Personality Disorders

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Personality Disorders
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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.

• Paranoid PD pervasive distrust and
  suspiciousness of others believe that everyone
  is out to get them, deceive them or take
  advantage of them.
• Schizoid PD pervasive pattern of detachment
  from social relationships and a restricted range
  of expression of emotions in interpersonal
  settings lack basic social skills.
• Schizotypal pervasive pattern of social and
  interpersonal deficits marked by acute discomfort
  with, and reduced capacity for close
  relationships as well as by a cognitive and
  perceptual distortions and eccentricities of
  behavior (odd thinking and speech, odd beliefs,
  inappropriate or constricted affects).

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. Dramatic, Emotional, and Erratic PD

• Histrionic PD (drama queen) pervasive pattern
  of excessive emotionality and attention seeking.
  They want to be the center of attention, 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. Seem
  confident on the surface, but these people really
  lack self-confidence and need approval and
  acceptance from others.
• Narcissistic PD pervasive pattern of
  grandiosity (in fantasy or behavior), need for
  admiration, and lack of empathy. Grandiose ideas
  about their own abilities these people think
  that they are exceptional and will react with
  anger if others dont recognize this.

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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

• a. 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.

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  Schizophrenia
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• Described as the most devastating mental
  disorder.
• Fragmentation of basic psychological functions
  (attention, perception, thought, emotions, and
  behavior).
• Problems with adjusting to the demands of
  reality. Misperceive what is happening around
  them, often hearing and seeing things that arent
  there (hallucinations).
• Trouble paying attention to what is going on
  around them, thinking is often confused and
  disorganized that they cannot communicate
  w/others.
• Bizarre behavior and blunting emotions.

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• Characterized as having psychotic symptoms. The
  essential features of schizophrenia are a mixture
  of both positive and negative symptoms.
• Positive symptoms adding something that is not
  normally there. Include delusions,
  hallucinations, disordered thought processes, and
  disordered behavior.
• Delusions are misinterpretations of normal events
  and experiences. 1) Delusion of persecution 2)
  Delusion of grandeur 3) Delusion of control.
  These are phasic meaning they come and go
  just like most of the positive symptoms.

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• Hallucinations seeing and hearing things that
  arent really there. Usually voices telling them
  what to do.
• Disorganized speech word salad (jumbled words),
  frequent derailment (start with one thought and
  go off into another) or incoherence, create their
  own words. All this seems to stem from the fact
  the schizophrenics are easily distracted lack
  capacity for selective attention.
• Disorganized behaviors odd movements or strange
  gestures or no movement at all for long periods
  of time catatonia.

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• Negative symptoms absence of functions or
  reactions that most persons show.
• Flat affect no emotion stare off in space
  with a glazed look. When they do show emotion it
  is often times inappropriate may laugh at
  funerals and cry at birthday parties.
• Avolition lack of motivation or will persons
  may sit down doing nothing for hours.
• Alogia lack of speech may answer direct
  questions, but otherwise tend to remain silent
  w/drawn into private world.

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Onset and Course

• Chronic disorder last at least 6 months,
  generally begins in early 20. Equal among
  gender, although males have earlier onset than
  females.

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Five types of Schizophrenia

• Catatonic type at least 2 of the following
  motoric immobility catalepsy (including waxy
  flexibility) or stupor excessive motor activity
  (purposeless) extreme negativism (resistance to
  all instructions or maintenance of a rigid
  posture against attempts to be moved) or mutism
  echolalia (repetition or words) or echopraxia
  automatic imitation of movements.
• Disorganized type disorganized speech,
  disorganized behavior, flat or inappropriate
  affect.

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• Paranoid type preoccupation with one or more
  delusions (centered around the belief that others
  are out to get him) or frequent auditory
  hallucinations dont show disorganized speech or
  catatonic behavior or flat affect.
• Undifferentiated type meet all of Criteria 'A'
  symptoms delusions, hallucinations,
  disorganized speech, catatonic behavior, and flat
  affect, but dont meet the criteria for
  catatonic, disorganized or paranoid.
• Residual type waste-basket used when there
  has been at least one episode of schizophrenia,
  but the current clinical picture is w/o positive
  psychotic symptoms.

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Causes

• Genetic factors run in families twin studies.
  
• Biological factors brain dysfunction larger
  ventricles may produce abnormalities in the
  cerebral cortex. Reduced activity in the frontal
  lobes. (page 570).
• Biochemical factors neurotransmitters
  disturbance high levels of dopamine.
• Psychological factors families create
  environments that place their children at risk.
  Studies done on relapse shows - harsh criticism,
  hostility, and show too much concern with their
  problems.