Personality Disorders
Definition of Personality?
 Definition of Personality Disorder
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 Manifest
across many life areas
 Inflexible
 Maladaptive
 Cause
either significant impairment or
distress to self or others
Personality Disorders
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Dimensions or Categories?
DSM-IV
 Consided
as Categories (not dimensions)
 Axis II of the multiaxial system

Not usually primary diagnosis
 Ten Specific Labels
 Cluster A: “Odd / Eccentric”
 Cluster B: “Dramatic / Emotional”
 Cluster C: “Anxious / Fearful”
 High
Rates of Comorbidity
 Gender Bias in Diagnosis?
Paranoid Personality Disorder
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Excessively Mistrustful
Excessively Suspicious
Without Justification
Treatment Options
 Few
seek professional help on their own
 Treatment focuses on development of trust
 Cognitive therapy to counter negativistic thinking
 Lack good outcome studies
Schizoid Personality Disorder
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Extreme Social Detachment (Loner)
Appear Aloof, Cold, Indifferent
Limited Range of Emotions
Treatment Options
 Few
seek professional help on their own
 Focus on the value of interpersonal relationships,
empathy, and social skills
 Treatment prognosis is generally poor
 Lack good outcome studies
Schizotypal Personality
Disorder
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Also Socially Isolated
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BUT Behavior Is More Unusual
Often Considered Odd or Bizarre
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Ideas of Reference
Magical Thinking
Illusions
Apparent Connection to Schizophrenia (but be careful!)
Treatment Options
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Developing social skills
Treatment also addresses comorbid depression
Medical treatment is similar to that used for schizophrenia
Treatment prognosis is generally poor
Antisocial Personality Disorder
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Long Histories of
 Violating
Cultural Norms
 Violating Rights of Others
 Impulsivity & Aggressiveness
 Lack of Remorse, Conscience, Empathy
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Not Always Criminal
Relation Between ASPD, Conduct Disorder, and
Early Behavior Problems
Antisocial Personality
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Neurobiological Theories
 Underarousal,
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Fearlessness, & Behavioral Inhibition
Treatment
 Few
seek treatment on their own
 Antisocial behavior is predictive of poor prognosis,
even in children
 Emphasis is placed on prevention and rehabilitation
 Often incarceration is the only viable alternative
Borderline Personality Disorder

Unstable Relationships
 Love/Hate
Behavior
 Fear of Abandonment
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Poor Self-Image
 Mood

Swings, Feel Empty
Impulsivity
 Substance Abuse,

Self-mutilation
Sex, Suicidality
Borderline Personality Disorder
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Causes?
 Borderline
personality disorder runs in families
 Early trauma and abuse seem to play some role

Treatment Options
 Few
good treatment outcome studies
 Antidepressant medications provide some short-term
relief
 Dialectical behavior therapy is the most promising
psychosocial approach
Histrionic Personality Disorder
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Overly Dramatic
Center of Attention
Emphasis on Appearance
Emotions are Shallow
Seductive & Provocative
Treatment Options
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Few good treatment outcome studies
Treatment focuses on attention seeking and long-term negative
consequences
Targets may also include problematic interpersonal behaviors
Little evidence that treatment is effective
Narcissistic Personality Disorder
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Grandiose Sense of Self
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Exaggerated Self-Importance
Preoccupied with Attention
Requires Admiration
Little Empathy
Highly Sensitive to Criticism
Treatment Options
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Focuses on grandiosity, lack of empathy, unrealistic thinking
Treatment may also address co-occurring depression
Little evidence that treatment is effective
Avoidant Personality Disorder
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Sensitive to Other’s Opinions
Avoid Social Relationships
Extreme Low Self-Esteem
Takes Few Risks
Socially Inhibited & Anxious
Treatment Options
 Several
well-controlled treatment outcome studies exist
 Treatment is similar to that used for social phobia
 Treatment targets include social skills and anxiety
Dependent Personality Disorder
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Excessive Reliance on Others
 Submissive
& Passive
 Rely on Others to Make Even Minor Decisions
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Fear Abandonment
 Clingy
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Treatment Options
 Research
on treatment efficacy is lacking
 Therapy typically progresses gradually
 Treatment targets include skills that foster
independence
Obsessive-Compulsive
Personality Disorder
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NOT same thing as OCD
Fixation on Doing Things “The Right Way”
Preoccupation with
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Perfectionism
Control
Orderliness, Details, and Rules
Obsessions and Compulsions Are Rare
Treatment Options
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Data supporting treatment are limited
Treatment may address fears related to the need for orderliness
Other targets include rumination, procrastination, and feelings of
inadequacy
Problems with Persoanlity Disoders
The Causes of Personality Disorders Are
Difficult to Pinpoint
 Treatment of Personality Disorders Is
Often Difficult
 Often Comorbid Issues
 Egosyntonic (vs. Egodystonic)
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