ABNORMAL PERSONALITY

The study of human personality or character (from the Greek charaktr, the
mark impressed upon a coin) dates back at least to antiquity. In
his Characters, Tyrtamus (371-287 bc)nicknamed Theophrastus or divinely
speaking by his contemporary Aristotle divided the people of the Athens of
the 4th century BC into thirty different personality types, including
'arrogance', 'irony', and 'boastfulness'.
The Characters exerted a strong influence on subsequent studies of human
personality such as those of Thomas Overbury (1581-1613) in England and
Jean de la Bruyre (1645-1696) in France.
The concept of personality disorder itself is much more recent and
tentatively dates back to psychiatrist Philippe Pinels 1801 description
of manie sans dlire, a condition which he characterized as outbursts of rage
and violence (manie) in the absence of any symp- toms of psychosis such as
delusions and hallucinations (dlires).
Across the English Channel, physician JC Prichard (1786-1848) coined the
term moralinsanity in 1835 to refer to a larger group of people
characterized by morbid perversion of the natural feelings, affections,
inclinations, temper, habits, moral dispositions and natural impulses, but the
term, probably considered too broad and non-specific, soon fell into disuse.
Some 60 years later, in 1896, psychiatrist Emil Kraepelin (1856-1926)
described seven forms of antisocial behaviour under the umbrella of
psychopathic personality, a term later broadened by Kraepelins younger
colleague Kurt Schneider (1887-1967) to include those who suffer from their
abnormality.
Schneiders seminal volume of 1923, Die psychopathischen
Persnlichkeiten(Psychopathic Personalities), still forms the basis of current
classifications of personality disorders such as that contained in the

influential American classification of mental disorders, the Diagnostic and

Statistical Manual of Mental Disorders 5th Revision (DSM-5).
According to DSM-5, a personality disorder can be diagnosed if there are
significant impairments in self and interpersonal functioning together with
one or more pathological personality traits. In addition, these features must
be (1) relatively stable across time and consistent across situations, (2) not
better understood as normative for the individuals developmental stage or
socio-cultural environment, and (3) not solely due to the direct effects of a
substance or general medical condition.
DSM-5 lists ten personality disorders, and allocates each to one of three
groups or clusters: A, B, or C
Cluster A (Odd, bizarre, eccentric)
Paranoid PD, Schizoid PD, Schizotypal PD
Cluster B (Dramatic, erratic)
Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD
Cluster C (Anxious, fearful)
Avoidant PD, Dependent PD, Obsessive-compulsive PD
Before going on to characterize these ten personality disorders, it should be
emphasized that they are more the product of historical observation than of
scientific study, and thus that they are rather vague and imprecise
constructs. As a result, they rarely present in their classic textbook form,
but instead tend to blur into one another. Their division into three clusters in
DSM-5 is intended to reflect this tendency, with any given personality
disorder most likely to blur with other personality disorders within its cluster.
For instance, in cluster A, paranoid personality is most likely to blur
with schizoid personality disorderand schizotypal personality disorder.

The majority of people with a personality disorder never come into contact
with mentalhealth services, and those who do usually do so in the context of
another mental disorder or at a time of crisis, commonly after self-harming or
breaking the law. Nevertheless, personality disorders are important to health
professionals because they predispose to mental disorder, and affect the
presentation and management of existing mental disorder. They also result
in considerable distress and impairment, and so may need to be treated in
their own right. Whether this ought to be the remit of the health professions
is a matter of debate and controversy, especially with regard to those
personality disorders which predispose to criminal activity, and which are
often treated with the primary purpose of preventing crime.
1. Paranoid personality disorder
Cluster A comprises paranoid, schizoid, and schizotypal personality
disorders. Paranoid personality disorder is characterized by a pervasive
distrust of others, including even friends, family, and partner. As a result, the
person is guarded and suspicious, and constantly on the lookout for clues or
suggestions to validate his fears. He also has a strong sense of personal
rights: he is overly sensitive to setbacks and rebuffs, easily feels shame
and humiliation, and persistently bears grudges. Unsurprisingly, he tends to
withdraw from others and to struggle with building close relationships. The
principal ego defence in paranoid PD is projection, which involves attributing
ones unacceptable thoughts and feelings to other people. A large long-term
twin study found that paranoid PD is modestly heritable, and that it shares a
portion of its genetic and environmental risk factors with schizoid PD and
schizotypal PD.
2. Schizoid personality disorder
The term schizoid designates a natural tendency to direct attention toward
ones inner life and away from the external world. A person with schizoid PD
is detached and aloof and prone to introspection and fantasy. He has no
desire for social or sexual relationships, is indifferent to others and to social

