Personality Disorders

Overview

Personality trait
- enduring patterns of behavior exhibited in a wide range of personal contexts
Personality disorder
- pervasive, inflexible, extreme, maladaptive personality trait causing impaired functioning or subjective distress
- ego syntonic
  - patient has limited awareness of disorder
- course is usually stable by early adulthood
not usually diagnosed in children

Cluster A Personality Disorders

Cluster B Personality Disorders

Characterization
- “wild”
- dramatic, emotional, or erratic
- genetic association with mood disorders and substance abuse
Types
- antisocial
  - disregard for and violation of rights of others with lack of remorse
  - criminality
  - males > females
  - conduct disorder if < 18 years
  - commonly known as “psychopathy”
  - classic triad
    - set fires, torture animals, bed wetting
- borderline
  - unstable interpersonal relationships
  - impulsivity
  - sense of emptiness
  - fear of abandonment
  - females > males
  - splitting is a major defense mechanism
    - relationships are either all good (“my boyfriend is a perfect angel”) or all bad (“my boyfriend is evil and I hate him”)
  - self-mutilation
- histrionic
  - excessive emotionality and attention-seeking
  - sexually provocative
  - overly concerned with appearance
  - think “telenovelas”
- narcissistic
  - grandiosity
  - need for admiration
  - sense of entitlement
    - demands “the best”
  - lacks empathy
reacts to criticism with rage

Cluster C Personality Disorders

Characterization
- “worried”
- anxious or fearful
- genetic association with anxiety disorders
Types
- avoidant
  - hypersensitive to rejection
  - socially inhibited
  - feelings of inadequacy
  - desires relationships with others (vs. schizoid)
- obsessive-compulsive
  - preoccupation with order, perfectionism, and control
  - ego syntonic
    - vs. OCD which is ego dystonic
- dependent
  - submissive and clingy
  - excessive need to be taken care of
  - low self-confidence