Personality Disorders

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Personality Disorders
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• Their existence can be easily recognized, yet
  little is known about their origins and
  development
• Though this pattern of behaviour may cause great
  distress to the people involved they find it
  difficult to change the way they think about and
  respond to situations
• Personality disorders are diagnosed on DSM-IVS
  Axis II. Mental retardation is also diagnosed on
  this axis. Due largely to the fact that these two
  conditions have a lifetime or near lifetime
  duration and stability, there are not likely to
  be periods of improvement or change.
• A diagnosis of personality disorder can only be
  made when a persons inflexible, long-lasting
  behaviour pattern or personality style cause
  problems in social situations or at work
• Unlike axis II disorders, axis I disorders are
  called symptom disorders (they may come and go).
  Symptom disorders may be triggered by events or
  environmental factors and may disappear when
  conditions change, or when the person is taught
  new behaviours.

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• Extreme and inflexible patterns of perceiving,
  relating to, and thinking about the environment
  and oneself that are exhibited in a wide range of
  social and personal contexts.
• Most personality disorders are said to be
  ego-syntonic that means that they are in sync
  with the ego and not distressing to person
  experiencing the disorder.
• However, there are a few of the disorders that
  are ego-dystonic out-of-sync- with the ego and
  thus cause the person problems. These people
  will usually seek help as oppose to the former.

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Three clusters of Personality disorders

• Odd and Eccentric PD.
• Dramatic, Emotional, and Erratic PD.
• Anxious and Fearful PD

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Odd and Eccentric PD.

• Individuals in this group may read hidden
  demeaning or threatening meaning into benign
  remarks, seem detached from social relationships
  and have difficulty forming close relationships.
  They are often characterized as being withdrawn,
  cold and irrational

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Paranoid PD

• They have several outstanding characteristics
  such as
• unwarranted feelings of suspiciousness and
  mistrust of others hypersensitivity the
  expectation without sufficient justification that
  everyone is out to get them, deceive them or take
  advantage of them and the tendency to read
  hidden demeaning or threatening messages into
  benign remarks and events (e.g. suspecting that a
  neighbour has put out trash early just to annoy
  them).

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Paranoid PD CONTD

• It is difficult for these individuals to have a
  relationship because they are constantly
  expecting their partners to violate their trust
• Paranoid individuals rarely seek clinical help
• If help is sought the therapist have a difficult
  time penetrating the barrier of suspiciousness
• Because they are hypersensitive to criticisms
  they find it difficult to function in subordinate
  positions
• Individuals with paranoid personality disorder
  often seem cold, humourless, devious and
  scheming as such they are unable to have close
  rewarding relationships
• Their performance is usually impaired because
  they are preoccupied with searching for hidden
  motives and special meanings
• Often times their problems are noted in the
  workplace as work is an area in which
  interpersonal contacts are difficult to avoid

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Schizoid PD

• These individuals are reserved, socially
  withdrawn and seclusive. They prefer solitary
  work activities and hobbies and lack the capacity
  for warm, close relationships. They rarely
  express their feelings directly. Their emotional
  reaction is usually flat as well as cold. They
  often seem vague, self-absorbed and absent minded
  and not very aware of or interested in what is
  going on around them

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Schizoid PD Contd

• Not only do they have few relationships but they
  do not have the desire for relationships. They
  often have poor social skills, although their
  speech and behaviour pattern are not unusual.
• They lack humour and seem detached from their
  environment. They tend to have problems at work
  because of the contact with other people that
  most jobs require

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Schizotypal

• They have oddities of thinking, perceiving,
  communicating and behaving. These deviations are
  never as extreme as those found in cases of full
  blown schizophrenia.
• Like the schizoid individuals they are seclusive,
  emotionally shallow, and socially unskilled.

