Personality Disorder (cluster A) abnormal psychology PDF

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Personality Disorder (ClusterA)Personality is a person’s relatively stable ways of behavior, characteristic traits and coping styles, and that emerge during childhood and normally crystallize into established patterns by the end of adolescence or early adulthood.Today there is broad agreement among ...

Description

Personality Disorder (Cluster A) Personality is a person’s relatively stable ways of behavior, characteristic traits and coping styles, and that emerge during childhood and normally crystallize into established patterns by the end of adolescence or early adulthood. Today there is broad agreement among personality researchers that about five basic personality trait dimensions can be used to characterize normal personality. This five-factor model of personality traits includes the following five trait dimensions: •

Openness

•

Conscientiousness

•

Extraversion

•

Agreeableness

•

Neuroticism

According to general DSM-IV-TR criteria for diagnosing a personality disorder, the person’s enduring pattern of behavior must be pervasive and inflexible, as well as stable and of long duration. It must also cause either clinically significant distress or impairment in functioning and be manifested in at least two

of the following areas: cognition, affectivity, interpersonal functioning, or impulse control. A personality disorder is an inflexible pattern of inner experience and outward behavior. The pattern is seen in most of the person’s interactions, continues for years, and differs markedly from the experiences and behaviors usually expected of people From a clinical standpoint, people with personality disorders often cause at least as much difficulty in the lives of others as in their own lives. Personality disorders typically do not stem from negative reactions to stress but they stem largely from the gradual development of inflexible and distorted personality and behavioral patterns that result in persistently maladaptive ways of perceiving, thinking about, and relating to the world. In many cases, major stressful life events early in life help set the stage for the development of these inflexible and distorted personality patterns. The DSM-IV-TR personality disorders are grouped into three clusters on the basis of similarities of features among the disorders within a given cluster. Personality is a person’s relatively stable ways of behavior, characteristic traits and coping styles, and that emerge during childhood and normally crystallize into established patterns by the end of adolescence or early adulthood.

Today there is broad agreement among personality researchers that about five basic personality trait dimensions can be used to characterize normal personality. This five-factor model of personality traits includes the following five trait dimensions: •

Openness

•

Conscientiousness

•

Extraversion

•

Agreeableness

•

Neuroticism

According to general DSM-IV-TR criteria for diagnosing a personality disorder, the person’s enduring pattern of behavior must be pervasive and inflexible, as well as stable and of long duration. It must also cause either clinically significant distress or impairment in functioning and be manifested in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control. A personality disorder is an inflexible pattern of inner experience and outward behavior. The pattern is seen in most of the person’s interactions, continues for years, and differs markedly from the experiences and behaviors usually expected of people

From a clinical standpoint, people with personality disorders often cause at least as much difficulty in the lives of others as in their own lives. Personality disorders typically do not stem from negative reactions to stress but they stem largely from the gradual development of inflexible and distorted personality and behavioral patterns that result in persistently maladaptive ways of perceiving, thinking about, and relating to the world. In many cases, major stressful life events early in life help set the stage for the development of these inflexible and distorted personality patterns. The DSM-IV-TR personality disorders are grouped into three clusters on the basis of similarities of features among the disorders within a given cluster. Cluster A: Includes paranoid, schizoid, and schizotypal personality disorders. People with these disorders often seem odd or eccentric, with unusual behavior ranging from distrust and suspiciousness to social detachment. Cluster B: Includes histrionic, narcissistic, antisocial, and borderline personality disorders. Individuals with these disorders share a tendency to be dramatic, emotional, and erratic. Cluster C: Includes avoidant, dependent, and obsessive compulsive personality disorders. In contrast to the other two

clusters, people with these disorders often show anxiety and fearfulness.

CLUSTER A PARANOID PERSONALITY DISORDER Individuals with paranoid personality disorder have a pervasive suspiciousness and distrust of others, leading to numerous interpersonal difficulties. They tend to see themselves as blameless, instead blaming others for their own mistakes and failures. Such people are chronically tense and “on guard,” looking for clues to validate their expectations while disregarding all evidence to the contrary. They are often preoccupied with doubts about the loyalty of friends and hence are reluctant to confide in others. They commonly bear grudges, refuse to forgive perceived insults and slights, and are quick to react with anger and sometimes violent behavior. Paranoid personality disorder may consist of elements of both suspiciousness and hostility. It is important to keep in mind that people with paranoid personalities are not usually psychotic; that is, most of the time they are in clear contact with reality.

Criteria for Paranoid Personality Disorder A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early

adulthood and present in a variety of contexts, as indicated by four (or more) of the following: 1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her 2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates 3. Reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her 4. Reads hidden demeaning or threatening meanings into benign remarks or events 5. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights 6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack 7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition

SCHIZOID PERSONALITY DISORDER

Individuals with schizoid personality disorder are usually unable to form social relationships and usually lack much interest in doing so. Consequently, they do not have good friends, with the possible exception of a close relative. Such people are unable to express their feelings and are seen by others as cold and distant. They lack social skills and can be classified as loners or introverts, with solitary interests and occupations, although not all loners or introverts have schizoid personality disorder. They tend not to take pleasure in many activities, including sexual activity, and rarely marry. They are not very emotionally reactive, rarely experiencing strong positive or negative emotions, but rather show a generally apathetic mood. These deficits contribute to their appearing cold and aloof.

Criteria for schizoid personality disorder A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: 1. Neither desires nor enjoys close relationships, including being part of a family 2.

