1. Personality Disorders
Thomas G. Bowers, Ph.D.
Penn State Harrisburg

2. General Characteristics
Long-standing, maladaptive patterns of behavior
Generally recognizable by adolescence
Tend to be inflexible, persistent, and resistant to change
Must also be associated with significant life problems

3. Three W’s: Wild, Weird and Withdrawn
Easier to remember than Clusters A, B, C
Wild
1. Borderline Personality Disorder
2. Histrionic Personality Disorder
3. Narcissistic Personality Disorder
4. Antisocial Personality Disorder

4. Three W’s: Wild, Weird and Withdrawn
1. Paranoid Personality Disorder
2. Schizoid Personality Disorder
3. Schizotypal Personality Disorder

5. Three W’s: Wild, Weird and Withdrawn
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder

6. Borderline Personality Disorder
Intense, unstable relationships
Instability in mood, self-image
“Who am I?”
Unpredictable and impulsive behavior
Often self damaging, as gambling, sexual behavior, spending sprees

7. Borderline Personality Disorder
Intense fear of aloneness
Extreme fears of abandonment
Demand attention
Alternate between idealization and devaluation
Chronic feelings of emptiness and boredom
Often suicidal feelings and gestures

8. Borderline Personality Disorder
Long interest from psychoanalytic field (as Kernberg)
Thought to be “borderline” between psychosis and neurosis
Tend to decompensate into psychotic state under stress

9. Borderline Personality Disorder
Object relations theory
Introjection of important values and images of other important people (as parents) may be faulty
Frequently see issues as a weak, ineffectual father (often totally absent, or even abandoning family)
Domineering mother

10. Borderline Personality Disorder
Inconsistent provision of warmth and affection
Frequently reported childhood physical and sexual abuse
Some biological relationships
Respond positively to SSRI
Familial, thought to be be genetic links
Related to bipolar affective disorder

11. Borderline Personality Disorder
Video assignment: “Fatal Attractions” note Glen Close in her role

12. Histrionic Personality Disorder
Overly dramatic, attention-seeking
Display excessive emotion, but in fact are emotionally shallow
Self-centered
Inappropriately sexually provocative and seductive
Pseudohypersexuality

13. Narcissistic Personality Disorder
Grandiose and exaggerated sense of self
Literary in love with themselves
Require constant attention and admiration
Lack of empathy, strong feelings of arrogance, entitlement
Take advantage of others

14. Antisocial Personality Disorder
Psychopathy (or sociopathy)
Cleckly - The Mask of Sanity
Emotional aloofness and detachment
Hare - contemporary researcher
Psychopathy appears to be distinct from ASPD

15. Antisocial Personality Disorder
Little ability to profit from experience
In particular, ASPD individuals do not seem to learn well to aversive stimulus conditions
Genetic factors appear to play a role, as do environmental factors
Lack of affection, severe rejection, inconsistent discipline, fathers often are antisocial

16. Antisocial Personality Disorder
Chronic cortical under arousal
Impulsivity, difficulties in goal directed behavior
Noted increased slow wave activity, temporal region spikes on EEG

17. “Weird” Cluster Paranoid Personality Schzoid Personality
Highly suspicious of people, tends to mistrust others, expects to be mistreated
Extremely jealous
Schzoid Personality
Does not desire or enjoy social relationships
Bland, aloof, loners

18. “Weird” Cluster Schizotypal Personality
Attenuated form of schizophrenia
Interpersonally similar to schizoid, with eccentric nature
Odd beliefs, magical thinking
Illusions

19. “Weird” Cluster Etiology
May be a variant of schizophrenic range disorders
Family patterns noted

20. Withdrawn Cluster Dependent Personality
Lacks self-confidence, independence, self-reliance
Passive and dependent stance
Intense need to be taken care of, unable to make demands on others
Tends to sacrifice needs of self for others
Fairly common

21. Withdrawn Cluster Avoidant Personality
Keenly sensitive to rejection, disapproval
Extremely restrained, easily embarrassed
Exaggerate risks, dangers

22. Withdrawn Cluster Obsessive Compulsive Personality
Perfectionistic, preoccupied with rules, details
Work excessively
Stubborn, rigid, demanding
Tend to be rigid and inflexible, moralistic

23. Diagnostic Issues Reliability problems been noted
Structured interviews are now helpful
Considerable comorbidity

24. Interrater and Test-retest Reliability

25. Treatment of Personality Disorders
Psychodynamic therapy
Object relations therapy (Kernberg)
Focus on ego development
Interpretative
“Reality testing”
Dialectical behavior therapy
Linehan - Empirically tested
Client centered and cognitive methods

26. Treatment of Personality Disorders
Dynamic-Cognitive Therapy
Turner
Cognitive Therapy
Beck
Negative schemata of world thought to operate

27. Treatment of Personality Disorders
Psychopathy is very difficult to treat effectively
May be unsuitable for psychotherapy (or any type of personal relationship)