, unstable relationships • uncertainty about sexuality • everything is “good” or “bad” • chronic feeling of “emptiness” • recurrent threats of self-harm/ “slashers” Docsity.com Borderline and comorbidity • High degree of overlap with both Axis I and Axis II disorders • 24%-74% also diagnosed with major depression; 4% to 20% bipolar • 25% of bulimics also diagnosed with BPD • 67% also diagnosed with substance use disorder Docsity.com Cluster C: Anxious or Fearful • Avoidant PD – is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation • Dependent PD – is a pattern of submissive and clinging behaviour related to an excessive need to be taken care of • Obsessive-Compulsive PD – is a pattern of preoccupation with orderliness, perfectionism, and control at the expense of flexibility Docsity.com Avoidant Personality Disorder • over-riding sense of social discomfort • easily hurt by criticism • always need emotional support • occasionally try to socialize – so distressing they retreat into loneliness Docsity.com Dependent Personality Disorder • submissive, clingy behaviour • fear of separation • easily hurt by criticism Docsity.com Comorbidity • Average number of PD diagnoses per patient: - 4.6 (Skodal et al., 1988) - 2.8 (Zanaarini et al., 1987) - 3.75 (Widiger et al., 1986) Docsity.com DSM – Categorical Approach • Based on the medical model • Disorder is present or absent Docsity.com Assumptions of the DSM • Personality pathology is suited to be classified into discrete types or disorders • These disorders group themselves into three clusters • The diagnostic criteria naturally fall into the particular personality disorders to which they have been assigned Empirical Evidence doesn’t support these assumptions!!! Docsity.com “ …the evidence on this point is so unequivocal that the only issue to explain is the field’s reluctance to accept empirical evidence” ~ W. John Livesley, (2000) Journal of Personality Disorders, 14, 2, p. 139-140. Docsity.com The “Big 5” Personality Traits  Openness to experience  Conscientiousness  Extraversion  Agreeableness  Neuroticism  personality disorders represent extreme variations of OCEAN Docsity.com Advantages of Categorical System • Ease in conceptualization and communication • Familiarity • Consistency with clinical decision making Docsity.com