Personality Disorders Module 69

Personality Disorders Disruptive, inflexible, enduring pattern of thoughts, emotions, behaviors, and interpersonal functioning that are stable over time and across situations, –deviate from the expectations of the individual’s culture

Anxious or Fearful Personality Disorders (Cluster C)

Avoidant Personality Disorder So sensitive about being rejected that personal relationships become difficult See how this differs from Social Anxiety Disorder HERE.HERE

Dependent Personality Disorder Behave in clingy, submissive ways and displays a strong need to have others take care of them

Obsessive Compulsive Personality Disorder Unreasonable Perfectionism Need for personal control, order and organization Does not have full blown obsessions & compulsions See how this differs from OCD HEREHERE

Odd or Eccentric Personality Disorders (Cluster A)

Paranoid Personality Disorder Pervasive mistrust and suspiciousness of others are the main characteristic

Schizoid Personality Disorder Is detached from social relationships Are true hermits, preferring life alone and avoiding intimate interactions at all costs

Schizotypal Disorder Exhibit the strange behaviors associated with schizophrenia but without the major symptoms (delusions, hallucinations)

Dramatic, Emotional, or Erratic Personality Disorders (Cluster A)

Histrionic Personality Disorder Displays shallow, attention-getting emotions Goes to great lengths to gain others’ praise and reassurance.

Narcissistic Personality Disorder Exaggerates their own importance, aided by fantasies. Find criticism hard to accept, often reacting in rage or shame.

Borderline Personality Disorder Instability of relationships, self- image, affects & control over impulses. See difference between Borderline Personality and Bipolar Disorder HERE. HERE

Antisocial Personality Disorder

Used to be called psychopath or sociopath Evidence often seen in childhood (conduct disorder) Shows absolutely no concern for the rights or feelings of other people Manipulative, can be charming, can be cruel and destructive Blaming the victim for his or her own stupidity Has no conscience and shows no remorse Occurs in approximately 6 percent of men and 1 percent of women See NBC News video on psychopathsNBC News video

The Mind of the Psychopath Psychopathy, or antisocial personality disorder, is characterized by a lack of conscience for wrongdoing. The psychopathic person (usually male) may be overtly aggressive and violent or a charming con artist; he shows little remorse for wrongdoing, even against friends and family. Dr. Robert Hare, a leading researcher in the field of psychopathy, developed a test called the lexical decision paradigm. Brain activity (EEG) is recorded while a person views strings of letters and presses a button whenever the letters form a word. The words are neutral (table, plate) or negative emotional (cancer, death) in content. Hare found that in psychopathic persons, unlike in normal persons, the brain processes neutral and emotional words in the same way, demonstrating a lack of affect.

Dr. Robert Hare describes his EEG studies and later SPECT (single photon emission computerized tomography) studies on language processing by psychopathic persons, and reflects on what these results reveal about psychopathy. (7:13) The Mind of the Psychopath Click HERE to view or on the box to the right.HERE Brain activity (EEG) is recorded while a person views strings of letters and presses a button whenever the letters form a word. The words are neutral (table, plate) or negative emotional (cancer, death) in content. Hare found that in psychopathic persons, unlike in normal persons, the brain processes neutral and emotional words in the same way, demonstrating a lack of affect.

The Murderous Mind PET scans illustrate reduced activation (less red and yellow) in a murderer's frontal cortex-a brain area that helps brake impulsive, aggressive behavior. (From Raine, 1999.) – Found 11% less frontal lobe tissue than normal

Cold - Blooded Arousability & Risk of Crime Levels of the stress hormone adrenaline were measured in two groups of 13-year - old Swedish boys. In both stressful and nonstressful situations, those who were later convicted of a crime (as 18- to 26- year - olds) showed relatively low arousal. (From Magnusson, 1990.)

Biological Causes of Antisocial Personality Two combined factors predicted antisocial problems: 1.Childhood maltreatment 2.A gene that altered neurotransmitter balance Either “bad” environment “turned on” these genes or the genes made these children more sensitive to the maltreatment. When shown emotional arousing pictures, they display lower levels of heart rate and perspiration responses and less activity in emotional areas of their brain. Hyper-reactive dopamine reward system that may lead them to be more impulsive to do something rewarding despite the consequences.

Bio psycho social roots of crime Danish male babies whose backgrounds were marked both by obstetrical complications and social stresses associated with poverty were twice as likely to be criminal offenders by ages 20 to 22 as those in either the biological or social risk groups. (From Raine & others, 1996.)

Gender Bias in Diagnosis In this study, case histories were more likely to be diagnosed as antisocial personality if they described a fictitious male patient and as histrionic personality if they described a fictitious female patient, regardless of which disorder the case history was designed to portray.