PERSONALITY DISORDERS:

1
PERSONALITY DISORDERS

• An enduring (long-standing) pattern in two or
  more of the following areas
• 1) Cognition (thoughts) - ways of interpreting
  and perceiving events
• 2) Affectivity (emotions) - range, intensity,
  lability, appropriateness
• 3) Interpersonal functioning (behavior)
• 4) Impulse control (behavior)

2
Personality Traits vs. Disorders

• Deviation from social cultural norms consider
  contribution of situational cultural context
• Inflexibility rigid patterns of behaviors
  responses
• Pervasive present in a variety of contexts
• Clinically significant distress for self or
  others
• Impairment in functioning highly maladaptive
• Stable long-lasting - onset by early adulthood,
  long-term pattern vs. occasional

3
CLUSTER A PERSONALITY DISORDERS

• Characterized by
• Odd behavior, reactions, emotions
• Eccentric thoughts behaviors e.g. illusory or
  magical thinking, inappropriate social
  interactions
• Isolative behavior social withdrawal
• Suspiciousness paranoia

• Includes
• Paranoid Personality Disorder
• Schizoid Personality Disorder
• Schizotypal Personality Disorder
• May represent mild variations of Schizophrenia,
  but reality testing is intact

4
PARANOID PERSONALITY DISORDER

• A. A pervasive pattern of distrusting, being
  suspicious of, and attributing malevolent
  intention to others
• B. Pattern of behavior is not due to
  Schizophrenia, a Mood Disorder with Psychotic
  Features, another Psychotic Disorder, the effects
  of a substance, or a general medical condition

5
PARANOID PERSONALITY DISORDER

• Indicated by 4 or more of the following 7
• Assuming others will exploit, harm, or deceive
  them
• Continually doubting the loyalty or
  trustworthiness of friends or associates
• Reluctance to confide in others because fear info
  will be used against them
• Reading hidden demeaning or threatening meanings
  into benign remarks or events
• Persistently bearing grudges
• Often believing they have been attacked or
  slighted and are quick to react angrily or with
  counterattack
• Continually suspecting spouse or sexual partner
  of being unfaithful

6
PARANOID PERSONALITY DISORDER

• What it looks like
• Chronically suspicious of others
• Distrusting of others
• Assuming the worst intention
• Not open
• Continually doubting loyalty of others
• Unforgiving
• Hold grudges

7
PARANOID PERSONALITY DISORDER

• Facts Figures
• Prevalence 0.5-2.5 in general population
• Gender more common in males
• Onset often first apparent in childhood and
  adolescence
• Cultural Factors need for caution in diagnosing
  members of minority, ethnic, immigrant, refugee
  groups
• Treatment Considerations
• Importance of developing trust a solid
  therapeutic alliance
• Cognitive therapy to counter mistaken assumptions
  and negative beliefs about others
• No evidence that therapy is very successful

8
SCHIZOID PERSONALITY DISORDER

• A.Characterized by a pervasive pattern of
• -detachment from social relationships
• -restricted range of emotional expression in
  interpersonal settings
• B. Pattern of behavior is not due to
  schizophrenia, a Mood Disorder with Psychotic
  Features, another Psychotic Disorder, or a
  Pervasive Developmental Disorder.

9
SCHIZOID PERSONALITY DISORDER

• Indicated by 4 or more of the following 7
• 1. Neither desiring nor enjoying close
  relationships, including being part of a family
• Almost always choosing solitary activities
• Having little, if any, interest in sexual
  experiences/relationships
• 4. Taking pleasure in few, if any, activities
• 5. Lacking close friends or confidants
• 6. Indifference to praise or criticism
• 7. Emotional coldness, detachment, or flatness

10
SCHIZOID PERSONALITY DISORDER

• What it looks like
• Emotionally cold distant
• Great difficulty forming relationships
• Social isolation loner
• Restricted affect lack of emotional
  expressiveness
• Lack of interest in people, relationships, most
  activities

11
SCHIZOID PERSONALITY DISORDER

• Facts Figures
• Prevalence uncommon lt1
• Gender slightly more common and impairing in
  males
• Onset often first apparent in childhood and
  adolescence
• Cultural need for caution in diagnosing people
  from different cultural backgrounds,
  environments, or immigrants

