Personality Disorders

• Personality traits


  Enduring tendencies to feel, think and behave in a characteristic way in similar life situations
• People differ from each other by relatively stable basic tendencies which appear in all or in many similar situations
• The Big Five Personality Traits


  • Neuroticism
  • Extraversion
  • Openness to Experience
  • Agreeableness
  • Conscientiousness

  
• Personality traits are relatively stable in time and across situations
• Personality matters! Personality traits have an important impact on people's lives
• Neuroticism


  The general tendency to experience negative affects such as fear, sadness, embarrassment, anger, guilt, and disgust
• Neuroticism


  Predicts onset of Common Mental Disorders controlling for most (but not all) psychiatric confounders
• Neuroticism


  Items used to assess it partially overlap with CMD symptoms, especially for internalizing disorders
• Neuroticism


  Shares substantial but not all genetic and environmental determinants with CMDs
• Neuroticism


  Has higher temporal stability than CMD symptoms, although the difference is smaller than commonly thought
• Neuroticism


  Probably moderates the impact of life stress on CMD
• Reductions in neuroticism


  May partially mediate the effect of treatment on CMDs
• Personality disorders


  An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment
• Personality disorder clusters/types


  • Odd/eccentric
  • Dramatic/erratic
  • Anxious/fearful
• Individuals frequently present with co-occurring personality disorders from different clusters
• Prevalence estimates suggest 5.7% for disorders in Cluster A, 1.5% for disorders in Cluster B, 6.0% for disorders in Cluster C, and 9.1% for any personality disorder
• Data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions suggest that approximately 15% of U.S. adults have at least one personality disorder
• Alternative DSM-5 Model for Personality Disorders


  • Significant impairments in self and interpersonal functioning
  • At least one pathological personality trait domain or facet
  • Personality impairments are persistent and pervasive
  • Personality impairments are not explained by developmental stage, sociocultural environment, substance abuse, another psychological or a medical condition
• Clinicians can further specify which personality traits are of most concern for a given client

  
• The dimensional scores provide a richer sense of detail than do the PD diagnoses
• Personality trait ratings tend to be more stable over time than are PD diagnoses and are significantly related to many aspects of psychological adjustment, physical and mental health, and social outcomes