norms and conventions, and lacks emotional response. A competing theory

about people with schizoid PD is that they are in fact highly sensitive with a
rich inner life: they experience a deep longing for intimacy but find initiating
and maintaining close relationships too difficult or distressing, and so retreat
into their inner world. People with schizoid PD rarely present to medical
attention because, despite their reluctance to form close relationships, they
are generally well functioning, and quite untroubled by their apparent
oddness.
3. Schizotypal disorder
Schizotypal PD is characterized by oddities of appearance, behaviour, and
speech, unusual perceptual experiences, and anomalies of thinking similar to
those seen inschizophrenia. These latter can include odd beliefs, magical
thinking (for instance, thinking that speaking of the devil can make him
appear), suspiciousness, and obsessive ruminations. People with schizotypal
PD often fear social interaction and think of others as harmful. This may lead
them to develop so-called ideas of reference, that is, beliefs or intuitions that
events and happenings are somehow related to them. So whereas people
with schizotypal PD and people with schizoid PD both avoid social interaction,
with the former it is because they fear others, whereas with the latter it is
because they have no desire to interact with others or find interacting with
others too difficult. People with schizotypal PD have a higher than average
probability of developing schizophrenia, and the condition used to be called
latent schizophrenia.
4. Antisocial personality disorder
Cluster B comprises antisocial, borderline, histrionic, and narcis- sistic
personality disorders. Until psychiatrist Kurt Schneider (1887-1967)
broadened the concept of personality disorder to include those who suffer
from their abnormality, personality disorder was more or less synonymous
with antisocial personality disorder. Antisocial PD is much more common in
men than in women, and is characterized by a callous unconcern for the

feelings of others. The person disregards social rules and obligations, is

irritable and aggressive, acts impulsively, lacks guilt, and fails to learn from
experience. In many cases, he has no difficulty finding relationshipsand
can even appear superficially charming (the so-called charming
psychopath)but these relationships are usually fiery, turbulent, and shortlived. As antisocial PD is the mental disorder most closely correlated with
crime, he is likely to have a criminal record or a history of being in and out of
prison.
5. Borderline personality disorder
In borderline PD (or emotionally unstable PD), the person essentially lacks a
sense of self, and, as a result, experiences feelings of emptiness and fears of
abandonment. There is a pattern of intense but unstable relationships,
emotional instability, outbursts of anger and violence (especially in response
to criticism), and impulsive behaviour. Suicidal threats and acts of selfharm are common, for which reason many people with borderline PD
frequently come to medical attention. Borderline PD was so called because it
was thought to lie on the borderline between neurotic (anxiety) disorders
and psychotic disorders such as schizophrenia and bipolar disorder. It has
been suggested that borderline personality disorder often results
from childhood sexual abuse, and that it is more common in women in part
because women are more likely to suffer sexual abuse. However, feminists
have argued that borderline PD is more common in women because women
presenting with angry and promiscuous behaviour tend to be labelled with it,
whereas men presenting with similar behaviour tend instead to be labelled
with antisocial PD.
6. Histrionic personality disorder
People with histrionic PD lack a sense of self-worth, and depend for their
wellbeing on attracting the attention and approval of others. They often
seem to be dramatizing or playing a part in a bid to be heard and seen.
Indeed, histrionic derives from the Latinhistrionicus, pertaining to the