Almost always chooses solitary activities

3. Has no little, if any, interest in having sexual experiences with another person 4.

Takes pleasure in few, if any, activities

5. Lacks close friends or confidants other than first-degree relatives 6.

Appears indifferent to the praise or criticism of others

7. Shows emotional coldness, detachment, or flattened affectivity B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition.

SCHIZOTYPAL PERSONALITY DISORDER Individuals with schizotypal personality disorder are also excessively introverted and have pervasive social and interpersonal deficits (like those that occur in schizoid personality disorder), but in addition they have cognitive and perceptual distortions, as well as oddities and eccentricities in their communication and behavior. Although contact with reality is usually maintained, highly personalized and superstitious thinking is characteristic of people with

schizotypal personality, and under extreme stress they may experience transient psychotic symptoms Other cognitive–perceptual problems include ideas of reference (the belief that conversations or gestures of others have special meaning or personal significance), odd speech, and paranoid beliefs. Oddities in thinking, speech, and other behaviors are the most stable characteristics of schizotypal personality disorder and are similar to those often seen in schizophrenic patients. Many researchers conceptualize schizotypal personality disorder as an milder form of schizophrenia.

Criteria for Schizotypal Personality Disorder A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1.

Ideas of reference (excluding delusions of reference)

2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations)

3.

Unusual perceptual experiences, including bodily illusions

4. Odd thinking and speech (vague, circumstantial, metaphorical, over elaborate, or stereotyped) 5.

Suspiciousness or paranoid ideation

6.

Inappropriate or constricted affect

7.

Behavior or appearance that is odd, eccentric, or peculiar

8. Lack of close friends or confidants other than first-degree relatives 9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.: Includes paranoid, schizoid, and schizotypal personality disorders. People with these disorders often seem odd or eccentric, with unusual behavior ranging from distrust and suspiciousness to social detachment. Cluster B: Includes histrionic, narcissistic, antisocial, and borderline personality disorders. Individuals with these disorders share a tendency to be dramatic, emotional, and erratic. Cluster C: Includes avoidant, dependent, and obsessive compulsive personality disorders. In contrast to the other two

clusters, people with these disorders often show anxiety and fearfulness. CLUSTER A PARANOID PERSONALITY DISORDER Individuals with paranoid personality disorder have a pervasive suspiciousness and distrust of others, leading to numerous interpersonal difficulties. They tend to see themselves as blameless, instead blaming others for their own mistakes and failures. Such people are chronically tense and “on guard,” looking for clues to validate their expectations while disregarding all evidence to the contrary. They are often preoccupied with doubts about the loyalty of friends and hence are reluctant to confide in others. They commonly bear grudges, refuse to forgive perceived insults and slights, and are quick to react with anger and sometimes violent behavior. Paranoid personality disorder may consist of elements of both suspiciousness and hostility. It is important to keep in mind that people with paranoid personalities are not usually psychotic; that is, most of the time they are in clear contact with reality. Criteria for Paranoid Personality Disorder A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her 2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates 3. Reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her 4. Reads hidden demeaning or threatening meanings into benign remarks or events 5. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights 6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack 7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition SCHIZOID PERSONALITY DISORDER Individuals with schizoid personality disorder are usually unable to form social relationships and usually lack much interest in doing so. Consequently, they do not have good

friends, with the possible exception of a close relative. Such people are unable to express their feelings and are seen by others as cold and distant. They lack social skills and can be classified as loners or introverts, with solitary interests and occupations, although not all loners or introverts have schizoid personality disorder. They tend not to take pleasure in many activities, including sexual activity, and rarely marry. They are not very emotionally reactive, rarely experiencing strong positive or negative emotions, but rather show a generally apathetic mood. These deficits contribute to their appearing cold and aloof.

Criteria for Schizoid Personality Disorder A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: 1. Neither desires nor enjoys close relationships, including being part of a family 2.

Almost always chooses solitary activities

3. Has no little, if any, interest in having sexual experiences with another person 4.

Takes pleasure in few, if any, activities

5. Lacks close friends or confidants other than first-degree relatives 6.

Appears indifferent to the praise or criticism of others

7. Shows emotional coldness, detachment, or flattened affectivity B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition. SCHIZOTYPAL PERSONALITY DISORDER Individuals with schizotypal personality disorder are also excessively introverted and have pervasive social and interpersonal deficits (like those that occur in schizoid personality disorder), but in addition they have cognitive and perceptual distortions, as well as oddities and eccentricities in their communication and behavior. Although contact with reality is usually maintained, highly personalized and superstitious thinking is characteristic of people with schizotypal personality, and under extreme stress they may experience transient psychotic symptoms Other cognitive–perceptual problems include ideas of reference (the belief that conversations or gestures of others have special meaning or personal significance), odd speech, and

paranoid beliefs. Oddities in thinking, speech, and other behaviors are the most stable characteristics of schizotypal personality disorder and are similar to those often seen in schizophrenic patients. Many researchers conceptualize schizotypal personality disorder as an milder form of schizophrenia.

Criteria for Schizotypal Personality Disorder A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1.

Ideas of reference (excluding delusions of reference)

2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations) 3.

Unusual perceptual experiences, including bodily illusions

4. Odd thinking and speech (vague, circumstantial, metaphorical, over elaborate, or stereotyped) 5.

Suspiciousness or paranoid ideation

6.

Inappropriate or constricted affect

7.

Behavior or appearance that is odd, eccentric, or peculiar

8. Lack of close friends or confidants other than first-degree relatives 9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder....