Personality 11-18

11/18/2014

Personality
Unique pattern of perceiving thinking about, relating to
environment
Stable, enduring, predictability and consistency to behavior
Flexibility also important
Personality disorder Inflexibility is a central feature
DSM 5 General Criteria
A- enduring pattern of inner experience and behavior that deviates
markedly from cultural expectations and is manifested in at least
two of the following areas: cognition, affectivity, interpersonal
functioning, impulse control
B- pattern is inflexible and pervasive
C- pattern leads to clinically significant distress or impairment
D pattern is stable and of long duration (adolescence or early
adulthood)
E not better explained by another mental disorder
F not due to substance or medical condition
Problems with Diagnosis
MUST LOOK AT LONG TERM PATTERNS OF FUNCTIONING
o Depression is assessing at the moment
o Personality disorder must be diagnosis over a long time
INDIVIDUALS MAY LACK INSIGHT
o They dont identify personality disorder as a disorder
o They dont think its wrong at times
OVERLAP AMONG CATEGORIES
o Too many personalities, a lot of overlap on the criterias
WITHIN DIAGNOSIS HETEROGENEITY
o Heterogeneity a lot of differences, diff kinds of people
o There might a group that have similar characteristics
CONTROVERSY ABOUT VALIDITY

DSM 5 Proposals
No Axis II adopted DSM-5 has completely eliminated the
multiaxial approach
o Axis II has stable characteristics (personality disorder was on
Axis II but not anymore). Axis II = personality disorder
o proposed to kill the categorical methods and go into a ranking
system
A dimensional approach instead of categorical NOT adopted
Complex hybrid approach that was NOT adopted
o They kept some categories AND rating so its a hybrid
retained 6 disorders schizotypal, antisocial,
borderline, narcissistic, avoidant, obsessive compulsive
Added a Personality Disorder-Trait specified
Specific Personality Disorders
Cluster A Odd or Eccentric (paranoid, schizoid, schizotypal)
o They dont have a lot of relationship so they do not seek help
Cluster B Dramatic, Emotional, Erratic (histrionic, narcissistic,
antisocial, borderline)
o They have problems with relationship due to behavior and
may have another disorder. So they go in for help for that
disorder usually.
Cluster C Anxious or Fearful (avoidant, dependent, obsessivecompulsive)
o Less research support for these disorder
o These are close to some of other categories that we already
talked about before
Borderline Personality Disorder: DSM-5
Pervasive pattern of instability of interpersonal relationships, self
image, and affects, and marked impulsivity, beginning in early
adulthood and present in a variety of contexts, as indicated by 5 or
more:
Stable instability
1. Frantic efforts to avoid abandonment
Cutting relationship before they can avoid them
2. Pattern of unstable and intense interpersonal relationships
(idealization and devaluation).
Ex: idealizing something and then totally switching
Hard to maintain relationships
3. Identity disturbance (unstable self image and sense of self)

4. Impulsivity in at least two areas that are potentially self

damaging
Excessive spending, sex, reckless driving
5. Recurrent suicidal behaviors, gestures, threats, self mutilation
6. Affective instability reactivity of mood
7. Chronic feelings of emptiness
8. Inappropriate intense anger
9. Transient stress-related paranoid ideation or severe dissociative
symptoms
In stress, they can have hallucinations
Borderline Personality Disorder
Linehan Diathesis-Stress perspective
o Thinks abt a biological diathesis and stress
o Difficult temperament
o Difficultly in regulating emotions
Emotional Dysregulation---Demands on family---Invalidation
(enviromemnt that doesnot response to the infants feeling; may or
may not get punishment)---Emotional outbursts receive attention
further Emotional Dysregulation (This is a circle)
Linehan: Dialectical Behavior Therapy
Acceptance Accepting environment
CBT techniques to
o Teach to modulate/control emotions and behavior
o Teach to tolerate feeling distressed
o Help learn to trust emotions and thoughts
Antisocial Personality Disorder: DSM-5
A. Pervasive pattern of disregard for and violation of rights of
others, occurring since age 15, as indicated by 3 or more:
Research: A lot of these people are in jail
Not all people in jail have antisocial
o Failure to conform to social norms with respect to lawful
behavior
o Deceitfulness

o Impulsivity or failure to plan ahead

o Irritability and aggressiveness
o Reckless disregard for safety of self or others
o Consistent irresponsibility
o Lack of remorse
B. At least 18
C. Conduct disorder before age 15
D. Antisocial behavior not just during schizophrenia or bipolar
disorder
Antisocial Personality Disorder
Psychodynamic theorists - parental love, leading to a lack of basic
trust
Behaviorists - antisocial symptoms may be learned through
modeling or unintentional reinforcement
Antisocial Personality Disorder
Cognitive view - people with the disorder hold attitudes that
trivialize the importance of other peoples needs
Biological factors
o Lower levels of serotonin, impacting impulsivity and
aggression
o Deficient functioning in the frontal lobes of the brain
o Lower levels of anxiety and arousal, leading them to be more
likely than others to take risks and seek thrills