L3 - Personality Disorders

• Article 1 of Te Tiritti o Waitangi

  Kawanatanga or governorship over their land
• Article 2

  Māori assured tino rangatiratanga in regards to all taonga
• Article 3

  Same rights and privileges
• Aspect of Te Whare Tapa Whā

  Te Taha Hinengaro, Personality disorders are poorly understood, People with personality disorders are often referred for anxiety.
• Biomedical

  Disease, Changing physical functioning, Medications and surgery
• Psychological approach

  Thought and behaviours, Changing how we interact with our thoughts, feelings, and behaviours, Therapy
• Psychodynamic

  Focus on dreams and free association and Strong focus on the past
• Behavioural

  Focus on reinforcement rather than punishment
• Cognitive


  Clients identify and address maladaptive thoughts, beliefs, and assumptions
• Which treatment is best?

  Combined treatment common e.g., CBT = Anxiety and Depression
• Personality Disorders

  • Persistent set of behaviours across multiple settings
  • Inflexible and pervasive across situations
  • Stable over time
• Paranoid Personality Disorder

  • Key features: Pervasive distrust and suspicion of others, believing that others are deceiving or harming them without sufficient evidence.
  • Symptoms:
  • Reluctance to confide in others due to fear of being betrayed.
  • Interpreting benign comments or actions as demeaning or threatening.
  • Holding grudges and being unforgiving of insults or slights.
• Schizoid Personality Disorder

  • Key features: Detachment from social relationships and a limited range of emotional expression.
  • Symptoms:
  • Preference for solitary activities and minimal interest in personal relationships, even with family.
  • Indifference to praise or criticism.
  • Emotional coldness or flat affect (lack of emotional expression).
• Cluster B – ‘Dramatic’

  Anti-social personality Disorders, Borderline Personality Disorder, Histrionic Personality Disorder, Narcissistic Personality Disorder
• Cluster C – Anxious

  Avoidant Personality Disorder, Dependent Personality Disorder, Obsessive Compulsive Personality Disorder
• Why might thresholds for diagnosing personality disorders be problematic?

  They don’t account for the fact that some personality disorders, like Antisocial Personality Disorder (ASPD), are experienced by 50-80% of people in prison.
• What is the likelihood of someone meeting the criteria for a second personality disorder if they have one already?

  50%
• Which personality disorder is often cited as an example of high heterogeneity (varied presentations) among individuals?

  Borderline Personality Disorder.
• Which personality disorder is often criticized for being based on a stereotypical presentation?

  Histrionic Personality Disorder.
• What are common causes of personality disorders?

  Genetics, childhood experiences (like invalidating environments and parent-child relationships), and individual temperament.
• What is an evidence-based treatment for Borderline Personality Disorder (BPD)?

  Dialectical Behavior Therapy (DBT) – supported by research (Linehan).
• Do most other personality disorders have evidence-based treatments?

  No, most personality disorders focus on treating symptoms rather than having specific evidence-based protocols.
• What are two approaches sometimes used for other personality disorders?

  Schema therapy and adaptations to treatment pathways.
• What are some difficulties in treating personality disorders?

  • Treatment takes longer.
  • Therapy can be challenging.
  • Poor research base.
  • High levels of stigma.