PERSONALITY DISORDERS

CREATED: Mark Anthony Adenir BaladhayBS-PSYCHOLOGY

PERSONALITY?comes from the Latin word persona, which referred to a theatrical mask work by performers in order to either project different roles or disguise their identities.pattern of relatively permanent traits and unique characteristics that give both consistency and individuality to a person's behavior.“ (Feist and Feist, 2009)

PERSONALITY DISORDER?

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture.

DSM IV-TR:

PERSONALITY DISORDER?manifested in two (or more) of the following areas:Cognition – ways of perceiving and interpreting

Affectivity – intensity of emotional response

Interpersonal functioning – social functioning

Impulse control – control actions after thinking

CHARACTERIZING NORMAL PERSONALITYFIVE–FACTOR MODEL OF PERSONALITY:

• NEUROTICISM – anxiety

• EXTRAVERSION/INTROVERSION – activity

• OPENNESS TO EXPERIENCE – feelings

• AGREEABLESNESS/ANTAGONISM – trust

• CONSCIENTIOUSNESS – competence

NEUROTICISM

EXTRAVERSION

OPENNESS TO

EXPERIENCE

AGREEABLENESS

CONSCIENTIOUSNESS

Anxiety Warmth Fantasy Trust Competence

Angry–Hostility

Gregariousness

Aesthetics Straightforwardedness

Order

Depression Assertiveness Feelings Altruism Dutifulness

Self–conscientious

ness

Activity Actions Compliance Achievement striving

Impulsiveness

Excitement seeking

Ideas Modesty Self–discipline

Vulnerability Positive emotions

Values Tender mindedness

Deliberation

Cluster A

Paranoid, Schizoid and Schizotypal

Cluster B

Cluster C

Seem odd or eccentric; with unusual behavior ranging from distrust and suspiciousness to social detachment.

Individuals with these disorders share a tendency to be dramatic, emotional and erratic.

In contrast to the other two clusters, people with these disorders often show anxiety and fearfulness.

Histrionic, Narcissistic, Anti-social and Borderline

Avoidant, Dependent and Obsessive-Compulsive

PARANOID PERSONALITY DISORDER

Paranoid personality disorder is characterized

by a distrust of others and a constant suspicion that people around you have sinister motives.

CRITERIA FOR PARANOID PERSONALITY DISORDER

DSM-IV-TR

A. Evidence of pervasive distrust or suspiciousness of others present in at least four of the 7 following ways:

(1) Pervasive suspiciousness of being deceived, harmed, or exploited.

(2) Unjustified doubts about loyalty or trustworthiness of friends or associates.

(3) Reluctance to confide in others because of doubts of loyalty or trustworthiness

(4) Hidden demeaning or threatening meanings read into benign remarks or events

(5) Bears grudges; does not forgive insults, injuries, or slights

(6) Angry reactions to perceived attacks on his or her character or reputation

(7) Recurrent suspicious regarding fidelity of spouse or sexual partner

B. Does not occur exclusively during course of Schizophrenia, Mood disorder

with Psychotic Features, or other psychotic disorder

It is important to remember that people with PPD are not usually psychotic; most of the time they are in clear contact with reality.

CAUSAL FACTORS of PPD

– Little is known for the causes and no clear cut

– Partial genetic transmission that may link the disorder to schizophrenia, but results examining this issue are inconsistent (Kendler, Czajkowski, et al., 2006; M. B. Miller et al., 2001)

CAUSAL FACTORS of PPD

– Psychosocial are suspected to play a role include parental neglect or abuse and exposure

to violent adults.

SCHIZOID PERSONALITY DISORDER

categorized under “odd” personality disorders or “Schizophrenia Spectrum Disorders”

Theorists believe that this disorder develops from unsatisfied need for human contact. Their parents are believed to have been unaccepting, neglective, or abusive of their children. People with this disorder are unable to give or receive love. (Comer 2009)

Psychoanalytic View

CRITERIA FOR SCHIZOID PERSONALITY DISORDER

A. Evidence of a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings shown in at least four of the 7 followings ways:

(1) Neither desires nor enjoys close relationships.

(2) Almost always chooses solitary activities

(3) Has little if any interest in sexual experiences with another person.

(4) Takes pleasure in few if any activities.

(5) Lacks of close friends and confidants

(6) Appears indifferent to the praise or criticism of others.