actor. People with histrionic PD may take great care of their appearance and
behave in a manner that is overly charming or inappropriately seductive. As
they crave excitement and act on impulse or suggestion, they can place
them- selves at risk of accident or exploitation. Their dealings with others
often seem insincere or superficial, which, in the longer term, can adversely
impact on their social and romantic relationships. This is especially
distressing to them, as they are sensitive to criticism and rejection, and react
badly to loss or failure. A vicious circle may take hold in which the more
rejected they feel, the more histrionic they become; and the more histrionic
they become, the more rejected they feel. It can be argued that a vicious
circle of some kind is at the heart of every personality disorder, and, indeed,
every mental disorder.
7. Narcissistic personality disorder
In narcissistic PD, the person has an extreme feeling of self-importance, a
sense of entitlement, and a need to be admired. He is envious of others and
expects them to be the same of him. He lacks empathy and readily exploits
others to achieve his aims. To others, he may seem self-absorbed,
controlling, intolerant, selfish, or insensitive. If he feels obstructed or
ridiculed, he can fly into a fit of destructive anger and revenge. Such a
reaction is sometimes called narcissistic rage, and can have disastrous
consequences for all those involved.
8. Avoidant personality disorder
Cluster C comprises avoidant, dependent, and anankastic personality
disorders. People with avoidant PD believe that they are socially inept,
unappealing, or inferior, and constantly fear being embarrassed, criticized, or
rejected. They avoid meeting others unless they are certain of being liked,
and are restrained even in their intimate relationships. Avoidant PD is
strongly associated with anxiety disorders, and may also be associated with
actual or felt rejection by parents or peers in childhood. Research suggests
that people with avoidant PD excessively monitor internal reactions, both

their own and those of others, which prevents them from engaging naturally
or fluently in social situations. A vicious circle takes hold in which the more
they monitor their internal reactions, the more inept they feel; and the more
inept they feel, the more they monitor their internal reactions.
9. Dependent personality disorder
Dependent PD is characterized by a lack of self-confidence and an excessive
need to be looked after. The person needs a lot of help in making everyday
decisions and surrenders important life decisions to the care of others. He
greatly fears abandonment and may go through considerable lengths to
secure and maintain relationships. A person with dependent PD sees himself
as inadequate and helpless, and so surrenders personal responsibility and
submits himself to one or more protective others. He imagines that he is at
one with these protective other(s), whom he idealizes as com- petent and
powerful, and towards whom he behaves in a manner that is ingratiating and
self-effacing. People with dependent PD often end up with people with a
cluster B personality disorder, who feed on the unconditional high regard in
which they are held. Overall, people with dependent PD maintain a nave and
child-like perspective, and have limited insight into themselves and others.
This entrenches their dependency, and leaves them vulnerable to abuse and
exploitation.
10. Anankastic personality disorder
Anankastic PD is characterized by excessive preoccupation with details,
rules, lists, order, organization, or schedules; perfectionism so extreme that
it prevents a task from being completed; and devotion to work
and productivity at the expense of leisure and relationships. A person with
anankastic PD is typically doubting and cautious, rigid and controlling,
humorless, and miserly. His underlying anxiety arises from a perceived lack
of control over a world that eludes his understanding; and the more he tries
to exert control, the more out of control he feels. In consequence, he has
little tolerance for complexity or nuance, and tends to simplify the world by

seeing things as either all good or all bad. His relationships with colleagues,
friends, and family are often strained by the unreasonable and inflexible
demands that he makes upon them.

PSYCHOLOGY
111

Melon, Shariah Brittany F.

