DSM-IV-TR General Discription of Personality Disorder
Enduring patterns of inner experience and behaviour that deviates markedly from individual’s cultural expectations.
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.
- 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.
- 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
- 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.
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
- - Lifetime Prevalence: 10-14%
- -Specific disorders: .2-3%
Higher rates in inpatient setting
- More common in males
Onset/ Course/ Duration
Traced back to at least adolescents/early adulthood.
- Some aspects ameliorate after 40yrs (most
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.
· Predominately environmental pathway
- · Sadistic, degrading, humiliating caregivers
- · Experiences of deep mistrust of motives of others from infancy
- · Little research on biological underpinnings
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
- Behavioral: Vigilance
- Intrapsychic: Overwhelming fear
- Interpersonal: Hostility
- 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)