personality disorder: enduring patterns of perceiving, relating to and thinking about the...

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Transcript of personality disorder: enduring patterns of perceiving, relating to and thinking about the...

Page 1: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.
Page 2: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself. . . . that are inflexible and maladaptive - cause functional impairment or subjective distress

• chronic• originate in childhood – continue as an adult• may or may not distress the person with the disorder• listed on Axis II of the DSM-IV

Page 3: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• Cluster A: odd or eccentric beliefs• Paranoid p.d.• Schizoid p.d.• Schizotypal p.d.

• Cluster B: dramatic, emotional, erratic• Antisocial p.d.• Borderline p.d.• Narcissistic p.d.• Histrionic p.d.

• Cluster C: fearful disorders• Obsessive-Compulsive p.d.• Avoidant p.d.• Dependent p.d.

Page 4: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• failure to conform to social norms

• deceitfulness

• impulsivity

• aggressiveness – repeated fights or assaults

• disregard safety of self and others

• irresponsibility

• lack of remorse

Page 5: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• psychopathypsychopathy: focuses on : focuses on personality traits – some personality traits – some psychopaths do not have legal or psychopaths do not have legal or severe interpersonal problemssevere interpersonal problems

• Glibness/superficial charm• Grandiose sense of self-worth• Prone to boredom/need stimulation• Pathological lying• Conning/manipulative• Lack of remorse

Page 6: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• Crowe • “adopted away” children of felons had significantly higher

criminality

• Eysenck & Eysenck criminality concordance rate

- Monozygotic – 55%- Dyzygotic – 13%

Page 7: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• under-arousal hypothesis: abnormally low level of cortical arousal

• fearlessness hypothesis: higher threshold for experiencing fear than others

• differences in autonomic arousal• galvanic skin response (GSR): measure of sweating

and autonomic arousal

Page 8: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• coercive family process – parents give into children to avoid problems

• trauma

• SES disadvantage

• after age 40 – the psychopath begins to “burn out”

Page 9: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• frantic efforts to avoid real or imagined abandonment

• unstable and intense interpersonal relationships

• unstable self-image or sense of self

• impulsivity in ways that are harmful

• recurrent suicidal behavior or self-mutilating

• affective instability

• chronic feelings of emptiness

• inappropriate anger

• transient paranoid ideation – severe dissociation

Page 10: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• Based on a bio-social theory of BPD.

Page 11: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• medications:• tricyclic antidepressants and lithium

• dialectical behavior therapy (DBT) – Linehan • help cope with stressors that trigger suicidal behaviors –

learn to identify and regulate emotions

Page 12: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• histrionic personality disorder: express emotions in an overly dramatic fashion – often seductive in appearance - speech is vague, impressionistic

• Lilienfeld and colleagues • Histrionic overlaps with antisocial

p.d. – females histrionic – while males antisocial

Page 13: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• narcissisic personality disorder: pervasive pattern of grandiosity, need for admiration, and lack of empathy

• Kohut – caused by a lack of empathic “mirroring” by parents early in development – child is fixated on self-centered grandiose stage of development

Page 14: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• paranoid personality disorder: excessively mistrustful and suspicious of others without justification

Page 15: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• schizoid personality disorder: pattern of detachment from social relationships combined with a limited range of emotions in interpersonal situations

• schizotypal personality disorder: social isolation combined with odd or eccentric beliefs

Page 16: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• preoccupied with details, rules, lists, order, preoccupied with details, rules, lists, order, or schedules – point of activity becomes lostor schedules – point of activity becomes lost

• excessively devoted to work and excessively devoted to work and productivity to exclusion of friends and productivity to exclusion of friends and leisureleisure

• inflexible about matters of moralityinflexible about matters of morality• can’t discard worn out itemscan’t discard worn out items• can’t delegate tasks to otherscan’t delegate tasks to others• miserly spendingmiserly spending• rigidity and stubbornrigidity and stubborn

Page 17: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• avoidant personality disorder: pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

• behavioral intervention techniques for anxiety and social skills problems

• systematic desensitization• behavioral rehearsal

Page 18: personality disorder: enduring patterns of perceiving, relating to and thinking about the environment and oneself.... that are inflexible and maladaptive.

• dependent personality disorder: excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation

• agree with others even when they disagree to avoid rejection – cling to relationships