1:00 2:00 PM (MWF)

ABNORMAL BEHAVIOR
Abnormal psychology is a division of psychology that studies people who are
"abnormal" or "atypical" compared to the members of a given society.

There is evidence that some psychological disorders are more common than was
previously thought.
Depending on how data are gathered and how diagnoses are made, as many as
27% of some population groups may be suffering from depression at any one
time (NIMH, 2001; data for older adults).

There are many ways that abnormality can be defined. For example:

Statistical Infrequency
Under this definition of abnormality, a person's trait, thinking or behavior is
classified as abnormal if it is rare or statistically unusual. With this definition it is
necessary to be clear about how rare a trait or behavior needs to be before we
class it as abnormal

For instance one may say that an individual who has an IQ below or above the
average level of IQ in society is abnormal.
However this definition obviously has limitations, it fails to recognize the
desirability of the particular behavior.
Going back to the example, someone who has an IQ level above the normal
average wouldn't necessarily be seen as abnormal, rather on the contrary they
would be highly regarded for their intelligence.
This definition also implies that the presence of abnormal behavior in people
should be rare or statistically unusual, which is not the case. Instead, any
specific abnormal behavior may be unusual, but it is not unusual for people to
exhibit some form of prolonged abnormal behavior at some point in their lives.

Limitation: However, this definition fails to distinguish between desirable and

undesirable behavior. Statistically speaking, many very gifted individuals could
be classified as abnormal using this definition. The use of the term abnormal
in this context would not be appropriate.

Many rare behaviors or characteristics (e.g. left handedness) have no

bearing on normality or abnormality. Some characteristics are regarded as
abnormal even though they are quite frequent. Depression may affect 27%
of elderly people (NIMH, 2001). This would make it common but that does
not mean it isnt a problem

Violation of Social Norms

Under this definition, a person's thinking or behavior is classified as abnormal if
it violates the (unwritten) rules about what is expected or acceptable behavior in
a particular social group. Their behavior may be incomprehensible to others or
make others feel threatened or uncomfortable. Social behavior varies markedly
when different cultures are compared.
For example, it is common in Southern Europe to stand much closer to strangers
than in the UK. Voice pitch and volume, touching, direction of gaze and
acceptable subjects for discussion have all been found to vary between cultures.
With this definition, it is necessary to consider: (i) The degree to which a norm is
violated, the importance of that norm and the value attached by the social
group to different sorts of violation. (ii) E.g. is the violation rude, eccentric,
abnormal or criminal?
Limitation: Social norms change over time. behavior that was once seen as
abnormal may, given time, become acceptable and vice versa. For example
drink driving was once considered acceptable but is now seen as socially
unacceptable whereas homosexuality has gone the other way. Until 1980
homosexuality was considered a psychological disorder by the World Health
Organization (WHO) but today is considered acceptable.

Failure to Function Adequately

Under this definition, a person is considered abnormal if they are unable to cope
with the demands of everyday life. They may be unable to perform the
behaviors necessary for day-to-day living e.g. self-care, hold down a job, interact
meaningfully with others, make themselves understood etc.

Rosenhan & Seligman (1989) suggest the following characteristics that

define failure to function adequately:
o Suffering
o Maladaptiveness (danger to self)
o Vividness & unconventionality (stands out)
o Unpredictably & loss of control
o Irrationality/incomprehensibility
o Causes observer discomfort
o Violates moral/social standards
One limitation of this definition is that apparently abnormal behavior may
actually be helpful, function and adaptive for the individual. For example, a
person who has the obsessive-compulsive disorder of hand-washing may find
that the behavior makes him cheerful, happy and better able to cope with his
day.
Many people engage in behavior that is maladaptive/harmful or threatening to
self, but we dont class them as abnormal
Adrenaline sports
Smoking, drinking alcohol
Skipping classes

Deviation from Ideal Mental Health

Under this definition, rather than defining what is abnormal, we define what is
normal/ideal and anything that deviates from this is regarded as abnormal. This
requires us to decide on the characteristics we consider necessary to mental
health.