12
SCHIZOID PERSONALITY DISORDER

• Contributing factors
• Childhood shyness
• Genetics
• Parenting neglectful cold parenting intrusive
  mother absent father
• Lower density of dopamine receptors
• Traumatic experiences
• Treatment
• Modeling healthy relationship skills emotional
  expression
• Empathy training teaching the person how to
  identify, express, respond to emotion
• Social skills training, including role playing
• Building a support network

13
SCHIZOTYPAL PERSONALITY DISORDER

• A. A pervasive pattern of social and
  interpersonal deficits marked by
• -acute discomfort with close relationships
• -a reduced capacity for close relationships
• -cognitive or perceptual distortions
• -eccentric behaviors
• B. Pattern is not due to schizophrenia, a Mood
  Disorder with Psychotic Features, another
  Psychotic Disorder, or a Pervasive Developmental
  Disorder

14
SCHIZOTYPAL PERSONALITY DISORDER

• Indicated by 5 or more of the following 9
• 1. Ideas of reference
• 2. Odd beliefs or magical thinking
• 3. Unusual perceptual experiences
• 4. Odd thinking speech
• Suspiciousness or paranoid ideation
• 6. Inappropriate or constricted affect
• 7. Odd, eccentric or peculiar behavior or
  appearance
• 8. Lack of close friends or confidants
• 9. Excessive social anxiety that does not
  diminish with familiarity and tends to be
  associated with paranoid fears

15
SCHIZOTYPAL PERSONALITY DISORDER

• What it looks like
• Social impairment isolation
• Social discomfort anxiety
• Variety of odd beliefs cognitions
• Unusual perceptions perceptual experiences
• Odd speech presentation
• Eccentric peculiar behavior
• Inappropriate or blunted affect

16
SCHIZOTYPAL PERSONALITY DISORDER

• Facts Figures
• Prevalence 3-5 of general population
• Gender slightly more common in males
• Onset often first apparent in childhood and
  adolescence
• Course chronic some go on to develop
  Schizophrenia
• Cultural need to consider cultural context
  when evaluating symptoms

17
SCHIZOTYPAL PERSONALITY DISORDER

• Contributing Factors
• Biological and genetic factors have been
  emphasized Schizotypal PD as a milder variant
  of schizophrenia
• Treatment Considerations
• Psychotropic medication antidepressants,
  antipsychotics
• Cognitive-behavioral therapy
• Social skills training

18
Cluster A Scenario

• An individual receives an invitation to attend
  the birthday party of a supervisor at work. This
  supervisor is not well known to the individual,
  in fact, they have only spoken on a couple of
  occasions.

19
Paranoid Personality Disorder

• Cognitions include
• This person reached their position through
  dishonesty or fraud they are not to be trusted.
• My colleagues are out to get me it will not be
  safe to be in an unfamiliar setting with them.
• My job security is being threatened.

• Behaviors include
• Approaching the supervisor to research these
  suspicions in a hostile and accusatory manner
• Finding an excuse to not attend the birthday
  party
• Increased irritability in the workplace
• Hypervigilance for suspicious behavior from
  colleagues

20
Schizoid Personality Disorder

• Cognitions Include
• Not wanting to go to the party
• I would rather be alone.
• This party wont be enjoyable.

• Behaviors include
• Not attending the party
• Telling the supervisor she wont attend in a
  cold, detached way

21
Schizotypal Personality Disorder

• Cognitions Include
• I was meant to go to this birthday party because
  something supernatural will occur
• I wonder why the supervisor chose me?
• Will I be prepared to handle what is to come?

• Behaviors Include
• Wearing an unusual ceremonial costume to the
  party
• Remaining detached from others at the party
• Speaking to others in an elaborate way

22
CLUSTER B PERSONALITY DISORDERS

• Characteristics
• Dramatic
• Emotional
• Erratic behavior
• Impulsiveness
• Reduced capacity for empathy
• Unstable emotions relationships

• Includes
• Antisocial Personality Disorder
• Borderline Personality Disorder
• Histrionic Personality Disorder
• Narcissistic Personality Disorder

23
ANTISOCIAL PERSONALITY DISORDER

1. Pervasive pattern of disregard for and violation
   of the basic rights of others
2. Beginning in childhood or early adolescence (must
   have evidence of Conduct Disorder prior to 15
   years)
3. Continuing into adulthood (must be at least 18
   years)
4. Occurrence of antisocial behavior is not
   exclusively during a course or Schizophrenia or
   Mania

