Chapter 13

Personality Disorders
 Personality Disorders
Personality Disorder:
An enduring pattern of inner experience and
behavior that deviates markedly from the
expectations of the individual’s culture

Pervasive and inflexible

Has an onset in adolescence or early childhood

3 Personality Disorder Clusters

 Odd/Eccentric Personality Disorders

 Dramatic/Emotional Personality Disorders

 Anxious/Fearful Personality Disorders

Baird
Personality Disorder Clusters

Personality
Disorders
Axis II

Cluster A Cluster B Cluster C

anti-social
paranoid avoidant
borderline
Schizoid dependent
histrionic
schizotypal obsessive-compulsive
narcissistic
Personality Disorder Clusters

Odd/Eccentric Dramatic/Emotional
Antisocial PD
Paranoid PD
Borderline PD
Schizotypal PD
Histrionic PD
Schizoid PD
Narcissistic PD

Anxious/Fearful
Avoidant PD
Dependent PD
Obsessive-compulsive PD
Cluster A: Odd/Eccentric
Cluster
 Odd/Eccentric Personality

a) Paranoid Personality Disorder:

 Suspiciousness in almost all situations and with
almost all people, usually for poor reasons

 Involves an impairment in cognitive functioning

Baird
 Odd/Eccentric Personality

b) Schizotypal Personality Disorder:

 Evidence of odd speech, behavior, thinking,
and/or perception, but not odd enough for a
diagnosis of schizophrenia

Baird
 Odd/Eccentric Personality

c) Schizoid Personality Disorder:

 Severely restricted range of emotions that is
most notably associated with social
detachment

Baird
 Etiology of Cluster A
 Genetically linked to schizophrenia

 Perhaps less severe variants of this Axis I

disorder

 Could be linked to a history of PTSD and

childhood maltreatment
Cluster B: Dramatic/Erratic
Cluster
 Dramatic/Emotional Personality

a) Antisocial Personality Disorder

 History of behavior problems in childhood

 Lack of constancy and responsibility
 in relationships, employment, debts
 Irritability and aggressiveness
 Reckless and impulsive behavior
 Disregard for truth, law, social standards

Baird
 Etiology of Psychopathy
• Emotion and Psychopathy
– Unresponsive to punishments / no conditioned fear responses
– Have  than normal levels of skin conductance in resting
situations
– Skin conductance is less reactive when confronted or
anticipate intense or aversive stimuli
– Heart rate normal under resting conditions but in when
anticipating intense or aversive stimuli heart rate  than
norms

• Response Modulation, Impulsivity, and Psychopathy

– Slow brain waves and spikes in the temporal area
– Less activity in the amygdala/hippocampal formation
– Decreased prefrontal activity
 Dramatic/Emotional Personality

b) Borderline Personality Disorder:

 Difficulties in establishing a secure self-identity
 Distrust

 Impulsive and self-destructive behavior

 Difficulty in controlling anger and other emotions

Baird
 Etiology of BPD
• Object-relations • Linehan’s diathesis-
theory stress theory
• Biological evidence
– Runs in families
– Poor functioning of
the frontal lobes
 Dramatic/Emotional Personality
c) Histrionic Personality Disorder:
 Self-dramatization: exaggerated display of emotion
 Etiology Unknown

d) Narcissistic Personality Disorder:

 A grandiose sense of self-importance, often
combined with periodic feelings of inferiority
 Etiology
 Product of our times and system of values?

Baird
Cluster C: Anxious/Fearful
Cluster
 3. Anxious/Fearful Personality
a) Avoidant Personality Disorder:
 Presence of social withdrawal based on fear
of rejection

b) Dependent Personality Disorder:

 Dependence on others based on a fear of
abandonment

Baird
 Anxious/Fearful Personality
c) Obsessive-compulsive Personality Disorder:
 Excessive preoccupation with orderliness,
perfectionism, and control

 Should not be confused with obsessive-compulsive

disorder

Baird
 Etiology of Cluster C

• Unknown
– Little data exist

• Speculation about causes has focused on

parent-child relationships
Personality Disorders: Overview

Baird
 Therapies for BPDs
• Note. Not much research-based information on
treating personality disorders

– Object-relations psychotherapy
• Strengthening client’s weak ego;
• Reducing ‘splitting’

– Dialectical behaviour therapy (synthesis)

• For borderline personality disorder
 Therapy for Psychopathy
• Psychopathy is virtually impossible to treat

• Psychopaths do not want to be in psychotherapy

– They are unable to form trusting, honest relationships
with therapists

• Biological treatments are also inefficient

– Except for large does of anti-anxiety medication can
reduce hostility
 Personality Disorders:
Theory and Therapy
 The Psychodynamic Perspective:
 Character disorders - disturbances in the parent-
child relationship
 Insight therapy

 The Behavioral Perspective:

 Skills acquisition, modeling, and reinforcement
 New learning

Baird
 Personality Disorders:
Theory and Therapy
 The Cognitive Perspective:
 Faulty schemas
 Altering schemas

 The Sociocultural Perspective

 Sociocultural influence
 Change the society not the victim
(e.g., lack of power for women)

Baird
 Personality Disorders:
Theory and Therapy

 The Neuroscience Perspective:

 Genes and personality
 Drug treatment

Baird