Personality Disorders

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Features

- Maladaptive & inflexible patterns of behaviour typically present in early childhood & present in a variety of contexts & stable over time

-  Decreases over time

- All Axis II by DSM IV

- 30-40% psych pts

- 10% adult population

 

Classification

- Cluster A: Odd or Eccentric

-  Paranoid, schizopherniform, schizotypal

- Cluster B: Dramatic, Emotional or Erratic

-  Antisocial, borderline, narcissistic, histrionic

- Cluster C: Anxious

-  Avoidant, dependant, obsessional, passive-aggressive

 

 

 

Cluster A: Odd or Eccentric

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- Paranoid

- Schizophreniform

- Schizotypal

 

 

Paranoid Personality Disorder

-  Distrustful, suspicious, hostile, intimidating, w denial & splitting

-  Bears grudges, easily offended, everyone out to get them

-  Prone to litigation, acts of independence or disobedience treated w hostility

-  Child Hx often harsh parenting

-  Depression, anxiety or psychosis may result from stress

 

Schizophreniform Personality Disorder

-  Detachment from social relationships

-  4+ of

-  Does not desire nor enjoy close relationships or family

-  Typically chooses solitary activities

-  Little to no interest in sexual activity

-  Pleasure in few activities

-  Lacks close friends or confidants

-  Indifferent to praise or criticism

-  Emotional coldness, detachment, flattened affect

 

Schizotypal Personality Disorder

-  Social & interpersonal defecits

-  Reduced capacity for close realationships

-  5+ of

-  Ideas of reference (not delusions)

-  Odd beliefs, magical thinking which influences behaviour & is inconsistent w subculture

-  Perceptual abnormalities, bodily illusions

-  Odd thinking & speech (vague, circumstantial..)

-  Suspiciousness & paranoid ideation

-  Innappropriate or constricted affect

-  Odd, eccentric or perculiar behaviour or appearance

-  Lacks close friends or confidants

-  Excessive social anxiety from paranoid fears

 

 

 

Cluster B: Dramatic, Emotional or Erratic

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- Antisocial

- Borderline

- Nacissistic

- Histrionic

 

 

Antisocial Personality Disorder

-  Disregard & violation of others rights since age of 15 yrs

-  Pt must be > 18 yrs

-  Conduct Disorder evident prior to 15 yrs

-  3+ of

-  Failure to conform to social norms, repeated unlawful acts

-  Deceitfullness, repeated lies, use of aliases, conning for personal pleasure &/or profit

-  Impulsivity or failure to plan ahead

-  Irritability & aggressiveness, repeated fights or assaults

-  Reckless disregard for safety of self &/or others

-  Consistent irresponsibility, poor work behaviour, financial dishonour

-  Lack of remorse, indifferent to hurting, mistreating or stealing

 

Borderline Personality Disorder

-  Unstable interpersonal relationships, self-image & affect w marked impulsivity

-  5+ of

-  Frantic efforts to avoid real or imagined abandonment

-  Unstable & intense interpersonal relationships alternating between idealising & devaluation

-  Identity disturbance

-  Self damaging impulsivity ($, sex..)

-  Recurrent suicidal behaviour, gestures, threats, self mutilation

-  Affective instability due to marked reactivity of mood

-  Chronic feelings of emptiness

-  Innappropriate, intense anger or difficulty controlling anger

-  Transient stress related paranoid ideation or severe dissociative symptoms

 

Narcisistic Personality Disorder

-  Grandiosity w a need for admiration & lack of empathy

-  5+ of

-  Grandiose sense of self importance

-  Preoccupied w fantasies of unlimited success, power, brilliance, beauty or ideal love

-  Believes they are special & unique & can only be understood or should associate w other special or high status people

-  Requires excessive admiration

-  Sense of entitlement

-  Interpersonally exploitive

-  Lacks empathy

-  Often envious of others or believes others are envious of them

-  Shows arrogant, haughty bahaviour or attitude

 

Histrionic Personality Disorder

-  Excessively emotional & attention seeking

-  5+ of

-  Uncomfortable in situations when not the centre of attention

-  Interaction w others is often inappropriately sexually seductive or provactive

-  Displays rapidly shifting & shallow expression of emtion

-  Consistently uses physical appearance to draw attention to self

-  Style of speech excessively impressionistic but lacking detail

-  Shows self dramatisation, theatricality and exaggerated expression of emotion

-  Suggestible

-  Considers relationships to be more intimate than they actually are

 

 

 

Cluster C: Anxious

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- Avoidant

- Dependant

- Obsessional

- Passive-Aggressive

 

 

Avoidant Personality Disorder

-  Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation

-  4+ of

-  Avoids occupational activities that involve interpersonal contact for fear of criticism, dissaproval or rejection

-  Unwilling to get involved w people unless certain of being liked

-  Shows restraint within intimate relationships for fear of being shamed or ridiculed

-  Preoccupied w criticism or rejection in social situations

-  Inhibited in new interpersonal situations for fear of feeling inadequate

-  Views self as socially inept, personally unappealing or inferior

-  Unusually relectunt to take personal risks or engage in new activities for fear of embarrassment

 

Dependant Personality Disorder

-  Excessive need to be taken care of leading to submissive & clinging behaviour & fears of seperation

-  5+ of

-  Difficulty making everyday decisions wo excessive advice or reassurance

-  Needs others to assume responsibility for most major areas of life

-  Difficulty expressing disagreement w others for fear of loss of support or approval

-  Difficulty initiating projects or independent work

-  Excessive lengths to obtain nuturing & support from others

-  Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for self

-  Urgently seeks another relationship as a source of care & support when a close one ends

-  Unrealistically preoccupied w fears of being left to take care of self

 

Obsessional Personality Disorder

-  Preoccupation w orderliness, perfectionism & mental & interpersonal control at the expense of flexibility, openness & efficiency

-  4+ of

-  Preoccupied w details, rules, lists, order, organistation or schedules to extent that major point of activity is lost

-  Shows perfectionism which interferes w task completion

-  Excessively devoted to work & productivity to exclusion of leisure activites & friendships

-  Overconscientious, scrupulous & inflexible about matters of morality, ethics or values

-  Unable to discard worn-out clothes or worthless objects even wo sentimental value

-  Relectant to delegate tasks or work w others unless they submit to exact ways of doing things

-  Money is viewed to be hoarded for future catastrophies

-  Rigidity & stubborness

 

Passive-Aggressive Personality Disorder

-  Resistance to demands for adequate social & occupational performance

-  5+ of

-  Procrastination

-  Sulky, irritable or argumentative when asked to do something they do not want to

-  Works deliberately slowly or does a bad job on tasks they do not want to do

-  Protests wo justification that others make unreasonable demands

-  Avoids obligations by claiming to have forgotten

-  Believes they do a much better job than others believe they do

-  Resents useful suggestions on how they could be more productive

-  Obstructs efforts of others by failing to do their share of work

-  Unreasonably criticises or scorns people in positions of authority