PSYB32: Personality Disorders
Definition and criteria for personality disorders
Inner experience and behaviour that:
- deviates from culture
- long term
- starts at adolescene or early adulthood
- causes dysfunction in social/professional life.
- across all aspects of life
Textbook 3 personality disorder criteria
- Rigid
- Cycle of dysfunction
- Instability
Other textbook cycle of personality disorder
Inability to solve life problems
Inability in these areas warrants diagnosis:
- Being able to form good representations of yourself and others.
- Having interpersonal relationships
- Co-operative and prosocial behaviour.
Personality disorders vs normal personality
More extreme versions of personality disorders, some response to an extreme.
Alternate Model of Personality Disorder (AMPD)
The dimensional model focused on:
- Criteria A/personal levels of functioning: the self with identity and self-direction/ others with empathy and intimacy
-Criterion B/rating of 5 dimensions: negative affect, detachment, antagonism, disinhibition, psychoticsm
OCEAN personality
Openness, conscientiousness, extraversion, agreeableness, neuroticism
HEXACO
openness, conscientiousness, extraversion, agreeableness, honesty-humidity, emotionality
Problems with categorical approach to personality
- The diagnoses are unstable when personality is supposed to be stable.
- Multiple PD can have the same behaviours.
- Need more expanded descriptions for the personality disorders.
3 categories of PD
Cluster A: Odd/eccentric
Cluster B: Eratic and dramatic
Cluster C: anxious and fearful
Odd/dramatic Cluster and it's details
Paranoid personality disorder, schizotypal personality disorder, schizoid personality disorder.
Similar/genetically related to schizophrenia. Similar life experiences, brain and cognitive dysfunctions. Heritability rates are moderate and lowest in schizotypal personality disorder.
Avoidant personality disorder
SUSPECT: 4/7
- Spouse infidelity suspected
- Untrusting
- Suspicious of others
- Percieves attacks and reacts quickly.
- Enemy or friend
- Confiding in others difficult
- Treats perceived in regular events
Not delusions due to being suspect only of stuff that is possible.
Schizoid personality disorder
DISTANT: 4/7
- Detached/ flattened affect
- Indifferent to criticism and praise
- Sexual experience of no interest
- Tasks done alone
- Alone
- Nrither interested or enjoys close relationships
- Things of no interest
Like an attenuated, predomal and residual phases of schiophrenia.
Schizotypal personality disorder
ME PECULIAR: 5/10
- Magical beliefs
- Experiences weird perceptions
- Paranoid ideation
- Eccentric thoughts and appearance
- Constrained affect
- Unusual thinking and speech
- Lacks close friends
- Ideas of reference
- Anxiety is social situations
- Rules out psychotic episode
Histrionic personality disorder
PRAISE ME (5/8)
- Provocative/sexual clothing
- Relationships perceived as closer than they actually are
- Attention needed
- Influences easily
- Speech dramatic but lacking in substance
- Emotions fluctuate a lot
- Made up stuff about appearances for attention
- Emotions changing rapidly
Causes of histrionic personality disorder
Weird parents that talk about sex as a scandelous and exciting thing that makes them interested but scared to engage in it. They have this underlying conflict and it is protective against it.
Narcissism personality disorder
SPECIAL (5/9)
- Special
- Preoccupied with thoughts of grandeur, success, love, etc.
- Entitlement
- Envious of others and want others to envy them.
- Excessive attention
- Concieted
- Interpersonal relationships exploited
- Arrogant
- Lacks remorse
Causes of narcissism
All to hide low self-esteem.
Parents did not respond positively to their failures and furthered their own ego instead.
Dark triad
Narcissism, psychoticism, Machiavellianism,
Dark tredad
Narcissism, machianvellianism, psychoism, sadism
Borderline personality disorder
AM SUICIDE
- Abandonment issues
- Mood instability
- Suicide ideation
- Unstable relationships
- Identity instability
- Control of anger difficult
- Impulsivity
- Delusions and paranoid symptoms
- Emptiness chronic
Borderline personality disorder causes
Object relation theory
Brain
Diathesis stress model
Brain of borderline personality disorder
Prefrontal cortex sucks so they are impulsive
Limbic system sucks so negative emotionality
Object-relations theory
Kids internalize the objects/ideas etc of those they care about, but they develop insecure egos so blocking (when things are separated into either good or bad to defend from that
Diathesis-stress model
Genetic predisposition to have higher emotionality, placed under stress/expectations, not paid attention to so they become overly emotional to get that parental love
Antisocial personality disorder
CORRUPT (3/7) in addition to conduct disorder before 15.
- Conformity to the law lacking
- Obligations ignores
- Reckless
- Remorse lacking
- Underhandedness
- Planning lacking
- Temper
Psychoticism
- No empathy
- No negative emotions
- No positive emotions
- No remorse (CENTRAL)
Antisocial personality disorder vs psychoticism
Most psychopaths have antisocial personality disorder but it does not go all the way around.
Differences:
- APD focuses on thinking, P focuses on behaviour
- APD requires only 3 symptoms
- APD can't be diagnosed before 18
Criminals and psychoticism
More likely to be released due to being good at lying
More likely to do premeditated crime
Causes of APD
Genetics
Brain: prefrontal cortex, amygdala, limbic system, grey matter loss
Enviornmental factors: APD of dad, abuse, no discipline
Dependent personality disorder
RELIANCE (5/8)
- Reassurance constantly needed
- Expressing disagreements difficult
- Life responsibilities lacking
- Initiating projects difficult
- Alone
- Negligence not taken well
- Companionship sought after obsessively especially if lost
- Exaggerated needs of being taken care of
Causes of DPD
- Fixation at anal stage
- Usually, someone anchors at their parents and go off on their own to explore and slowly detach, but they fail to detach
Avoidant personality disorder
CRINGES (5/7)
- Certainty of being liked before interacting
- Rejection and criticism stuck in head
- Interpersonal relationships hindered
- New interpersonal relationships stopped
- Gets around work/ responsibilities due to fear of others
- Embarrassment
- Self thought of in a sad way
Causes of Avoidant Personality Disorder
Strangers and new situations taught as dangerous
Obsessive personality disorder
LAW FIRMS (4/8)
- Lost of point of activities due to fixation on details
- Ability to complete tasks hindered
- Worthlessness things kept in case they are needed later on
- Friends and family ditched for work
- Reluctant to give in to demands
- Miserly speaking style
- Stubborn and rigid
OCPD vs OCD
They are different because OCPD do not have obsessions and compulsions
Causes of OCPD
Fixation at anal stage
Fears loss of control
Psychodynamic therapies
Finding and altering present day views of the childhood problems that underly the personality disorder
Cognitive-behavioural therapy
Behavioural part: fixing the behaviours that reflect the disorder
Cognitive part: altering schemas that maintain personality disorders
Borderline personality disorders and treatment difficulties
They are very resiliant to treatment due to not trusting therapist, and therapists not knowing what would be a serious issue or not.
Dialogical relating theory
Client-centered empathic therapy with social skills training and problem-solving.
Dialogical relating theory target
Life-threatening behaviours
Therapy-interfering behaviours
Quality of life behaviours
Skills acquisition
Ego syntonic
hard to get them to understand that their behaviour sucks.
Object-relating therapy
Looking at how a person identified and attaches to objects and shit of those around them. Targets their weak egos and stops the splitting which is a defence mechanism for those weak egos
Pharmacological therapies for personality disorders
Not effective
Schema therapy
identifying and modifying specific cognitive schemas at the root of personality dysfunction