Psychologists vary, but usual characteristics include:

o Positive view of the self
o Capability for growth and development

o Autonomy and independence

o Accurate perception of reality
o Positive friendships and relationships
o Environmental mastery able to meet the varying demands of day-to-day
situations
Limitation: It is practically impossible for any individual to achieve all of the
ideal characteristics all of the time. For example, a person might not be the
master of his environment but be happy with his situation. The absence of this
criterion of ideal mental health hardly indicates he is suffering from a mental
disorder.
Ethnocentric: Most definitions of psychological abnormality are devised by
white, middle class men. It has been suggested that this may lead to
disproportionate numbers of people from certain groups being diagnosed as
"abnormal."
For example, in the UK, depression is more commonly identified in women, and
black people are more likely than their white counterparts to be diagnosed with
schizophrenia. Similarly, working class people are more likely to be diagnosed
with a mental illness than those from non manual backgrounds.

Perspectives in Abnormal
Psychology

Behavioral
Behaviorists believe that our actions are determined largely by the experiences
we have in life, rather than by underlying pathology of unconscious forces.
Abnormality is therefore seen as the development of behavior patterns that are
considered maladaptive (i.e. harmful) for the individual.
Behaviorism states that all behavior (including abnormal) is learned from the
environment (nurture), and that all behavior that has been learnt can also be
unlearnt (which is how abnormal behavior is treated).
The emphasis of the behavioral approach is on the environment and how
abnormal behavior is acquired, throughclassical conditioning, operant
conditioning and social learning.
Classical conditioning has been said to account for the development of phobias.
The feared object (e.g. spider or rat) is associated with a fear or anxiety
sometime in the past. The conditioned stimulus subsequently evokes a powerful
fear response characterized by avoidance of the feared object and the emotion
of fear whenever the object is encountered.
Learning environments can reinforce (re: operant conditioning) problematic
behaviors. E.g. an individual may be rewarded for being having panic attacks by
receiving attention from family and friends this would lead to the behavior
being reinforced and increasing in later life.
Our society can also provide deviant maladaptive models that children identify
with and imitate (re: social learning theory).

Cognitive
The cognitive approach assumes that a persons thoughts are responsible for
their behaviour. The model deals with how information is processed in the brain
and the impact of this on behaviour.
The basic assumptions are:

Maladaptive behaviour is caused by faulty and irrational cognitions.

It is the way you think about a problem, rather than the problem
itself that causes mental disorders.

Individuals can overcome mental disorders by learning to use more

appropriate cognitions.

The individual is an active processor of information. How a person, perceives,

anticipates and evaluates events rather than the events themselves, which will
have an impact on behavior. This is generally believed to be an automatic
process, in other words we do not really think about it.
In people with psychological problems these thought processes tend to be
negative and the cognitions (i.e. attributions, cognitive errors) made will be
inaccurate:
These cognitions cause distortions in the way we see things; Ellis suggested it is
through irrational thinking, whileBeck proposed the cognitive triad.

Medical / Biological

The medical model of psychopathology believes that disorders have an organic

or physical cause. The focus of this approach is on genetics, neurotransmitters,
neurophysiology, neuroanatomy, biochemistry etc.
For example, in terms of biochemistry the dopamine hypothesis argues that
elevated levels of dopamine are related to symptoms of schizophrenia.
The approach argues that mental disorders are related to the physical structure
and functioning of the brain.
For example, differences in brain structure (abnormalities in the frontal and prefrontal cortex, enlarged ventricles) have been identified in people with
schizophrenia.

Psychodynamic

The main assumptions include Freuds belief that abnormality came from the
psychological causes rather than the physical causes, that unresolved conflicts
between the id, ego and superego create anxiety.

Freud also believed that early childhood experiences and unconscious

motivation were responsible for disorders.