Personality Disorders

  1. DSM-IV-TR General Discription of Personality Disorder
    Enduring patterns of inner experience and behaviour that deviates markedly from individual’s cultural expectations.
  2. DSM-TR-IV
    How do PD's manifest
    In which areas
    How many present for diagnoses
    • 1.Cognitions: Disorders regarding self & others
    • 2. Affective: Unstable, extremes of too much/too little/poor regulation and inappropriate affect.
    • 3.Interpersonal functioning: Problems in affiliation and power (and absence of) interpersonal functioning
    • 4.Impulse control: Problems controlling impulsive behaviour.
  3. Cluster A:
    • Odd or Eccentric
    • 1.Schizoid- Detachment from social relationships and restricted range of expression of emotions

    2. Paranoid- Distrust and suspiciousness of others

    3. Schizotypal- Discomfort with close relationships, cognitive and perceptual distortions, eccentricities of behaviour.
  4. Cluster B:
    • Dramatic, Erratic, Emotional
    • 1.Histrionic: Excessive emotionality and attention seeking

    2. Borderline: Instability of interpersonal relationships, self-image, emotions, and control over impulses.

    3. Antisocial: Disregard for and frequent violation of the rights of others

    4. Narcissistic: Grandiosity, need for admiration, and lack of empathy
  5. Cluster C:
    • Anxious or Fearful
    • 1.Avoidant: Social inhibition, feelings of inadequacy, and hypersensitivity or negative evaluations

    2.Obsessive –Compulsive: Preoccupation with orderliness and perfectionism at the expense of flexibility.

    3. Dependent: Excessive need to be taken care of, leading to submissive and clinging behaviour.
  6. General info/ Symptoms
    • 1. Inflexible and maladaptive, causing significant (clinical) functional impairment & distress in social
    • occupational and interpersonal settings.
    • 2.Pervade all aspects ofpersons’ life (personal/social dysfunction)
    • 3. Ego Dystonic-may affect others more than person=family member more likely to seek treatment
    • 4. Comparable dysfunction to Axis I disorders
    • 5. Strong stigma attached
  7. Prevalence
    • - Lifetime Prevalence: 10-14%
    • -Specific disorders: .2-3%

    Higher rates in inpatient setting
  8. Gender Differences
    - More common in males

    -Often comorbidity
  9. Onset/ Course/ Duration
    Traced back to at least adolescents/early adulthood.


    • Some aspects ameliorate after 40yrs (most
    • continue)
  10. DSM-IV-TR Features of Paraoid PD
    • 1.Pervasive distrust and suspiciousness of others without justification
    • 2.Interprets others motives as malevolent
    • 3.Suspects others are exploiting, harming or deceiving them
    • 4. Preoccupied with doubts of loyalty or others
    • 5. Reluctant to confide
    • 6.Sees benign messages as demeaning or threatening
    • 7.Bears grudges
    • 8. Perceives attacks on character, quick to react with anger
    • 9. Recurrent suspicions regarding sexual fidelity of partner.
  11. Aetiology of Paranoid PD
  12. · Predominately environmental pathway
    • · Sadistic, degrading, humiliating caregivers
    • · Experiences of deep mistrust of motives of others from infancy
    • · Little research on biological underpinnings
  13. Treatment of Paranoid PD
    & Behavioural Markers
    Difficult to establish as do not trust therapist

    CBT based to challenge mistaken assumptions

    No good evidence of efficacy

    • Markers
    • Behavioral: Vigilance
    • Intrapsychic: Overwhelming fear
    • Interpersonal: Hostility
  14. Schizoid PD
    • 1.Pervasive detachment from social relationships
    • 2.Restricted emotional expression in interpersonal setting
    • 3.Neither wants nor enjoys close relationships, including family
    • 4.Strongly prefers solidary activities
    • 5.Little interest in sexual relationships
    • 6.Little pleasure from activities
    • 7.Lacks close friendships
    • 8.Indifferent to praise or criticism
    • 9.Emotional cold, detached, flat
    • 10.Do not experience strong subjective emotions (anger, sadness, happiness)
Card Set
Personality Disorders
Abnormal Psych: Personality Disorders