(7) Shows emotional coldness, detachment, or flat affect

B. Does not occur exclusively during course of Schizophrenia, Mood disorder

with Psychotic Features, or other psychotic disorder or Pervasive

Developmental Disorders

CAUSAL FACTORS of Schizoid PD

• Little causes known and inconsistent.

• Likely precursor to the development of schizophrenia but still

challenged.• Traits have shown to have only modest heritability.

Paranoid PD vs. Schizoid PD

NEO-PI-R

Paranoid PD High Angry-hostility, (Neuroticisim)Low in Trust, Straightforwardness, and compliance (Agreeableness)

Paranoid PD vs. Schizoid PD

NEO-PI-R

Schizoid PD Low in warmth, gregariousness, positive emotions (EXTRAVERSION)Low in feelings (OPENNESS)

DEMOGRAPHICS AND PREVALENCE OF PERSONALITY DISORDERS

The estimated overall prevalence of DSM-IV personality disorders was 9%. Cluster A

disorders were most prevalent in men who had never married. Cluster B disorders were most prevalent in young men without a high school degree, and cluster C disorders in high

school graduates who had never married.

DEMOGRAPHICS AND PREVALENCE OF PERSONALITY DISORDERS

In general, the prevalence of personality disorders in this community sample was higher in men than in women; higher in formerly married and highest in never-married, compared with ever-married individuals; and higher in people who

dropped out of high school than in graduates.

TREATMENTS FOR PPD

The therapist must be careful to balance being objective in therapy and with regards to these thoughts, and of raising the suspicions of the client that he or she is not trusted.

PSYCHOTHERAPY

TREATMENTS FOR PPD

It is a difficult balance to maintain, even after a good working rapport has been established.

PSYCHOTHERAPY

TREATMENTS FOR PPD

Medications which are prescribed for specific conditions should be done so for the briefest time period possible to bring the condition under management.

MEDICATIONS

TREATMENTS FOR PPD

An anti-anxiety agent, such as diazepam, is appropriate to prescribe if the client suffers from severe anxiety or agitation where it begins to interfere with normal, daily functioning.

MEDICATIONS

TREATMENTS FOR PPDAn anti-psychotic medication, such as thioridazine or haloperidol, may be appropriate if a patient decompensates into severe agitation or delusional thinking which may result in self-harm or harm to others.

MEDICATIONS

TREATMENTS FOR PPD

There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder.

SELP-HELP

TREATMENTS FOR PPDSuch approaches would likely not be very effective because a person with this disorder is likely to be mistrustful and suspicious of others and their motivations, making group help and dynamics unlikely and possibly harmful.

SELP-HELP

TREATMENTS FOR SPDWhile there are many suggested treatment approaches one could make for this disorder, none of them are likely to be easily effective. As with all personality disorders, the treatment of choice is individual psychotherapy.

PSYCHOTHERAPY

TREATMENTS FOR SPD

However, people with this disorder are unlikely to seek treatment unless they are under increased stress or pressure in their life.

PSYCHOTHERAPY

TREATMENTS FOR SPD

Goals of treatment most often are solution-focused using brief therapy approaches.

PSYCHOTHERAPY

TREATMENTS FOR SPD

Medication is usually not an issue for someone who suffers from this disorder, unless they also have an additional Axis I disorder, such as major depression.

MEDICATIONS

TREATMENTS FOR SPD

Most patients show no additional improvement with the addition of an antidepressant medication, though, unless they are also suffering from suicidal ideation or a major depressive episode.

MEDICATIONS

TREATMENTS FOR SPD

SELP-HELP Self-help methods for the treatment of this disorder are often overlooked by the medical profession because very few professionals are involved in them.

TREATMENTS FOR SPD

SELP-HELP The social network provided within a self-help support group can be a very important component of increased, higher life functioning and a decrease in an inability to function in the face of unexpected stressors.

Prognosis of Paranoid and Schizoid Personality Disorders

Treatments are very difficult for these two disorders and there are not many options. Many psychiatrists believe it to be out of their expertise and/or untreatable .

Prognosis of Paranoid and Schizoid Personality Disorders

People with these disorders have a hard time becoming emotionally close to their therapists. Sometimes therapy helps suffers to experience more positive feelings and have better social interactions.

Prognosis of Paranoid and Schizoid Personality Disorders

Drug therapy is also administered but has limited help.

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