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Personality Disorders. Odd/Eccentric Cluster Dramatic/Erratic Cluster Anxious/Fearful Cluster. Defining features. Long lasting, pervasive, inflexible patterns of behavior and inner experience Deviate from the person’s culture Impair social and occupational functioning

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Personality disorders l.jpg

Personality Disorders

Odd/Eccentric Cluster

Dramatic/Erratic Cluster

Anxious/Fearful Cluster


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Defining features

  • Long lasting, pervasive, inflexible patterns of behavior and inner experience

  • Deviate from the person’s culture

  • Impair social and occupational functioning

  • May cause emotional distress


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Additional characteristics

  • Features are found in normal folks

    • Beware 1st-year medical school syndrome

  • Characteristics begin in adolescence or early adulthood

    • Be careful with diagnosis if the symptoms have persisted for less than 10 years

  • Axis II disorders

  • High degree of comorbidity with Axis I disorders


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Reliability of diagnoses of personality disorders

  • Interrater reliabilities are good

  • Test-retest reliabilities are often poor:

    • Schizotypal .11; Dependent .15;

    • Narcissistic .32; Histrionic .40;

    • Avoidant .41


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Problems with diagnosis

  • Actual symptoms of people may fit more than one personality disorder

  • Personality traits may be on a continuum, making categorical diagnosis inappropriate

  • The characteristics listed as symptoms are features which diagnosticians find particularly difficult to deal with


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Odd/Eccentric Cluster: Loners

  • Paranoid Personality Disorder

    • Distrust, suspicion, see malevolent motives

    • Need to be autonomous and in control

  • Schizoid Personality Disorder

    • Detached relationships; do not seek intimacy

    • Limited variability of emotional expression

  • Schizotypal Personality Disorder

    • Sharp discomfort with close relationships

    • Mental distortions and behavioral oddities


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Dramatic/Erratic Cluster: Annoying

  • Borderline Personality Disorder

    • Unstable relationships, self-image, mood

    • Impulsiveness

  • Histrionic Personality Disorder

    • Intense affect and attention-seeking

  • Narcissistic Personality Disorder

    • Grandiose, needs admiration

    • Lacks empathy


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Antisocial Personality Disorder

  • Ignores and overrules rights of others

  • At least three of:

    • Repeated violations of legal social norms

    • Repeated deceitfulness

    • Impulsiveness or lack of planning

    • Repeated fights or assaults

    • Reckless disregard for safety: Self or others

    • Repeated failure to meet obligations

    • Lack of remorse: Indifference or rationalizing

  • Had conduct disorder before age 15


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    Cleckley’s criteria

    • Interpersonal: Charming, poised, calm

      • Unreliable, irresponsible, impulsive

      • Ungrateful, vulgar, rude

    • Cognitive: Average to above-average IQ

      • No delusions or irrational thinking

      • Poor judgment, lack of insight and planning

      • Manie sans delire


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    More Cleckley...

    • Emotional: No anxiety, incapable of love

      • No deep, lasting emotions; quick shifts

    • Moral: Untruthful and insincere

      • Lacking in remorse and shame

      • Impersonal and trivial sex life

      • No real suicide attempts

      • Natural Born Killers



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    Anxious/Fearful Cluster

    • Avoidant Personality Disorder

      • Socially inhibited, feels inadequate

      • Very sensitive to criticism

    • Dependent Personality Disorder

      • Overly submissive, clinging, “Care for me.”

    • Obsessive-Compulsive Personality Disorder

      • Neatness, perfectionism, control systems


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