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Schizotypal

• Though there are similarities there are also
  differences
• People with schizoid PD have no oddities of
  speech. The schizotypal individuals are often not
  understood because they use unusual words or
  phrases or use common words in unusual ways. They
  are likely to express ideas unclearly. Sometimes
  when they are under stress their thinking
  deteriorates and they may express ideas that seem
  delusional.
• Schizotypal PD may seem bizarre, much of the time
  they seem suspicious, superstitious and aloof

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. Dramatic, Emotional, and Erratic PD

• These individuals like to seek attention and
  their behaviour is often highly noticeable and
  very predictable

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Histrionic PD

• Their ultimate goal is to gain attention from
  others and they will do almost anything to attain
  this goal dress in unusual ways red cat suit
  with hot pink knee high boots excessive
  make-up. In interpersonal relationships they
  often act out the role of the star or the
  victim. They usually seem vain and immature and
  tend to speak in a dramatic, exaggerated and
  gushing manner. The exaggerate their expression
  of emotion, have stormy interpersonal
  relationships, have a self centered attitude and
  are manipulative. They often come to therapy
  because of drug overdose or other form of suicide
  attempt.
• They often react too quickly to situations with
  little analysis or thought. When they are asked
  to describe something they usually respond with
  impressions than with facts. They are easily
  influenced by others and are easily distracted
  their problems with attention lead them to appear
  naïve about many commonplace things

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Narcissistic PD

• The term comes from a classical Greek myth about
  a man Narcissus who fell in love with his
  reflection in a pond. Because he could never
  grasp his own image he despaired and died of
  anguish.
• Tend to have an extreme sense of self importance
  and the expectation of special favours, a need
  for constant attention, fragile self-esteem and
  lack of empathy and caring for others. They are
  often preoccupied with fantasies of unlimited
  success, brilliance, power, beauty and ideal love
  relationships. They may think that their problems
  are unique and feel that only equally special
  people are able to understand them

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• Antisocial PD pervasive pattern of disregard
  for and violation of the rights of others.
  Demonstrate at least 3 or more of the following
  symptoms failure to conform to social norms
  with respect to lawful behaviors, deceitfulness
  as is indicated by repeated lying, impulsivity,
  irritability and aggressiveness, reckless regard
  for safety of self and others, consistent
  irresponsibility, and lack of remorse.

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• Borderline PD pervasive pattern of instability
  of interpersonal relationships, self-image and
  affect. (love/hate). Need at least 5 or more of
  the following symptoms frantic efforts to avoid
  real or imagined abandonment, unstable and
  intense interpersonal relationships alternating
  b/w extremes of idealization and devaluation,
  identity disturbance, impulsivity in at least 2
  areas (substance abuse, sex, reckless driving,
  binge eating), recurrent suicidal behavior or
  gestures or threats or self-mutilating, chronic
  feelings of emptiness, and inappropriate intense
  anger.

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Anxious and Fearful PD

• What sets them apart from the other disorders is
  that each of these disorders has a prominent
  component of fear.

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Avoidant PD

• Pervasive pattern of social inhibition, feelings
  of inadequacy, and hypersensitivity to negative
  evaluation. Ego-dystonic these persons
  actually seek therapy they know that something
  is wrong and they want to change. These persons
  want friends, but they are afraid of being
  rejected they will take the chance if they are
  guaranteed not to be rejected see the
  difference with the schizoid they dont want
  friends.

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• b. Obsessive-Compulsive PD pervasive pattern of
  preoccupation with orderliness, perfectionism,
  and mental and interpersonal control at the
  expense of flexibility, openness and efficiency.
  Indicated by 4 or more f the following symptoms
  preoccupation with details, rules, lists and
  order, shows perfectionism that interferes with
  task completion, excessively devoted to work and
  productivity to the exclusion of leisure
  activities and friendships, unable to discard
  worn-out or worthless objects, reluctant to
  delegate tasks or work with others unless they
  submit to exactly his/her way of doing things,
  adopts miserly spending style, and shows rigidity
  and stubbornness.

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• c. Dependent PD pervasive and excessive need to
  be taken care of that leads to submissive and
  clinging behavior and fears of separation.
  Indicated by five or more of the following
  difficulty making everyday decisions w/o advice
  from others needs others to assume
  responsibility for most major areas of their
  lives has difficulty expressing disagreement
  with others b/c of fear of loss of support or
  approval difficulty initiating projects or doing
  things on their own feels uncomfortable or
  helpless when alone urgently seeks another
  relationship when one as ended preoccupied,
  unrealistically, with fears of being left to take
  care of self.