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Personality Disorders. What is meant by the concept of Personality?. Aspects to the concept ‘Personality’. Identity Social skill Impression created in others Temperament Essence Patterns of perceiving,understanding and behaving in a social context. Definition and Theory of ‘Personality’.

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aspects to the concept personality
Aspects to the concept ‘Personality’
  • Identity
  • Social skill
  • Impression created in others
  • Temperament
  • Essence
  • Patterns of perceiving,understanding and behaving in a social context
definition and theory of personality
Definition and Theory of ‘Personality’
  • “personality is defined by the particular concepts that are part of the theory of personality used by the observer” Hall and Lindzey (1957, p. 9)
goals of personality theory
Goals of Personality Theory
  • Kluckhohn & Murry (1953)
    • every human being is (1) like every other human being; (2) like some other human beings; and (3) like no other human being
personality disorders6
Personality Disorders
  • Clinical Features of Personality Disorders:
    • social, interpersonal concept
    • chronic, persistent and pervasive
    • often do not see themselves as having a problem
    • involve others
personality disorders7
Personality Disorders
  • Clinical Features of Personality Disorders:
    • inability to bring themselves into harmony with the social world, and use rigid, maladaptive behviour/interpersonal patterns to avoid negative emotions
    • lack authentic, straight-forward expressions of needs and desires
five criteria
Five Criteria
  • Two of the following areas must be disrupted: cognition, affectivity, interpersonal, or impulse control.
  • Enduring, inflexible and pervasive
  • Distress
  • Early onset
  • Not better accounted for by an other mental disorder
dsm iv definition
DSM-IV Definition
  • “an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment”
paranoid personality disorder
Paranoid Personality Disorder
  • Suspiciousness
  • Not seen in therapy very often
  • may have a genetic link to schizophrenia
schizotypal personality disorder
Schizotypal Personality Disorder
  • Odd, socially eccentric
  • Unusual thoughts/beliefs/perceptions
schizoid personality disorder
Schizoid Personality Disorder
  • Social detachment, flat affect
  • Anhedonia
  • Does not seem to be biologically related to Schizophrenia
borderline personality disorder
Borderline Personality Disorder
  • Difficulties establishing a secure self-identity
  • Extreme ambivalence towards others
  • Impulsive, and self-destructive behaviour
  • Poor emotional regulation
histrionic personality disorder
Histrionic Personality Disorder
  • Self-dramatization
  • Exaggerated display of emotion
  • See themselves as “sensitive” often perceived by others to be “shallow/insecure”
narcissistic personality disorder
Narcissistic Personality Disorder
  • Grandiose sense of self importance
  • Overly concerned with how others view them
avoidant personality disorder
Avoidant Personality Disorder
  • Social withdrawal (want to be loved, but expect to be rejected)
dependent personality disorder
Dependent Personality Disorder
  • Fearful and incapable of making independent decisions/actions
  • Self-effacement
obsessive compulsive personality disorder
Obsessive-Compulsive Personality Disorder
  • Preoccupation with orderliness, perfectionism, efficiency and control
  • Little spontaneity and experienced pleasure
comorbidity
Comorbidity
  • Rare in general population, but common in clinical population
  • Most do not seek help for PD
  • Treatment is sought for specific problem, and PD is identified during treatment
meta approaches to understanding personality disorders
Meta-Approaches to understanding personality disorders
  • Extreme variation of normal personality
  • Less acute versions of Axis I disorders
  • Origin of Axis I disorders
  • Personality and Psychopathology Theory
extreme variation of normal personality
Extreme variation of normal personality
  • Five factor dimensional model of personality
    • Extroversion
    • Agreeableness
    • Conscientiousness
    • Neuroticism
    • Openness
less acute versions of axis i disorders
Less acute versions of Axis I disorders
  • Early stages or less severe
  • Schizotypal and Schizophrenia
origin of axis i disorders
Origin of Axis I disorders
  • Personality disorders are the root of all other Axis I difficulties
psychodynamic approach
Psychodynamic Approach
  • Disturbed object relations (representations of self and others) and unstable sense of self
  • Weak ego functioning
  • Kohut (Narcissistic Personality Disorder)
    • lack love, approval and empathic responses from caretakers
psychodynamic approach27
Psychodynamic Approach
  • Kernberg (Borderline Personality Disorder)
    • splitting
  • Individuation
  • Introjection
research inspired by psychodynamic theory
Research inspired by psychodynamic theory
  • Feldman et al. (1999)
    • maternal synchrony with infant affect at 3 months and mutual synchrony at 9 were related to self-control at 2 years (stronger relation seen in difficult infants)
  • Weston et al. (1990); Nigg et al. (1992)
    • individuals with BPD remember and perceive themes of malevolence
cognitive approach
Cognitive Approach
  • Negative beliefs about self, other and environment
    • eg Beliefs of an individual with BPD include: the world is dangerous and malevolent, I am vulnerable and powerless, I am unacceptable to others.
  • Unlike Axis I disorders these schemas develop early
cognitive approach30
Cognitive Approach
  • Unlike psychodynamic approach, less emphasis on how, or why maladaptive schemas arise
  • Padesky (1987)
    • avoidant personality disorder- past history of critical and shaming parents - “I must be a bad, undesirable person to be treated so badly.” “If my parents don’t love me nobody will.”
differences between psychodynamic and cognitive explanations
Differences between Psychodynamic and Cognitive Explanations
  • Content of experience vs Constituting of experience
  • Different concept of self:
    • Negative view of self vs Unstable, incoherent experience of self as an entity, and as a perspective from which to view the world.
family systems approach
Family Systems Approach
  • Poor parenting (lack of affection, inconsistent and rejecting)
  • Retrospective and Prospective studies
  • Caution
behavioural approach
Behavioural Approach
  • Defective capacity to learn
  • Failure to develop social skills and emotional regulation skills
  • Learn dysfunctional behaviours
biological approach
Biological Approach
  • Biological abnormalities
  • Family studies suggest genetic involvement in Schizotypal and Borderline (equivocal)
  • Look at genetic and neurotransmitter involvement in traits like impulsivity and sociability
integrative causal models
Integrative Causal Models
  • Millon (1983) Biosocial Model
    • constitutional differences set the stage for subsequent learning and experiences
    • how caretakers respond to a child’s disposition (dimensional) is critical
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