24
ANTISOCIAL PERSONALITY DISORDER

• Indicated by 3 or more of the following 7
• Failure to conform to social norms and laws, e.g.
  repeatedly performing acts that are grounds for
  arrest
• Deceitfulness manipulation, e.g. repeated
  lying, using aliases, or conning others for
  personal profit or pleasure
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness, e.g. repeated
  physical fights or assaults
• Reckless disregard for safety of self or others
• Consistently extremely irresponsible, e.g.
  repeated failure to sustain consistent work or
  honor financial obligations
• Lack of remorse, e.g. being indifferent to or
  rationalizing having hurt, mistreated, or stolen
  from another

25
ANTISOCIAL PERSONALITY DISORDER

• What you see
• Aggressiveness
• Superficial charm
• Self-centered
• Bore easily, high need for stimulation,
  sensation-seeking, thrill-seeking
• Lie easily
• Conning, manipulative
• Relationships of utility
• Lack of remorse little or no guilt about the
  harm they cause others
• Lack of empathy may seem cold insensitive
• Enjoy testing, provoking, pushing, playing with
  others
• Criminal behavior feel rules dont apply to them

26
ANTISOCIAL PERSONALITY DISORDER

• Facts Figures
• Prevalence 3 males lt1 females
• Gender more common in males
• SES associated with low SES urban settings
  important to consider the social and economic
  context for behaviors
• Course chronic, but symptoms tend to lessen or
  remit by 4th decade of life

27
Antisocial Personality Disorder

• Contributing Factors
• Strong biological roots
• Genetic influence
• Low levels of 5HT
• Low arousability
• Excessive theta waves
• Poor impulse control
• Fearlessness
• Environmental factors
• Parenting harsh, inconsistent, neglectful,
  uninvolved, abusive
• Chronic stress, trauma
• Treatment
• Psychotherapy is not very effective often
  court-mandated
• Lithium SSRIs may help control impulsive,
  aggressive behaviors

28
BORDERLINE PERSONALITY DISORDER

• A pervasive pattern of marked impulsivity and
  unstable relationships, self image, and emotions
• Indicated by 5 or more of the following 9
• Frantic efforts to avoid real or imagined
  abandonment
• A pattern of unstable and intense interpersonal
  relationships shifts from extreme idealization
  to devaluation
• 3. Identity disturbance sudden dramatic
  shifts in self image, e.g. goals, values, career
  plans aspirations, sexual identity, types of
  friends

29
BORDERLINE PERSONALITY DISORDER

• 4. Impulsive behavior that is potentially
  self-damaging, e.g. spending, sex, substance
  abuse, reckless driving, binge eating
• 5. Recurrent suicidal behavior, gestures, or
  threats, or self-mutilating behavior
• 6. Affective instability due to highly reactive
  mood, e.g. episodes of dysphoria, anxiety, panic,
  irritability, anger, despair
• 7. Chronic feelings of emptiness
• 8. Inappropriate, intense anger or difficulty
  controlling anger e.g. frequent temper, biting
  sarcasm, enduring bitterness, verbal outbursts,
  recurrent fights
• 9. Transient, stress-related paranoia or
  dissociative symptoms, such as depersonalization

30
BORDERLINE PERSONALITY DISORDER

• What it looks like
• Unstable mood emotions lack control over
  emotions
• Unstable self-concept
• Unstable interpersonal relationships
• Poor impulse control
• Self-destructive
• Good at splitting
• Vacillating between extremely positive negative
  evaluations of self others

31
BORDERLINE PERSONALITY DISORDER

• Facts Figures
• Prevalence 1-3 of general population
• Gender 75 female
• Completed suicide rate 6-10
• Course
• greater instability, impairment, and suicide risk
  in adolescence young adulthood
• symptoms gradually wane with advancing age
• by 30s 40s, most attain greater stability in
  relationships and vocational functioning

32
BORDERLINE PERSONALITY DISORDER

• Contributing Factors
• Biological factors low levels of serotonin
• Family history of mood disorders
• Environmental factors invalidating neglectful
  parenting history of abuse trauma
• Treatment
• Drug therapies SSRIs for dysphoria mood
  stabilizers for mood instability
• Long-term therapy
• Dialectical Behavior Therapy
• Trauma work

