Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Personality Disorders ©

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. THE NATURE OF PERSONALITY DISORDERS Longstanding maladaptive pattern of inner experience and behavior manifested in at least two of the following areas: 1.______________ 2.Affectivity 3._______________ 4.Impulse control

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ANTISOCIAL (“psychopaths; sociopaths”) Associated Behaviors  Deceitfulness  __________  Unlawfulness  ___________  Aggressiveness  Manipulative  _____________

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL  Various brain abnormalities  Diminished ____________ response to social stressors  Possible genetic causes PERSPECTIVES ON ANTISOCIAL PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PERSPECTIVES ON ANTISOCIAL PERSONALITY PSYCHOLOGICAL Neurological deficits related to psychopathic symptoms. Response modulation hypothesis. Unable to process information not relevant to their primary goals. _________________

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SOCIOCULTURAL Family variables Childhood abuse Childhood neglect PERSPECTIVES ON ANTISOCIAL PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT OF ANTISOCIAL PERSONALITY DISORDER Address low self-esteem. ______________________. Group therapy.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BORDERLINE PERSONALITY DISORDER Instability is evident in mood, interpersonal relationships, and self-image. Often they are confused about their own identity or concept of who they are. A personality disorder characterized by pervasive instability with a pattern of poor impulse control.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BORDERLINE Observed characteristics:  Intense interpersonal relationships  Splitting  __________________  _____________  Identity confusion  Shifting goals, plans, partners  ____________________  Risk taking, self injurious behaviors  Parasuicidal

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PERSPECTIVES ON BORDERLINE PERSONALITY BIOPSYCHOSOCIAL  Vulnerable temperament  _________________________________  Triggering events in adulthood BIOLOGICAL  __________________________ smaller

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Physical or sexual abuse Childhood caregiver interaction  Emotionally unavailable  Inconsistent treatment  Failed to validate their thoughts and feelings  Failed to protect from abuse  Anxious attachment style with mother PERSPECTIVES ON BORDERLINE PERSONALITY PSYCHOLOGICAL

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Poor ___ development Caregiver overinvolved yet inconsistent _________________ of others PERSPECTIVES ON BORDERLINE PERSONALITY PSYCHODYNAMIC

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Splitting Low sense of self- efficacy Lack of confidence Low motivation Inability to seek long-term goals PERSPECTIVES ON BORDERLINE PERSONALITY COGNITIVE-BEHAVIORAL Modern pressures on family. Diminished social cohesion and mental cohesion. Unstable family patterns.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. CHALLENGING AND COMPLEX  Unlikely to remain in treatment long  ____________________________ TECHNIQUES  Confrontive or  Supportive  Dialectical Behavioral Therapy  ________________________ TREATMENT OF BORDERLINE PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. HISTRIONIC Dramatic, attention-getting behavior Fleeting, shifting emotional states More commonly diagnosed in ______ Flirtatious and seductive Need for ____________________ Easily influenced by others Lack analytical ability _________________________ Clip art copyright © Used with permission.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.  Feelings of inadequacy and need for others  Global nature of thinking underlies diffuse, exaggerated and changing emotional states TREATMENT GOALS  Learn how to think more objectively and precisely  Learn ____________________________  Learn _________________  Acquire assertiveness skills VIEWS AND TREATMENT OF HISTRIONIC PERSONALITY Clip art copyright © Used with permission.  COGNITIVE-BEHAVIORAL

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. NARCISSISTIC PERSONALITY DISORDER unrealistic, inflated sense of self-importance and lack of sensitivity to other people’s needs. egotistical arrogant exploitative of others

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. THEORIES OF NARCISSISTIC PERSONALITY Freudian  Stuck in early psychosexual stages Cognitive-Behavioral  Lack insight into or concern for feelings of others  Grandiose sense of self clashes with real world failures

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT OF NARCISSISTIC PERSONALITY PSYCHODYNAMIC and COGNITIVE- BEHAVIORAL therapies overlap in their goals for the client:  Reduce grandiose thinking.  Develop _________________.  Develop _____________________.  Enhance ability to relate to others  Avoid demands for special attention

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PARANOID PERSONALITY DISORDER SUSPICIOUSNESS GUARDEDNESS _____________________ AND DAMAGING MOTIVES ONTO OTHERS ________________________ TO OTHERS LOW SELF-EFFICACY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE BEHAVIORAL  COUNTER ERRONEOUS THINKING  ESTABLISH TRUST  INCREASE FEELINGS OF SELF-EFFICACY  REDUCE VIGILANT AND DEFENSIVE STANCE  INSIGHT INTO OTHERS’ PERSPECTIVES  APPROACH CONFLICT ASSERTIVELY  INTERPERSONAL SKILLS TREATMENT OF PARANOID PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SCHIZOID INDIFFERENCE TO SOCIAL AND SEXUAL RELATIONSHIPS SECLUSIVE; PREFER TO BE ALONE _________________________________ COLD, RESERVED, WITHDRAWN __________________________________ TREATMENT: Unlikely to seek or respond to therapy.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SCHIZOTYPAL PERSONALITY DISORDER Peculiarities and eccentricities of thought, behavior, appearance, and interpersonal style. CONSTRICTED, INAPPROPRIATE AFFECT ________________________________ SOCIAL ISOLATION PECULIAR COMMUNICATION TREATMENT: Parallels interventions commonly used in treating schizophrenia.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. AVOIDANT PERSONALITY DISORDER Most prominent feature: The individual desires, but is fearful of, any involvement with other people and is terrified at the prospect of being publicly embarrassed.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. AVOIDANT - THEORIES COGNITIVE-BEHAVIORAL  ______________________________  Feel unworthy of others’ regard  Expect _________________  Avoid getting close to avoid expected rejection  Distorted perceptions of experiences with others

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE-BEHAVIORAL  BREAK NEGATIVE CYCLE OF AVOIDANCE  CONFRONT/CORRECT DYSFUNCTIONAL ATTITUDES AND THOUGHTS  _________________ TO SOCIAL SITUATIONS  _____________ TREATMENT OF AVOIDANT PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. DEPENDENT CLINGY FEAR OF ABANDONMENT ____________________________ UNABLE TO ____________________ INSECURE ABOUT MAKING DECISIONS WITHOUT OTHERS GO TO EXTREME TO GAIN APPROVAL OF OTHERS DEVASTATED WHEN RELATIONSHIPS END

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. DEPENDENT - THEORIES Theories PSYCHODYNAMIC  Fixated at ________ psychosexual stage due to parental overindulgence or neglect OBJECT RELATIONS  ______________________ to parents led to fear of abandonment  Low self-esteem leads them to rely on others COGNITIVE-BEHAVIORAL  Thinking they are ___________________, they find someone to take care of them

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE-BEHAVIORAL  Therapist and client develop structured ways to increase client independence in daily activities  Identify skill deficits and improve functioning  Therapist must avoid becoming an authority figure or making client dependent on therapist TREATMENT OF DEPENDENT PERSONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. OBSESSIVE-COMPULSIVE PERFECTIONSTIC RIGID BEHAVIORAL PATTERNS FANATICAL CONCERN WITH SCHEDULES STINGY WITH TIME AND MONEY HOARDIING LOW LEVEL OF EMOTIONALITY

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. THEORIES OF OBSESSIVE-COMPULSIVE FREUDIAN  Fixation at ________ psychosexual stage OBJECT RELATIONS  Insecure parent-child attachments COGNITIVE-BEHAVIORAL  ___________________  Unrealistic standard of perfection TREATMENT: Difficult to treat. Therapy may reinforce ruminative tendencies.