Personality Disorders in Modern Life

Introductionand

Perspectives

Personality – three definitions

1) Persona – mask 2) Outer appearance 3) Inner characteristics

What is personality?

Personality: Characteristic ways of thinking, feeling and behaving

Personality Disorder: personality that is not necessarily disorganized, but a way of being that is maladaptive in a variety of ways

Defined

Cognition Interpersonal relationships Impulse control Affect

2/4 areas affected at minimum

Areas affected (2/4)

Personality and Psychiatry

Personology Psychiatry

Personality Disorders

Abnormal PsychologyPersonality Psychology

Inflexible traits Maladaptive behavior Long-standing Pervasive Difficult to treat Ego syntonic

Characteristics of PDs

1952

2000◦ Diagnostic Criteria

DSM

Polythetic, Monothetic Format

Personality Disorders 7, 8, or 9 criteria

DSM

schizoid, paranoid, schizotypal narcissistic, histrionic, borderline, antisocial avoidant, compulsive, dependent

self-defeating, sadistic (1987 – cut 1994)

depressive, negativistic (1994)

Types of Personality Disorders

Apathetic, remote solitary, indifferent Little need for attachment Not aware of feelings Few drives or ambitions

Schizoid

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Schizoid

withdrawn, emotional suppression, spouses complain of lack of intimacy

Develop anxiety, somatoform reactions, brief reactive psychosis

Check for alcohol abuse or PTSD

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Hesitant, self-conscious, embarrassed Fears rejection, anxious Inept, inferior, unappealing, lonely

AvoidantClick here

Avoidant Hypersensitive to evaluation

Profound feelings of inadequacy

Sensitive to signs of disapproval

Use fantasy as defense (if only…)

Risk for developing social phobia

Somber, pessimistic, fatalistic, brooding

Valueless, guilty, impotent

Worthy of criticism and contempt

Depressive

Depressive New scale, not a lot of validity

Gloomy, passive, quiet, pessimistic

Down, hard to please, defeatist

Difficulty expressing anger

High scores could be due to major depression or dysthymia

Helpless, incompetent, submissive Irresponsible, Weak, fragile

Dependent

What about Bob?

Submissive, acquiescent, concerns about being abandoned, fears of rejection, self-blame, insecure

Co-morbid with depression and anxiety

DependentClick here

Dramatic, seductive, shallow

Attention seeking, exhibitionistic

“attractive”, “charming”

Colourful

HistrionicVivian Leigh

A Street Car Named Desire

Center of attention

Shallow emotions

Might be a style…

More common with substance abusers

Histrionic

Vivian Leigh

Gone with the Wind

Egotistical, arrogant, entitled, grandiose

“Admirable”, “superior”

Narcissistic

Jack Nicholson

A Few Good Men

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Egocentricity, independence, grandiosity, feelings of superiority

Self-centered, entitled, constant praise

Bubble bursts… prone to depression, paranoia, substance abuse

Might be a style

Narcissistic

A Few Good Men

JackTom

Impulsive, irresponsible, deviant, unruly Non-reflective, self-serving Disrespectful, free, independent

AntisocialCape Fear

Robert DeNiro

Antisocial Motivated to avoid control and domination

Competitive, blunt, intimidating

Prone to legal, vocation and marital difficulties

Antisocial

Hostile, abrasive, cruel, dogmatic Explosive, intimidating, dominating opinionated and close-minded

SadisticVincent D'OnofrioLaw and Order

Top Dog persona Publicly “ok” – successful Private “monster” Type A personalities Not official PD, diagnosis – PD NOS

Sadistic

Warning Very violent

Restrained, conscientious, respectful

Rigid, conventional, regulated

“Reliable, efficient, productive”

Compulsive

Compulsive Organized, perfectionistic, impatient, good

morals, obedient behavior, suppression of emotions

Fears disapproval

Might be a style

Resentful, skeptical, discontented

Resisting, inefficient

Angry, moody, irritable, sullen

Negativistic

twisted, conflicted irritable, hostile, negativistic

complaining, disgruntled feel unappreciated, pout

disillusioned vacillate Not official, PD NOS

Negativistic

effacing, servile, blameful

defeatist, self-condemning

Masochistic

Self-sacrificing, deserve to suffer

Martyr-like, endures abuse

Look for victimization

Not a well-validated scale

Not official anymore – PD NOS

Self-defeating PD

Guarded, defensive, distrustful

“persecuted”

Paranoid

Hypervigilance Sensitive Rigid and argumentative Annoyance with others Grandiosity Edgy defensiveness Secretive

Paranoid PD

Eccentric, bizarre, absent

Peculiar, odd, disconnected

Schizotypal

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WarningFoul Language

Cognitive impairments

Self-absorbed in own thoughts

Ideas of reference

Detachment, social isolation

Self-conscious and anxious

Schizotypal PD

Borderline

Unpredictable, manipulative, unstable

Fears abandonment

Moody, contrary

Types of PDs

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WarningFoul Language

Theron

Unstable mood, anger, guilt, dependency seeking, Impulsive, self-damaging

Suicidal

Constantly seek approval

Prone to brief psychotic reactions

Poor sense of self and boundaries

Borderline PD

Rent or click on following Next slide to view this movie…

Do a Character Analysis of Annie.

What PD(s) does she have?

Misery

Part I Part II Part III

Part IV Part V Part VI

Part VII Part VIII Part IX

Part X Part XI

Misery (warning, violent)