33
HISTRIONIC PERSONALITY DISORDER

• A pervasive pattern of excessive emotionality and
  attention-seeking behavior
• Indicated by 5 or more of the following 8
• Feels uncomfortable or unappreciated when not the
  center of attention
• Inappropriately seductive or provocative behavior
• Displays rapidly shifting and shallow emotions

34
HISTRIONIC PERSONALITY DISORDER

1. Consistently uses physical appearance to draw
   attention to self
2. Have strong opinions impressions, but cant
   back up with facts, details, examples, evidence
3. Is overly dramatic, theatrical and emotionally
   expressive
4. Is suggestible, i.e. easily influenced by others,
   fads, or circumstances
5. Considers relationships to be more intimate than
   they actually are

35
HISTRIONIC PERSONALITY DISORDER

• What it looks like
• Flamboyant self expression presentation
• Over-blown, overly dramatic emotional rxns
• Needy solicitous of others
• Require excessive approval reassurance
• Frequently dependent
• Impressionistic superficial
• Overly concerned with appearance
• Seductive charming

36
HISTRIONIC PERSONALITY DISORDER

• Facts Figures
• Prevalence 2-3 in general population
• Gender diagnosed more frequently in women
  prevalence may be equal for males females
• Sex role stereotypes influence the behavioral
  expression of the disorder
• Aging presents special difficulties
• Course chronic, but sx may improve with age
• Contributing Factors
• Unmet needs for attention success

37
NARCISSISTIC PERSONALITY DISORDER

• Pervasive pattern of grandiosity in fantasy or
  behavior, need for admiration, and lack of
  empathy
• Indicated by 5 or more of the following 9
• Grandiose sense of self importance, e.g.
  overestimating ones abilities, exaggerating
  ones accomplishments, underestimating/devaluing
  others.
• Fantasies about unlimited success, power,
  brilliance, beauty, or love.
• Belief that one is special, superior, or unique.

38
NARCISSISTIC PERSONALITY DISORDER

• 4. Need for excessive admiration and/or constant
  attention
• 5. Sense of entitlement, i.e. expecting
  especially favorable treatment or automatic
  compliance from others
• 6. Conscious or unwitting exploitation of others
• 7. Lack of empathy for others e.g.
  insensitivity, emotional coldness, lack of
  interest in others
• 8. Envying others believing others envy them
• 9. Arrogant, haughty, patronizing, snobby, or
  disdainful behaviors or attitudes

39
NARCISSISTIC PERSONALITY DISORDER

• What it looks like
• Self-enhancing, self-aggrandizing
• Self-centered, self-absorbed
• Readily dismiss opinions of others
• Need to feel special
• Love to receive special treatment
• Can become rageful attacking in response to
  perceived threat

40
NARCISSISTIC PERSONALITY DISORDER

• Facts Figures
• Prevalence lt1 in general population
• Gender up to 75 male
• Age narcissistic traits are particularly common
  in adolescents
• Course the aging process presents special
  difficulties may improve over time

41
NARCISSISTIC PERSONALITY DISORDER

• Causes
• Parental factors failure in modeling empathy
  rejecting, abandoning, or cold capricious,
  unreliable treating the child as an extension of
  themselves overvaluation lack of genuine,
  sincere affection
• Treatment
• Usually seek treatment at insistence of family
  member or as a result of a major life crisis
• Coping skills to improve ability to accept
  criticism rejection and to help person develop
  a more realistic view of their abilities and
  talents
• Empathy building
• Addressing depression other underlying problems
  that may exist

42
Cluster B Scenario

• An individual sees someone they occasionally date
  out at the movies with another date.

43
Antisocial Personality Disorder

• Cognitions Include
• Thoughts about what could be done to ensure that
  they are the one selected for the date next time
  it is, after all, a dog eat dog world.

• Behaviors Include
• Socially unacceptable or unlawful behavior to
  interrupt the date (calling in a bomb threat to
  the movie theatre)
• Starting rumors about the person who their
  romantic interest was on a date with, or about
  the romantic interest themselves.

44
Borderline Personality Disorder

• Cognitions Include
• She must hate me now.
• I am worthless.
• I will never have a relationship.
• My life is over.
• I was in love with her.

