1. Abnormal Psychology Leading Researcher Perspectives
Edited by Elizabeth Rieger
Images, Figures and Tables Chapter 9
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2. Australian serial killer Leonard Fraser.
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3. Figure 1 The personality profile of a male with antisocial personality disorder and heroin dependence based on the Five Factor Model (N = neuroticism, E = extroversion, O = openness to experience, A = agreeableness, C = conscientiousness)
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5. Image by Getty Images
Scarlett O’Hara in the novel and film Gone with the Wind had characteristics consistent with histrionic personality disorder.
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9. Continued on next slide
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10. continued 9-10 Copyright © 2011 McGraw-Hill Australia Pty Ltd
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11. Figure 2 The diagram used in cognitive analytic therapy for Jacqui to summarise her dysfunctional interpersonal patterns
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12. Image by Dr P. Marazzi/SPL/Photolibrary
Self-harm in the form of superficial cutting is commonly seen in individuals with borderline personality disorder.
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13. Figure 3 The percentage of patients with avoidant and obsessive-compulsive personality disorder who experienced a clinically significant improvement in their personality and depressive symptoms after cognitive therapy
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16. Proposed changes for personality disorders in DSM-V
Four proposed parts to personality disorder assessment:
The first step is an overall rating of personality (self and interpersonal functioning) involving five severity levels of personality functioning.
The second step proposes only five specific personality disorders: schizotypal, borderline, antisocial/psychopathic, obsessive-compulsive and avoidant. Each is defined by core personality disorder components and a subset of traits.
The third component of assessment involves the measurement of six broad, higher-order trait domains: negative emotionality, introversion, antagonism, disinhibition, compulsivity and schizotypy. These traits comprise 37 specific traits.
These broad and specific traits are to be used for providing more information on the five specific personality disorders, and also for describing the personality characteristics of individuals who either do not have a personality disorder or have a personality disorder (e.g., paranoid, schizoid, dependent, histrionic or narcissistic) that does not conform to one of the five proposed personality disorders.
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17. Proposed changes for personality disorders in DSM-V
Four proposed parts to personality disorder assessment (continued):
The fourth and final part of the assessment provides a new definition of personality disorder as entailing the failure to develop a healthy sense of self-identity and capacity for interpersonal functioning.
The DSM-V Personality and Personality Disorders Work Group has attempted to reconcile the issue of whether personality disorders are best represented by categories or dimensions by including both and reducing the number of personality disorder types virtually by half.
Nevertheless, the proposed personality disorders system for the DSM-V is lacking for three reasons. First, the proposed system is overly complex and will be too unwieldy and time-consuming for clinicians. Second, because little research has been undertaken with certain personality disorders, it cannot be assumed that these personality disorders do not exist and are unworthy of inclusion in the DSM-V. Third, it is unclear why the Work Group has devised its own trait system when other trait models exist, including the Five Factor Model (McCrae & Costa, 1984) and Livesley’s 18-Factor Model (Livesley, Jang, & Vernon, 1998).
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18. Chapter 9 Summary
The DSM-IV-TR identifies 10 personality disorders which are further categorised into three clusters.
Epidemiological data reveal a relatively high level of personality disorders in the community, with estimates of up to 13 per cent of the general population having a personality disorder. The prevalence of personality disorders increases dramatically to 25–40 per cent of individuals in mental health settings.
Among the contemporary models for understanding personality disorders are various factor models (e.g., the Five Factor Model), Beck’s cognitive model, Young’s schema therapy, Linehan’s biosocial model and dialectical behaviour therapy, and Ryle’s cognitive analytic therapy.
Common to most of these approaches is the view that a genetic predisposition (e.g., for personality traits) in conjunction with aversive psychosocial factors during childhood (particularly disrupted attachment experiences with primary caregivers and trauma) results in the development of personality disturbance.
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19. Chapter 9 Summary (continued)
However, research on the aetiology and treatment of specific personality disorders is generally lacking (with borderline personality disorder being one exception).
Thus, although the field of personality disorders has developed rapidly over the last decade or so, it is at a much less mature stage of development compared to work in other fields of psychological disorder.
There are several challenges currently facing the personality disorder field. These include the categorical versus dimensional debate, the role of culture in the development of personality disorder, and whether gender differences exist in the prevalence of certain personality disorders.
Among these, perhaps the major cause for current debate is the classificatory system to be used in the DSM-V.
Important priorities for future research include further understanding the development and maintenance of personality disorders and developing new and more effective treatments for those with personality disorders.
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