personality_lec - PERSONALITY DISORDERS Personality...

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PERSONALITY DISORDERS Personality Disorders: “Character Disorders” “Axis II” Pathology (DSM-IV) “Difficult People” DSM-IV Definition of Personality Disorders: * Personality Disorders are patterns of maladaptive inner experiences and behavior * Patterns fall into two (or more) of the following areas: - Distorted perceptions (of self, others, events) - Affectivity (e.g., intense, labile, inappropriate) - Interpersonal relationships - Impulse control * Pattern is stable and of long duration * Onset goes back to at least adolescence/early adulthood * Pattern is inflexible and pervasive across a broad range of situations * Significant subjective distress OR impairment from this pattern * Pattern deviates markedly from the expectations of the individual’s culture Sigmund Freud * “Character disorders” are not just patterns of “traits,” but the entire dynamic of personality is to be considered. That entails the defense mechanisms which, according to Freud, are pretty much set by the end of adolescence. Problems of treating personality disorders: * Remember: “How many psychiatrists does it take to change a light bulb?” * A person may have only an Axis I diagnosis, or only an Axis II diagnosis. Or, a person may have both , a diagnosis on Axis I and Axis II. If there is an Axis II personality disorder, this tends to make it more difficult to treat the Axis I disorder.
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DSM-IV distinguishes 10 personality disorders, falling into 3 clusters: A. ODD, ECCENTRIC CLUSTER (“WEIRD”) - Paranoid, Schizoid, Schizotypal B. DRAMATIC, EMOTIONAL CLUSTER (“WILD”) - Antisocial, Histrionic, Narcissistic, Borderline C. ANXIOUS, FEARFUL CLUSTER (“WORRIED”) - Avoidant, Dependent, Obsessive-Compulsive Problems with the DSM-IV Personality Disorder Model: * The organization of personality disorders into distinct, discrete categories has been criticized as misleading. Rather than being separate disorders, we should talk about overlapping trait dimensions. Everybody falls somewhere on these dimensions and it is the configuration of highs and lows on multiple dimensions that describers personality, adaptive or maladaptive. For example, we all need to be somewhat “paranoid” (suspicious) or we would be taken advantage of all the time. Being “overly trusting” (“naive”) is maladaptive but so is to mistrust everybody at all times. Likewise, having some dependency needs is human, being completely dependent on others and not be able to emotionally survive without constant guidance is maladaptive. Or, another example, a healthy self-esteem is adaptive, but an exaggerated, grandiose sense of self-importance we might call pathological “narcissism.” * Another problem with the organization of personality disorders into distinct categories is that there is tremendous overlap among them. Instead of talking about their comorbidity, it would be a more efficient model to talk about correlating trait dimensions. Much research has been done on linking personality disorders with the Big Five factor model in
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This note was uploaded on 07/16/2009 for the course PSC 168 taught by Professor Zane during the Fall '07 term at UC Davis.

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personality_lec - PERSONALITY DISORDERS Personality...

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