• Behaviors Include
• An emotional outburst
• Self injurious behavior
• Calling attention to himself impulsively in the
  moment

45
Histrionic Personality Disorder

• Cognitions Include
• I cant stand that person (either the romantic
  interest or the date).
• Didnt someone tell me he was promiscuous?
• We were in love.

• Behaviors Include
• A dramatic outburst
• Sexually seductive behavior
• Excessive emotional response that is prolonged
  and involves many people

46
Narcissistic Personality Disorder

• Cognitions Include
• A brief thought of being rejected
• Thoughts of being superior to the other date
• Thoughts that the date would be envious if they
  knew who she was

• Behaviors Include
• Loudly discussing accomplishments in the movie
  theatre so the romantic interest and date are
  sure to hear
• Showing how well known they are by greeting every
  acquaintance in the movie theater
• Approaching the romantic interest and asking them
  to call or actually starting up a conversation

47
Cluster C Personality Disorders

• Characterized by
• Anxious behavior
• Chronic fears
• Perfectionism
• Constant self-doubt

• Includes
• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive- Compulsive Personality Disorder

48
AVOIDANT PERSONALITY DISORDER

• A pervasive pattern of social inhibition, feeling
  inadequate, and hypersensitivity to negative
  evaluation
• Indicated by 4 or more of the following 7
• 1. Avoid work or school activities involving
  significant interpersonal contact because fear
  disapproval, criticism, or rejection
• 2. Resist getting involved with people without
  assurance that they will be liked and accepted
  without criticism
• 3. Are restrained in intimate relationships
  because fear being shamed or ridiculed

49
AVOIDANT PERSONALITY DISORDER

• Continued
• 4. Are preoccupied with being criticized or
  rejected in social situations (confirmatory bias)
• 5. Inhibited in new interpersonal situations due
  to feeling inadequate having low self-esteem
• 6. See self as socially inept, unappealing, or
  inferior to others
• 7. Unusual reluctance to take personal risks or
  engage in any new activities because these may
  prove embarrassing

50
AVOIDANT PERSONALITY DISORDER

• What it looks like
• Feel inadequate
• Low self-esteem
• Socially incompetent
• Worry about being criticized
• Avoid situations, activities, relationships, and
  people where there is any potential for them to
  be criticized, rejected, ridiculed, embarrassed,
  or disapproved of

51
AVOIDANT PERSONALITY DISORDER

• Facts Figures
• Prevalence 0.5-1.0 in general population
• Gender equally frequent for men women
• Course avoidant/shy behavior often starts in
  infancy or childhood increases during
  adolescence early adulthood
• Prognosis modest improvements with treatment
• Need for caution with (1) different
  cultural/ethnic groups (2) immigrants (3)
  children adolescents
• Causal Factors
• Parental rejection
• Sensitive temperament
• Treatment
• Behavioral interventions systematic
  desensitization, behavioral rehearsal, social
  skills assertiveness training

52
DEPENDENT PERSONALITY DISORDER

• A pervasive and excessive need to be taken care
  of that leads to submissive and clinging behavior
  and fears of separation.
• Indicated by 5 or more of the following 8
• Difficulty making everyday decisions without an
  excessive amount of advice and reassurance from
  others.
• Allow others to assume responsibility for major
  areas of his/her life.
• Difficulty expressing disagreement with others
  because they fear losing support or approval.

53
DEPENDENT PERSONALITY DISORDER

• 4. Difficulty initiating projects or doing things
  on own because lack self confidence
• 5. Go to excessive lengths to obtain nurturance
  and support from others, e.g. volunteering to do
  things that are unpleasant
• 6. Feel uncomfortable or helpless when alone due
  to exaggerated fears of being unable to take care
  of self
• 7. Urgently seek another relationship as a source
  of care and support when a close relationship
  ends become quickly indiscriminately attached
  to people
• 8. Preoccupied with fears of being left to take
  care of self

54
DEPENDENT PERSONALITY DISORDER

• What it looks like
• Worry about being abandoned
• Lack self-confidence
• Submissive, clingy, needy
• Urgency, desperation with relationship-seeking
• Need for others to assume responsibility for them
• Rely on others for almost everything
• To take care of them
• To do things for them
• To make decisions for them
• To support and nurture them

