Psychopathology, Ch. 12
{Note: This chapter is about personality disorders & impulse-control disorders, so I’m reasonably confident it contains (a) outdated or misleading statements and (b) moderate to severe ableism. If you’re a qualified professional and/or a person with one of these disorders, I invite you to drop corrections in the comments.}
Personality disorders: excessively rigid behavior patterns, or ways of relating to others, that ultimately become self-defeating.
Ego syntonic: referring to behaviors or feelings that are perceived as natural parts of the self.
Ego dystonic: referring to behaviors or feelings that are perceived to be alien to one’s self-identity.
Identify three clusters of personality disorders used in the DSM system.
Cluster A: People who are perceived as odd or eccentric. This cluster includes paranoid, schizoid, and schizotypal personality disorders.
Cluster B: People whose behavior is perceived as overly dramatic, emotional, or erratic. This cluster includes antisocial, borderline, histrionic, and narcissistic personality disorders.
Cluster C: People who often appear anxious or fearful. This cluster includes avoidant, dependent, and obsessive-compulsive personality disorders.
Describe the key features of personality disorders characterized by odd or eccentric behavior.
Paranoid personality disorder: characterized by undue suspiciousness of others’ motives, but not to the point of delusion.
Schizoid personality disorder: characterized by persistent lack of interest in social relationships, flattened affect, and social withdrawal.
Schizotypal personality disorder (SPD): characterized by lack of close personal relationships and eccentricities of thought and behavior, but without clearly psychotic features.
Describe the key features of personality disorders characterized by dramatic, emotional, or erratic behavior.
Antisocial personality disorder (ASPD): characterized by antisocial and irresponsible behavior and lack of remorse for harmful actions.
Sociocultural factors
Antisocial behavior & criminal activity
Profile
Borderline personality disorder (BPD): characterized by abrupt shifts in mood, lack of a coherent sense of self, and unpredictable/impulsive behavior.
Splitting: an inability to reconcile the positive and negative aspects of the self and others, resulting in sudden shifts between positive and negative feelings toward others.
Histrionic personality disorder (HPD): characterized by excessive need for attention, praise, reassurance, and approval.
Narcissistic personality disorder (NPD): characterized by an inflated self-image and extreme needs for attention/admiration.
Describe the key features of personality disorders characterized by anxious or fearful behavior.
Avoidant personality disorder (AVPD): characterized by avoidance of social relationships due to fears of rejection.
Dependent personality disorder (DPD): characterized by difficulty making independent decisions and overly dependent behavior.
Obsessive-compulsive personality disorder (OCPD): characterized by rigid ways of relating to others, perfectionistic tendencies, lack of spontaneity, and excessive attention to detail.
Evaluate problems associated with the classification of personality disorders.
Categories or dimensions?
Differential diagnoses
Overlap between disorders
Difficulty distinguishing between normal & abnormal behavior
Confusing labels with explanations
Sexist bias
Describe psychodynamic perspectives on the development of personality disorders.
Earlier Freudian theory focused on unresolved Oedipal conflicts in explaining normal and abnormal personality development. More recent psychodynamic theorists have focused on the pre-Oedipal period in explaining the development of personality disorders such as NPD & BPD.
1. Hans Kohut
2. Otto Kernberg
3. Margaret Mahler
Describe learning theory perspectives on the development of personality disorders.
Learning theorists view personality disorders in terms of maladaptive patterns of behavior rather than personality traits. Learning theorists seek to identify the early learning experiences and present reinforcement patterns that explain the development and maintenance of personality disorders. Antisocial adolescents are more likely to interpret social cues as provocations or intentions of ill will. This cognitive bias may lead them to be confrontational in their relationships with peers.
Describe the role of family relationships in the development of personality disorders.
Many theorists argue that disturbed family relationships play formative roles in the development of personality disorders. For example, theorists connect ASPD to parental rejection or neglect and parental modeling of antisocial behavior.
Describe biological perspectives on the development of personality disorders.
Biological explanations of ASPD focus on the possible role of lack of emotional responsiveness to physically threatening stimuli and reduced levels of ANS reactivity and the need for higher levels of stimulation to maintain optimal levels of arousal in people with antisocial personalities.
Genetic factors
Lack of emotional responsiveness
The craving-for-stimulation model
Brain abnormalities
Describe sociocultural perspectives on the development of personality disorders.
Sociocultural theorists focus on the roles of poverty, urban blight, and drug abuse in leading to family disorganization and disintegration that makes it less likely that children will receive the nurturance and support they need to develop more socially adaptive personalities. Sociocultural theorists believe that such factors may underlie the development of personality disorders, especially ASPD.
Describe psychodynamic approaches to treating personality disorders.
Psychodynamic therapists seek to help people with personality disorders become aware of the underlying roots of their self-defeating behavior patterns and learn more adaptive ways of relating to others in the context of their close relationships.
Describe cognitive behavioral approaches to treating personality disorders.
Cognitive behavioral therapy focuses on helping clients change their maladaptive behaviors and dysfunctional thought patterns rather than their personality structures. Two major forms of cognitive behavioral treatment for personality disorders have emerged: Beck’s cognitive therapy approach and Linehan’s dialectical behavior therapy approach.
Describe drug therapy approaches to treating personality disorders.
Drug therapy is limited to helping people with personality disorders control troubling emotional states such as depression and anxiety, temper feelings of anger or rage, and help control aggressive/self-destructive behavior. However, it doesn’t directly help people with personality disorders change long-standing patterns of maladaptive behavior.
Describe the key features of impulse-control disorders.
Impulse-control disorders are psychological disorders characterized by a pattern of repeated failure to resist impulses to perform acts that lead to harmful consequences to self or others. People affected by these disorders experience a rising level of tension or arousal just before the act, then a sense of relief or release when the act is committed.
Describe the key features of kleptomania.
Kleptomania is characterized by a compulsion to steal, usually involving items of little value to the person.
Describe the key features of intermittent explosive disorder.
Intermittent explosive disorder (IED) involves acts of impulsive aggression and may involve irregularities in serotonin transmission in the brain.
Describe the key features of pyromania.
Pyromania, or compulsive fire setting, is poorly understood but may be motivated in part by the desire to control the response of firefighters and even assist them in their work.
