Personality-Disorders.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Abnormal Psychology:An Integrative Approach,4th Edition,David H.Barlow,Chapter 12:Personality Disorders,Personality Disorders,0,Personality Disorders:An Overview,The Nature of Personality and Personality Disorders,Enduring and relatively stable predispositions(i.e.,ways of relating and thinking),Predispositions are inflexible and maladaptive,causing distress and/or impairment,Coded on Axis II of the DSM-IV and DSM-IV-TR,Categorical vs.Dimensional Views of Personality Disorders,0,Personality Disorders:Facts and Statistics,Prevalence of Personality Disorders,About 0.5%to 2.5%of the general population,Rates are higher in inpatient and outpatient settings,Origins and Course of Personality Disorders,Thought to begin in childhood,Run a chronic course,Comorbidity,rates are high,Gender Distribution and Gender Bias,Gender bias exists in diagnosis,Criterion vs.assessment gender bias,0,DSM-IV and DSM-IV-TR Personality Disorder Clusters,Cluster A,Odd or eccentric,Examples include paranoid,schizoid,Cluster B,Dramatic,emotional,erratic,Examples include antisocial,borderline,Cluster C,Fearful or anxious,Examples include avoidant,obsessive-compulsive,0,Cluster A:Paranoid Personality Disorder,Overview and Clinical Features,Pervasive and unjustified mistrust and suspicion,The Causes,Biological and psychological contributions are unclear,Early learning that the world is a dangerous place,Treatment Options,Few seek professional help on their own,Treatment focuses on development of trust,Cognitive therapy to counter negativistic thinking,Lack good outcome studies,0,Cluster A:Schizoid Personality Disorder,Overview and Clinical Features,Pervasive pattern of detachment from social relationships,Very limited range of emotions in interpersonal situations,The Causes,Etiology is unclear,Preference for social isolation resembles autism,Treatment Options,Few seek professional help on their own,Focus on the value of interpersonal relationships,Building empathy and social skills,Lack good outcome studies,0,Cluster A:,Schizotypal,Personality Disorder,Overview and Clinical Features,Odd and unusual behavior and appearance,Most are socially isolated,highly suspicious,Magical thinking,ideas of reference,and illusions,Many meet criteria for major depression,The Causes,A phenotype of a schizophrenia genotype?,More generalized brain deficits,Treatment Options,Main focus is on developing social skills,Treatment also addresses,comorbid,depression,Medical treatment similar to schizophrenia,Treatment prognosis is generally poor,0,Cluster B:Antisocial Personality Disorder,Overview and Clinical Features,Noncompliance with social norms,Violate rights of others,Irresponsible,impulsive,and deceitful,Lack a conscience,empathy,and remorse,Psychopathy,and Antisocial Personality Disorder,Relation with Conduct Disorder and Early Behavior Problems,Early histories of behavioral problems(e.g.,conduct disorder),Families with inconsistent parental discipline and support,Families have histories of criminal and violent behavior,0,George,Cluster B:Antisocial Personality Disorder(cont.),Figure 12.2,Overlap and lack of overlap among antisocial personality disorder,psychopathy,and criminality.,0,Cluster B:Antisocial Personality Disorder(cont.),0,Figure 12.3,Lifetime course of criminal behavior in psychopaths and,nonpsychopaths,(based on Hare,McPherson,&Forth,1988).,Neurobiological Contributions andTreatment of Antisocial Personality,Prevailing Neurobiological Theories,Brain damage Little support for this view,Underarousal,hypothesis Cortical arousal is too low,Cortical immaturity hypothesis Cortex is not fully developed,Fearlessness hypothesis Fail to respond to danger cues,Grays model of behavioral inhibition and activation,Treatment,Few seek treatment on their own,Antisocial behavior is predictive of poor prognosis,Emphasis is placed on prevention and rehabilitation,Often incarceration is the only viable alternative,0,Cluster B:Borderline Personality Disorder,Overview and Clinical Features,Patterns of unstable moods and relationships,Impulsivity,fear of abandonment,very poor self-image,Self-mutilation and suicidal gestures are common,Most common personality disorder in psychiatric settings,Comorbidity,rates are high,The Causes,Runs in families,Early trauma and abuse seem to play some role,Treatment Options,Few good treatment outcome studies,Antidepressant medications Some short-term relief,Dialectical behavior therapy Most promising treatment,0,Cluster B:Histrionic Personality Disorder,Overview and Clinical Features,Overly dramatic,sensational,and sexually provocative,Impulsive and need to be the center of attention,Thinking and emotions are perceived as shallow,Common diagnosis in females,The Causes,Etiology is largely unknown,Sex-typed variant of antisocial personality?,Treatment Options,Focus on attention seeking/long-term consequences,Address problematic interpersonal behaviors,Little evidence that treatment is effective,0,Cluster B:Narcissistic Personality Disorder,Overview and Clinical Features,Exaggerated/unreasonable sense of self-importance,Preoccupation with receiving attention,Lack sensitivity and compassion for other people,Sensitive to criticism,envious,and arrogant,The Causes,Link with early failure to learn empathy as a child,Sociological view Product of the“me”generation,Treatment Options,Focuses on grandiosity,lack of empathy,May also address co-occurring depression,Little evidence that treatment is effective,0,Cluster C:Avoidant Personality Disorder,Overview and Clinical Features,Extreme sensitivity to the opinions of others,Highly avoidant of most interpersonal relationships,Interpersonally anxious and fearful of rejection,The Causes,Numerous factors have been proposed,Difficult temperament and early rejection,Treatment Options,Several well-controlled treatment outcome studies exist,Treatment is similar to that used for social phobia,Treatment targets include social skills and anxiety,0,Cluster C:Dependent Personality Disorder,Overview and Clinical Features,Reliance on others to make major and minor life decisions,Unreasonable fear of abandonment,Clingy and submissive in interpersonal relationships,The Causes,Still largely unclear,Linked to early disruptions in learning independence,Treatment Options,Research on treatment efficacy is lacking,Therapy typically progresses gradually,Treatment targets include skills that foster independence,0,Cluster C:Obsessive-Compulsive Personality Disorder,Overview and Clinical Features,Excessive and rigid fixation on doing things the right way,Highly,perfectionistic,orderly,and emotionally shallow,True obsessions and compulsions are rare,The Causes,Are largely unknown,Treatment Options,Data supporting treatment are limited,Addresses fears related to the need for orderliness,Rumination,procrastination,and feelings of inadequacy,0,Summary of Personality Disorders,Personality Disorders,Long-standing patterns of behavior,Begin early in development and run a chronic course,Disagreements Exist,Over how to categorize personality disorders,Categorical,vs,.dimensional,or some combination of both,DSM-IV and DSM-IV-TR 10 Personality Disorders,The Causes of Personality Disorders Are Difficult to Pinpoint,Treatment of Is Often Difficult and Prognosis Poor,0,Exploring Personality Disorders(Cluster A),0,Exploring Personality Disorders(Cluster A),0,Exploring Personality Disorders(Cluster A),0,Exploring Personality Disorders(Cluster A),0,Exploring Personality Disorders(Cluster B),0,Exploring Personality Disorders(Cluster B),0,Exploring Personality Disorders(Cluster B),0,Exploring Personality Disorders(Cluster C),0,Exploring Personality Disorders(Cluster C),0,