55
DEPENDENT PERSONALITY DISORDER

• Facts Figures
• Prevalence 2 one of the most frequently
  reported personality disorders in mental health
  clinics
• Age cultural factors need to be considered
• Gender diagnosed more frequently in females may
  be equally prevalent for men women
• Causes
• Disruption in early bonding/attachment due to
  early death of a parent or neglect or rejection
  by caregivers
• Treatment
• Long-term psychotherapy
• Assertiveness training, self-esteem work, skills
  building

56
OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

• A pervasive pattern of preoccupation with
  orderliness, perfectionism, and control, at the
  expense of flexibility, openness, and efficiency
• Indicated by 4 or more of the following 8
• So preoccupied with procedures, details, lists,
  order, and schedules that the major point of the
  activity is lost.
• Perfectionism interferes with task completion and
  causes significant dysfunction and distress.
• Excessive devotion to work and productivity to
  the exclusion of leisure activities and
  friendships (not accounted for by obvious
  economic necessity).

57
OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

• 4. Excessively conscientious, scrupulous, and
  inflexible about matters of morality, ethics or
  values (not accounted for by cultural or
  religious identification)
• 5. Inability to discard worn-out or worthless
  objects, even when they have no sentimental value
• 6. Reluctance to delegate tasks or work to others
  unless they submit to exactly their way of doing
  things
• 7. Overly miserly and stingy with money hoard
  money for future catastrophes
• 8. Rigidity and stubbornness

58
OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

• What it looks like
• Controlling have to have control over
  everything in their life
• Believe they have to be perfect to be accepted by
  others
• Follow rigid routines become anxious when
  routines are disrupted
• Orderly
• Lose the forest for the trees
• Inefficient at completing tasks
• Workaholics unable to delegate
• Rigid morals values
• Pack rats
• Rigid and stubborn
• Overly frugal and stingy with money

59
OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

• Facts Figures
• Prevalence 1-4 of community samples
• Gender diagnosed twice as often among males
• Special considerations individuals reference
  group
• Treatment Considerations
• May seek Tx due to depression or slipping
  productivity
• Dont like the loss of control inherent in
  therapy tend to counter by providing a
  detailed, orderly account of Sx issues
• Therapist needs to avoid competing with client to
  direct the session
• Antidepressants may be helpful for underlying
  anxiety depression

60
Cluster C Scenario

• This individual is going to meet her boyfriends
  parents in another city for the first time.

61
Avoidant Personality Disorder

• Cognitions Include
• Is it possible to get out of this?
• They wont approve of me.
• They might be mean to me.
• How could they ever like me?

• Behaviors Include
• Speaking very little around the family
• Avoiding the situation altogether
• Taking excessive measures to ensure that she is
  approved of (bringing luxurious gifts)

62
Dependent Personality Disorder

• Cognitions Include
• What will I wear, do, say? (Followed by asking
  her boyfriend for input about this.)
• I have to make sure they like me.

• Behaviors Include
• Volunteering to babysit all the children while
  the adults go out to dinner
• Sticking by her boyfriends side the entire time
• Agreeing to everything the family suggests and
  with all the opinions they offer

63
Obsessive-Compulsive Personality Disorder

• Cognitions Include
• Everyone here is doing everything wrong.
• Distress about having to delegate work tasks
  while away, and about the dogsitters ability to
  perform tasks (or the babysitters)

• Behaviors Include
• Planning out activities to fill the entire trip.
• Making extensive lists of things to bring but not
  packing until the last minute.
• Exhibiting a great deal of distress when
  conforming to others ways of doing things or
  being stubborn and ensuring that things are done
  her way.

64
Theories of Personality Disorders

• Family dynamics growing up in a dysfunctional,
  abusive, invalidating, overprotective,
  controlling, or uncaring environment poor
  parenting parent-child relationship
• Genetic Influences
• Biological/biochemical Influences
• Trauma other significant experiences
• Continuum model personality disorders represent
  extreme variations of normal personality traits

65
Treatment for Personality Disorders

• Long-term supportive, structured psychotherapy
• Dialectical Behavior Therapy (DBT) accepting
  validating client, setting limits, skills
  training
• Cognitive Behavioral Therapy (CBT) challenging
  maladaptive thoughts, beliefs, schemas skills
  training behavioral experimentation
• Psychodynamic/Object Relations Therapy emphasis
  on transference, the effect of past relationships
  on the present, raising insight
• Relational/Interpersonal Therapy using the
  therapeutic relationship and other significant
  relationships to foster growth, change, and
  healing