Personality D isorders

1. Personality Disorders BY DR. RAJA ROY CHOUDHURY

2. What is Personality? “You have a strong need for other people to like & admire you. You have a tendency to be critical of yourself. You have a great deal of unused capacity, which you have not turned to your advantage… disciplined & controlled on the outside, you tend to be worrisome & insecure inside…at times, you’re extraverted, affable, & sociable; at other times, you’re introverted, wary, & reserved”

3. Personality • Unique, relatively consistent pattern of thinking, feeling and behaving. • It is how you handle situations, your sense of humor, or your expectations of others

4. Psychoanalytic approach • Sigmund Freud (1856 – 1939) • Josef Breuer’s “talking cure”. • Individuals are ruled by unconscious forces, they resist painful insights, and that transfer feelings for one object to another. • Iceberg Metaphor.

5. Consciousness Conscious—Acute awareness Ego Preconscious—Just under awareness; easily known Superego Id Unconscious—Well below awareness; Difficult to know but very influential Freud’s Structure of Personality

6. Psychoanalytic Approach • Personality is result of the battle for control between id, ego & superego • Defense mechanisms (or defense mechanisms) are unconsciouspsychological strategies brought into play by various entities to cope with reality and to maintain self-image.

7. Freud’s Psychosexual Stages of Development • Oral (Birth to 1½ years) • Anal (1½ to 3 years) • Phallic (3 to 6 years) • Latency (6 years to puberty) • Genital (puberty – adulthood)

8. Allport’s Trait Theory • Trait • Relatively enduring, consistent personality characteristics - inferred from behavior • 3 types of traits • Cardinal traits • Central traits • Secondary traits

9. Type theories • 5-factor model of personality • 5 different dimensions determines personality type • Dimensions • Openness to experience • Conscientiousness • Extraversion • Agreeableness • Neuroticsm

10. Behaviorist perspective • Albert Bandura • Self Efficacy: The more influence a person thinks they have on a behavior, the more likely they are to engage in it, especially to the degree that it has positive outcomes. • Mischel • Situational specificity • Interactionism: both traits and situations interact to produce behavior, thoughts

11. Humanist Perspective • Focuses on the positive aspects of being human (e.g., goodness, creativity, free will) • Rogers: Person-centered therapy • Congruence vs. incongruence

12. Personality in the contemporary era • The challenges faced in the current era is different. • They exert a pressure on the shaping of personality.

13. Factors influencing the development of personality • Parenting styles and parental values. • New and advanced technology. • Need for achievement. • Cut-throat competition. • Societal pressures. • Value system.

14. Personality Disorder Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning.

15. DSM IV Criteria for Personality Disorder • An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. Manifested in two or more of the following: • Cognition • Affectivity • Interpersonal functioning • Impulse control

16. DSM IV General Criteria for Personality Disorder • Pattern is inflexible and pervasive across a broad range of personal and social situations • Pattern leads to clinically significant impairment or distress • Pattern is stable and of long duration and onset can be traced to adolescence or early childhood • Maladaptive behavior leads to poor life functioning

17. DSM IV General Criteria for Personality Disorder • Pattern not better accounted for as a manifestation of another disorder • Not due to substance or Medical Condition (e.g., head trauma) • Ego syntonic (feels like a normal part of oneself, and that others are the root of all problems)

18. Disorder Vs. Trait • Conscientiousness and scrupulosity in small doses is advantageous (trait). • In the extreme, leads to paralyzing over attention to detail with interferes with finishing tasks (disorder). • Some traits are maladaptive at either extreme: • Too little trust: paranoid • Too much trust: gullibility leading to being taken advantage of

19. The history of personality disorders • The Greek and Roman Gods and Goddess were the personality disorder types of the ancient world. • Most of the disorders describe their traits.

20. Paranoid personality disorder. • Hera-Juno, Wife of Zeus- Queen of the gods • Archetype of the suspicious Paranoid.

21. Paranoid personality disorder Pervasive distrust and suspiciousness, sees motives of others as malevolent. • Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her • Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates • Reluctant to confide in others due to lack of trust

22. Paranoid personality disorder • Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights. • Reads hidden demeaning or threatening meanings into benign remarks/events. • Perceives attacks on character that are not apparent to others and responds with counterattacks. • Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

23. Schizoid personality disorder • Athena-Minerva - Virgin goddess of wisdom. • She had a Schizoid aspect to her personality.

24. Schizoid personality disorder Pervasive detachment from social relationships and a restricted range of emotional expression interpersonally. • Neither desires nor enjoys close relationships, including being part of a family • Almost always chooses solitary activities • Exhibits little interest in having sexual experiences with another person.

25. Schizoid personality disorder • Takes pleasure in few, if any, activities. • Lacks close friends or confidants. • Appears indifferent to the praise or criticism of others. • Emotionally cold, detached.

26. Schizotypal personality disorder • Artemis- twin sister of Apollo. • She is a goddess of transitions, a hunter, a virgin, and one of the goddesses who assists at childbirth • Most often off by her self in her Schizotypal world of wild things and strange thoughts.

