Personality Disorders Chapter 11

Personality Disorder Persistent pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or others and may cause difficulties with work and relationships May not feel subjective distress-others do because of the actions of the person with the disorder Weird, Wacky and Worried Weird: Cluster A: Paranoid, Schizoid, Schizotypal; appear odd/eccentric Wacky: Cluster B: Antisocial, Borderline, Histrionic, and Narcissistic; appear dramatic, emotional, or erratic Worried: Cluster C: Avoidant, Dependent, and Obsessive-Compulsive; appear fearful/anxious

Paranoid Personality Disorder Distrust and suspiciousness of others- interpret motives as malevolent- 4 or more of the following Others are exploiting, harming, or deceiving person Preoccupied with unjustified doubts about loyalty and trustworthiness of friends Reluctant to confide in others because of fear that info will be used maliciously Reads hidden demeaning or threatening meanings into benign remarks/events Persistently bears grudges; unforgiving of insults/slights Perceives attacks that are not apparent to others, quick to react angrily or counterattack Recurrent suspicions regarding fidelity of partner

Schizoid Personality Disorder Pervasive pattern of detachment from social relationships and restricted range of expression of emotions in interpersonal settings 4 or more of the following: Neither desires nor enjoys close relationships, including being part of a family Almost always chooses solitary activities Has little if any interest in having sexual experiences with another person Takes pleasure in few, if any, activities Lacks close friends or confidants other than first-degree relatives Appears indifferent to the praise or criticism of others Shows emotional coldness, detachment, or flattened affectivity

Schizotypal Personality Disorder Pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well by cognitive or perceptual distortions and eccentricities of behavior 5 or more of the following: Ideas of reference (events or coincidences as having significance) Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms Unusual perceptual experiences Odd thinking and speech Suspiciousness or paranoid ideation Inappropriate or constricted affect Behavior or appearance that is odd, eccentric, or peculiar Lack of close friends or confidants other than first degree relatives Excessive social anxiety that does not diminish with familiarity and tensd to be associated with paranoid fears rather than negative judgments about self

Antisocial Personality Disorder A pervasive disregard for and violation of the rights of others 3 or more of the following: Failure to conform to social norms with respect to lawful behaviors- repeated acts that are grounds for arrest Deceitfulness- lying, use of aliases, conning Impulsivity or failure to plan ahead Irritability and aggressiveness, repeated physical fights or assaults Reckless disregard for safety of self or others Consistent irresponsibility- failure to sustain work behavior or honor financial obligations Lack of remorse- indifferent to or rationalizing having hurt, mistreated or stolen from others 18yoa, evidence of Conduct Disorder before 15yoa

Psychopathy and Sociopathy Hare- glibness/superficial charm, grandiose sense of self-worth, pathological lying, conning/manipulative, lack of remorse or guilt, callous lack of empathy Actual inability to experience empathy Because of situational factors- squashed ability to experience empathy Recidivism How to make staying lawful beneficial for them

Conduct Disorder Violation of rights of others or societal norms/rules 3 of following Aggression to people or animals- 7 criteria including fights, bullying/threatening/intimidating, caused physical injury with a weapon, physically cruel to people/animals, stolen while confronting victim, forced sexual activity Destruction of property- engaged in fire setting to do damage, destroyed others’ property Deceitfulness or theft- broken into house/building/car, lies/cons to obtain goods or avoid obligations, stolen items of nontrivial value without confronting victim Serious violation of rules: stay out despite parental prohibitions (before 13yoa), run away from home overnight at least twice without returning for lengthy period, truant from school (before 13yoa)

Borderline Personality Disorder Pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity 5 or more of the following Frantic efforts to avoid real or imagined abandonment Pattern of unstable and intense interpersonal relationships- alternating between idealization and devaluation Identity disturbance- unstable self-image or sense of self Impulsivity in at least two areas that are self-damaging (spending, sex, substance abuse reckless driving, binge eating) Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior Affective instability- marked reactivity of mood, intense but short Chronic feelings of emptiness Inappropriate or intense anger/difficulty controlling anger Transient stress-related paranoid ideation or sever dissociative symptoms

Histrionic Personality Disorder Pervasive pattern of emotionality and attention seeking 5 or more of the following Uncomfortable in situations in which he or she is not the center of attention Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior Displays rapidly shifting and shallow expression of emotions Consistently uses physical appearance to draw attention to self Has a style of speech that is excessively impressionistic and lacking in detail Shows self-dramatization, theatricality, and exaggerated expression of emotion Is suggestible (i.e., easily influenced by others or circumstances) Considers relationships to be more intimate than they actually are

Narcissistic Personality Disorder Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy 5 or more Grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love Believes that he or she is “special” and unique and can only be understood by, or should be associated with, other special or high-status people/institutions Requests excessive admiration Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his/her expectations) Interpersonally exploitative (takes advantage of others to achieve his or her own ends) Lacks empathy; is unwilling to recognize or identify with the feelings and needs of others Often envious of others or believes that others are envious of him/her Shows arrogant, haughty behaviors or attitudes

Avoidant Personality Disorder Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation 4 or more Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection Unwilling to get involved with people unless certain of being being liked Shows restraint within intimate relationships because of fear of being shamed or ridiculed Preoccupied with being criticized or rejected in social situations Inhibited in new interpersonal situations because of feelings of inadequacy Views self as socially inept, personally unappealing, or inferior to others Unusually reluctant to take personal risks or to engage in new activiites because they may prove embarrasing

Dependent Personality Disorder Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation 5 or more Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others Needs others to assume responsibility for most major areas of his/her life Has difficulty expressive disagreement with others because of fear of loss of support of approval (Not realistic fears of retribution) Has difficulty initiating projects or doing things on his/her own (lack of self-confidence in judgment or abilities rather than lack of motivation or energy) Goes to excessive lengths to obtain nurturance and support form others, to the point of volunteering to do things that are unpleasant Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for him/herself Urgently seeks another relationship as a source of care and support when a close relationship ends Unrealistically preoccupied with fears of being left to take care of him/herself

Obsessive-Compulsive Personality Disorder Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency 4 or more Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost Shows perfectionism that interferes with task completion (unable to complete a project because overly strict standards not met) Excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by economic necessity) Overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) Unable to discard worn-out or worthless objects even when they have no sentimental value Reluctant to delegate tasks or to work with others unless they submit to exactly his/her way of doing things Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes Shows rigidity and stubborness