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Chapter_11_Summary_Outline - Chapter 11 Overview/Summary...

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Chapter 11 Overview/Summary Personality disorders are characterized by inflexible and distorted behavioral patterns and traits that result in maladaptive ways of perceiving, thinking about, and relating to other people and the environment. Difficulties in diagnosing personality disorders occur because even with structured interviews, the reliability of diagnosing personality disorders is less than ideal. Moreover, most researchers agree that a dimensional approach for assessing personality disorders would be preferable to the more categorical approach taken by the DSM system. Difficulties in studying the causes of personality disorders occur because most people with one personality disorder have at least one more, making it difficult to disentangle the causes of one from the other. Three general clusters of personality disorders have been described in DSM: Cluster A includes paranoid, schizoid, and schizotypal personality disorders; individuals with these disorders seem odd or eccentric. Little is known about the causes of paranoid and schizoid disorders, but genetic factors are implicated in schizotypal personality disorder. Cluster B includes histrionic, narcissistic, antisocial, and borderline personality disorders; individuals with these disorders share a common tendency to be dramatic, emotional, and erratic. Little is yet known about the causes of histrionic and narcissistic disorders. Certain biological and psychosocial causal factors have been identified as increasing the likelihood of developing borderline personality disorder in those at risk because of high levels of impulsivity and affective instability. Cluster C includes avoidant, dependent and obsessive-compulsive personality disorders; individuals with these disorders show fearfulness or tension, as in anxiety-based disorders. Children with an inhibited temperament may be at heightened risk for avoidant personality disorder, and individuals high on neuroticism and agreeableness, with authoritarian or overprotective parents, may be at heightened risk for dependent personality disorder. There is also relatively little research on treatments for most personality disorders. Treatment of the Cluster C disorders seems most promising, and treatment of Cluster A disorders is the most difficult. A new form of behavior therapy (dialectical behavior therapy) shows considerable promise for treating borderline personality disorder, which is in Cluster B. Although the DSM diagnoses antisocial personality disorder (ASPD), many clinicians continue to use the diagnosis of psychopathy. A person with psychopathy is callous and unethical, without loyalty or close relationships, but often with superficial charm and intelligence. Individuals with a diagnosis of ASPD engage in an antisocial, impulsive, and socially deviant lifestyle. Genetic
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and constitutional, learning, and adverse environmental factors seem to be important in causing these disorders. There is some evidence that these may be distinct disorders with unique causal pathways. Psychopaths also show
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