27. Schizotypal personality disorder Exhibit little capacity for close relationships accompanied by cognitive or perceptual disturbances and eccentricities of behavior • Ideas of reference • Odd beliefs or magical thinking, inconsistent with cultural norms • Unusual perceptual experiences, including bodily illusions • Excessive social anxiety related to paranoid fears.

28. Schizotypal personality disorder • Odd thinking and speech (e.g. vague, circumstantial,metaphorical,over elaborate) • Suspiciousness or paranoid ideation • Inappropriate or constricted affect • Behavior or appearance that is odd, eccentric, or peculiar • Lack of close friends or confidants

29. Antisocial personality disorder • Ares - war god and god of violence • He was not well-liked or trusted by the ancient Greeks • He does not care who suffers from his violent behavior.

30. Antisocial personality disorder Pervasive pattern of disregard for and violation of rights of others since age 15. • Repeatedly breaking the law • Deceitfulness - repeated lying, use of aliases, conning others for personal profit or pleasure • Impulsivity or failure to plan ahead

31. Antisocial personality disorder • Irritability and aggressiveness, as indicated by repeated physical fights or assaults • Reckless disregard for safety of self or others • Consistent irresponsibility - inconsistent work behavior, doesn’t pay bills/debts • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

32. Antisocial personality disorder • The individual is at least age 18 years. • ASPD vs. criminality • “criminal” is a legal term denoting conviction for breaking a law: • Not all people with ASPD are criminals (or in jails) • Not all people with ASPD are psychopaths

33. Antisocial personality disorder

34. Borderline personality disorder • Aphrodite- Goddess of beauty, love, and sexuality • Has love affairs with gods and mortals. • Archetype of a love addicted Borderline.

35. Borderline personality disorder Pervasive instability of interpersonal relationships, self-image and affect with marked impulsivity by early adulthood. • Frantic efforts to avoid real or imagined abandonment • Pattern of intense and unstable interpersonal relationships, alternating between extremes of idealization and devaluation

36. Borderline personality disorder • Identity disturbance: markedly and persistently unstable self-image or sense of self • Impulsivity in at least two potentially self-damaging areas (sex, spending, substance abuse, reckless driving, binge eating) • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

37. Borderline personality disorder • Chronic feelings of emptiness • Inappropriate and intense anger • Transient, stress-related paranoid ideation or severe dissociative symptoms. • Affective instability with marked reactivity of mood, lasting few hours to few days

38. Histrionic personality disorder • Hermes- the messenger god. • Tricking the other gods and sometimes making a public show of himself.

39. Histrionic personality disorder Pervasive excessive emotionality and attention seeking. • Uncomfortable in situations in which he or she is not the center of attention • Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

40. Histrionic personality disorder • Displays rapidly shifting and shallow expression of emotions • Consistently uses physical appearance to draw attention to self • Has a style of speech that is excessively impressionistic and lacking in detail • Shows self-dramatization, theatricality, and exaggerated expression of emotion

41. Histrionic personality disorder • Suggestible, i.e., easily influenced by others. • Considers relationships to be more intimate than they actually are. • Inability to maintain deep, long-lasting attachments • Exaggeration of thoughts and feelings - everything is catastrophic or of extreme importance. • Endless need for reassurance • Superficial relationships, vain, self-absorbed

42. Narcissistic Personality Disorder • Narcissus- A handsome and Proud Hunter. • He became so enamored with his own image in the water. He remained at the water's edge until he eventually wasted to death.

43. Narcissistic Personality Disorder Pervasive grandiosity, need for admiration, lack of empathy. • Grandiose sense of self-importance, expects to be recognized as superior • Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

44. Narcissistic Personality Disorder • Believes he/she is “special,” unique and can only be understood by or should associate with other special people • Requires excessive admiration • Sense of entitlement • Interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

45. Narcissistic Personality Disorder • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others. • Is often envious of others or believes that others are envious of him or her. • Shows arrogant, haughty behaviors or attitudes.

46. Narcissistic Personality Disorder • Become enraged at criticism • Fragile self-esteem, prone to depression • Their behavior produces interpersonal difficulties, rejection, loss, occupational problems, which they can’t handle

47. Avoidant personality disorder • Poseidon- The sea God. • Avoidant tendencies in his desire to hide away in the deep parts of the sea.

48. Avoidant personality disorder Pervasive social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation. • Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection • Unwilling to get involved with people unless certain of being liked

49. Avoidant personality disorder • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed • Preoccupied with being criticized or rejected in social situations • Inhibited in new interpersonal situations because of feelings of inadequacy • Extreme sensitivity to rejection leads to socially withdrawn life

50. Avoidant personality disorder • Views self as socially inept, personally unappealing, or inferior to others • Unusually reluctant to take personal risks or to engage in new activities for fear of embarrassment • Withdraw and feel hurt if a request is refused or if they feel rejected or ridiculed