personality disorders

• Personality Disorders

  Maladaptive with significant impairment of function in the areas of productivity, relationships, and self awareness and care
• Characteristics of Personality Disorders

  • Mood/attitude
  • Emotional expression
  • Dependency
  • Socially unacceptable behaviors at the expense of others that is motivated by self only
  • Interferes with ability to work or build and maintain healthy relationships
• Personality


  A combination of what we are born with and what we learn over time
• We can learn dysfunctional patterns
• General information about Personality Disorders

  • Diagnosed >18 years old (basis of behavior can be seen in childhood)
  • Lack of self awareness that impedes progress
  • Common in 10-20% of the general population
  • Almost half of the people with a chronic mental illness also has a PD
  • Comorbid with substance use
• Characteristics of people with Personality Disorders


  • Higher suicide rates
  • More accidents and ER visits
  • Higher rates of divorce
  • More legal issues overall
• Etiology of Personality Disorders

  Theory of balance between inherited tendencies and learned behaviors
• 4 temperament traits of Personality Disorders

  • Harm avoidance
  • Novelty seeking
  • Rewardence dependent
  • Persistence
• 3 character traits (used as a scale)

  • Self Directedness
  • Cooperativeness
  • Self transcendence
• Temperament is born with, character is learned
• Personality Disorder categories

  • Cluster A: Odd or eccentric behaviors
  • Cluster B: Dramatic, erratic, or emotional behaviors
  • Cluster C: Anxious or fearful behaviors
• Antisocial Personality Disorder


  Marked pattern of disregard for others, arrogant and self-centered, lack of empathy
• Males with alcohol use disorder and those released from substance abuse clinics have the highest rates of Antisocial Personality Disorder
• Aggression to people or animals, destruction of property is associated with Antisocial Personality Disorder
• Diagnosis of Antisocial Personality Disorder is not warranted if the behavior only occurs while drinking
• Borderline Personality Disorder


  Unstable self image, unstable interpersonal relationships, unstable affects
• Borderline Personality Disorder is the most frequently diagnosed personality disorder, with higher rates in females
• Borderline Personality Disorder has a high mortality rate (about 10%)
• Borderline Personality Disorder decreases with age
• 85% of people with Borderline Personality Disorder have a comorbid illness
• Narcissistic Personality Disorder


  Grandiose with need for attention, lacking feelings of empathy, feelings of superiority
• Histrionic Personality Disorder


  Attention seeking, insatiable need or attention and approval, sexually seductive to gain attention, dramatic speech
• Histrionic Personality Disorder has a prevalence of 1.8% and no gender differences, but is higher among African Americans
• Avoidant Personality Disorder


  Avoidance of social situations, sensitive to negative comments, engagement in interpersonal relationships only with unconditional approval
• Avoidant Personality Disorder has a prevalence of 2.4%
• Dependent Personality Disorder


  Clinging to others, intense need to be taken care of, total submission and disregard for self, withdrawal from adult responsibilities
• Obsessive-Compulsive Personality Disorder


  Preoccupation with order and perfectionism, completely devoted to work, need to control others, tense, joyless mood, difficulty making decisions
• Obsessive-Compulsive Personality Disorder is different from OCD (no obsessions and compulsions but a pattern of preoccupation with order and perfectionism)
• Obsessive-Compulsive Personality Disorder is associated with higher education, employment, and marriage
• Treatment for all Personality Disorders is a combination of medications and talk therapy, with medications being symptom focused
• Most people with Personality Disorders do not seek help/think that they are the problem
• Medications for Personality Disorder symptoms


  • Aggression (as a response): Lithium, Mood Stabilizer, Antipsychotic
  • Predatory Aggression: Lithium, Antipsychotics
  • Aggression (organic): Donepezil, Tofranil
  • Emotional Lability: Lithium, Mood Stabilizer, Antipsychotic
  • Atypical Depression: SSRI's, MAOI's, Antipsychotics
  • Emotional Detachment: SSRI's, Atypical antipsychotics
  • BPD: Low dose antipsychotics, Anticonvulsant, mood stabilizers, Naltrexone