chap 13

• Personality


  A unique and long-term pattern of inner experience and outward behavior

  
• Personality tends to be consistent and is often described in terms of "traits"
• Personality is also flexible, allowing us to learn and adapt to new environments
• For those with personality disorders, however, that flexibility is usually missing
• Personality disorder


  An enduring, rigid pattern of inner experience and outward behavior that impairs sense of self, emotional experience, goals, and capacity for empathy and/or intimacy

  
• The rigid traits of people with personality disorders often lead to psychological pain for the individual or others
• A personality disorder typically becomes recognizable in adolescence or early adulthood and symptoms last for years
• Personality disorders are among the most difficult psychological disorders to treat

  
• Many sufferers are not even aware of their personality disorder (or do not realize their responsibility in the matter)
• It has been estimated that 9% to 13% of all adults may have a personality disorder

  
• It is common for a person with a personality disorder to also suffer from another disorder, a relationship called comorbidity

  
• The presence of a personality disorder complicates a person's chances for a successful recovery from other psychological problems
• Clusters of personality disorders in the DSM-5

  • Odd or eccentric behavior
  • Dramatic, emotional, or erratic behavior
  • Anxious or fearful behavior

  
• Categorical approach


  Assumes that problematic personality traits are either present or absent, and a personality disorder is either displayed or not

  
• The symptom of the personality disorders overlap each other so much that it can be difficult to distinguish one from another

  
• Diagnosticians sometimes determine that particular individuals have more than one personality disorder

  
• The lack of agreement has raised concerns about the validity (accuracy) and reliability (consistency) of these categories
• Dimensional approach


  Personality disorders differ more in degree than in type of dysfunction, with each trait varying along a continuum extending from nonproblematic to extremely problematic

  
• The framers of DSM-5 initially proposed a dimensional approach, but this was met with enormous concern and criticism in the clinical field, leading to a reversion back to the categorical approach
• Odd personality disorders


  • Paranoid personality disorder
  • Schizoid personality disorder
  • Schizotypal personality disorder

  
• People with odd personality disorders display behaviors similar to, but not as extensive as, schizophrenia

  
• Clinicians have learned much about the symptoms of odd personality disorders, but little of their causes or how to treat them

  
• People with odd personality disorders rarely seek treatment
• Paranoid personality disorder


  Characterized by deep distrust and suspicion of others, although the suspicion is usually not "delusional"
• People with paranoid personality disorder are critical of weakness and fault in others, unable to recognize their own mistakes, extremely sensitive to criticism, and repeatedly bear grudges
• Between 0.5% and 3% of adults are believed to experience paranoid personality disorder, apparently more men than women
• Proposed explanations for paranoid personality disorder

  • Psychodynamic: early interactions with demanding parents
  • Cognitive: maladaptive assumptions like "People are evil and will attack you if given the chance"
  • Biological: genetic causes
• People with paranoid personality disorder do not typically see themselves as needing help and few come to treatment willingly
• Therapy for paranoid personality disorder, as for most other personality disorders, has limited effect and moves slowly
• Schizoid personality disorder


  Characterized by persistent avoidance of social relationships and limited emotional expression
• People with schizoid personality disorder do not have close ties with other people and genuinely prefer to be alone
• Schizoid personality disorder is estimated to affect fewer than 1% of the population and is slightly more likely to occur in men than in women
• Proposed explanations for schizoid personality disorder

  • Psychodynamic: unsatisfied need for human contact, parents were unaccepting or abusive
  • Cognitive: deficiencies in thinking, unable to pick up on emotional cues

  
• People with schizoid personality disorder remain emotionally distant from the therapist, seem not to care about treatment, and make limited progress
• Schizotypal personality disorder


  Characterized by a range of interpersonal problems, marked by extreme discomfort in close relationships, odd (even bizarre) ways of thinking, and behavioral eccentricities

  
• People with schizotypal personality disorder tend to drift aimlessly and lead an idle, unproductive life, choosing undemanding jobs in which they are not required to interact with other people
• It has been estimated that 2% to 4% of all people (slightly more males than females) may have schizotypal personality disorder
• Proposed explanations for schizotypal personality disorder

  • Similar factors to schizophrenia, including family conflicts, psychological disorders in parents, and biological factors like high dopamine activity
  • Linked to mood disorders, especially depression

  
• Therapy is as difficult in cases of schizotypal personality disorder as in cases of paranoid and schizoid personality disorders
• Dramatic personality disorders

  • Antisocial personality disorder
  • Borderline personality disorder
  • Histrionic personality disorder
  • Narcissistic personality disorder