Personality Disorders

General Criteria for Personality Disorders
· Specific pattern of internal experience and external behavior
#. cognition
# affect regulation
# interpersonal functioning
# impulse control

· These patterns are
# inflexible
# pervasive across situations / development
# Enduring and stable

· These patterns are maladaptive
# distress
# impairment

DSM-IV Personality Disorder Clusters
· Cluster A: Odd / Eccentric
# Paranoid PD
# Schizoid PD
# Schizotypal PD
· Cluster B: Dramatic / Erratic / Emotional
# Histrionic PD
# Narcissistic PD
# Borderline PD
# Antisocial PD
· Cluster C
# Avoidant PD
# Dependant PD
# Obsessive-compulsive PD

Cluster C Personality Disorders
· All are associated with anxiety and depression
· Avoidant Personality Disorder
ß pervasive social inhibition
ß hypersensitivity to negative evaluation
ß Similar to social phobia
· Dependent Personality Disorder
ß Pervasive need to be cared for
ß Fear of separation
ß Submissive behavior
· Obsessive-compulsive Personality Disorder
ß Preoccupation with order, cleanliness, control

Histrionic Personality Disorder
· Symptoms
ß a pervasive pattern of excessive emotionality and attention seeking
ß Shallow emotional expression / overly intimate
ß Need for attention
ß Seductive / provocative
ß Overly dramatic
· Associated Features
ß physical attractiveness
ß sensation seeking
ß manipulative
· Comorbidity
ß MDD, Antisocial, Borderline, Narcissistic
· Gender ratio?

Narcissistic Personality Disorder
· Symptoms
ß a pervasive pattern of grandiosity
ß need for admiration
ß Believes special / unique
ß poor empathy
ß sense of entitlement
ß very sensitive to rejections or slights
· Associated Features
ß aggression
ß Manipulative
ß Self esteem?
· Comorbidity
ß MDD, GAD, Antisocial, Borderline, Histrionic
· Gender Ratio?

Borderline Personality Disorder
· Symptoms
ß pervasive pattern of unstable interpersonal relations
ß markedly unstable self image
ß strong fear of abandonment (real or perceived)
ß idealization versus demonization
ß Impulsivity
ß Suicidal ideation, gestures
ß paranoia
· Comorbidity
ß MDD, GAD, substance, extremely high with other PDs
· Gender Ratio?

Antisocial Personality Disorder
· Symptoms
ß Repeated acts that are grounds for arrest
ß Impulsivity / irresponsibility
ß Irritability / aggressiveness
ß Lack of remorse
· Associated features
ß Poor verbal skills
ß Much more common among men
ß Substance abuse / suicidality
ß Psychopathy: marker for severe form

Psychopathy
· Absence of normal responsiveness to distress cues
· Interpersonal
ß callous to others distress
ß superficial
ß manipulative
ß grandiose / arrogant
· Emotional
ß Short-tempered
ß Absence of emotional bonds with others
ß Less empathy / guilt / remorse
· Cognitive versus emotional empathy

Causes of Psychopathy
· Low arousal
· Less responsive to punishment
· Less reactive to distressing stimuli