PERSONALITY DISORDERS

Jimmy has been in trouble all his life. As a kid, he skipped school often, and when he was there, he
was prone to starting fights with other kids and getting into arguments with teachers. He was suspended
several times for stealing. He was finally expelled at the age of 14 for threatening a teacher, and he
essentially never went back to school.

Jimmy is now 29 and has been in and out for the past 15 years. Mostly, his crimes have involved
small time burglaries and shoplifting, possession of illegal drugs, and driving while intoxicated. He has
never kept a job for more than 6 months at a time. He always gets into fights with his bosses or
coworkers, whom he usually considers to be stupid. Then he quits or is fired. When his family members
ask Jimmy why he gets into so much trouble, he just shrugs and either blames his predicament on
someone else or says he cannot control his temper.

Jimmy actually talks to his family members only rarely. He has never gotten along with anyone but
his mother and has been physically violent toward several family members. Jimmy’s romantic
relationships have been few and have largely consisted of meeting a woman, having frequent and
somewhat violent sex with her for a few weeks, and then leaving her without a good-bye.

PERSONALITY DISORDERS
- A long-lasting pattern of behavior, thought and feeling that is highly maladaptive for the individual and for
the people around him or her
- Must be present continuously from adolescence or early adulthood into adulthood
- Defined as an enduring set of subjective experiences and behavioral traits that deviate from social norms
and lead to unhappiness and/or failure to achieve life goals.
- The term “disorder” is somewhat misleading PD is remarkably stable and “orderly” – i.e., predictable and
unmalleable (inflexible)
- A generally consistent (but personal) style of interacting with the world and other people
- Our ‘character’ is reflected in how we think, what and who we like, and how we respond to life
- It is generally stable over time -> allows some predictability
- Types of personality traits are limited and can be conceptualized as dimensional
- No trait or style is automatically indicative of disorder or disease (don’t confuse eccentricity with disorder)

DSM 5 PERSONALITY DISORDER

- A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from
the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early
adulthood, is stable over time, and leads to distress or impairment

FIVE-FACTOR MODEL OF PERSONALITY

- One of the most popular approaches among psychologists for studying personality traits is the “Five-Factor
Model” of personality.
- According to the “Five-Factor Model,” personality is made up of a combination of five factors, or traits
 NEUROTICISM: Neuroticism is the tendency to feel bad.

: Someone who scores highly on neuroticism may frequently feel anxious or sad.

 EXTROVERSION: “could also be called “outgoingness.” Someone who scores high on extroversion enjoys
being with other people and usually feels happy.
 OPENNESS TO EXPERIENCE: Openness to experience includes being curious about the world and open to
new ideas.
 AGREEABLENESS: measured by how likely you are to feel compassion for someone. Someone who scores
highly on agreeableness is generally concerned about other people.
 CONSCIENTIOUSNESS: Conscientiousness is defined as being organized, focused, and goal-oriented.

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WHAT IS A DISORDER?
- Implies functional impairment / failure to achieve what is expected and/or significant and persistent
emotional distress
- In the case of Personality Disorders this is by definition a result of a ‘maladaptive’ personality style

PERSONALITY DISORDERS

- are made up of ways of viewing and thinking

- about oneself and others that do not change much from one day to the next
- these perceptions, thoughts, and behaviours are upsetting to the individual who experiences them, or they
cause problems in the individual’s personal relationships.
- If a person’s characteristic ways of interacting with others cause significant problems in her life, and if she is
unable to change these behaviours, we might say that this person has a personality disorder.
- Personality disorders are different from other types of mental disorders, such as depression or
schizophrenia
- Personality disorders tend to be chronic and long-lasting.
- One way to think of a personality disorder is to liken it to a disease like diabetes. Someone with diabetes
always has diabetes and takes medicine everyday to help him control his symptoms.
- A different, more temporary kind of sickness is a cold. When you get a cold, you might have symptoms like a
runny nose and cough for a few days or even a few weeks.
- Likewise, someone with major depression might have depressive symptoms for a few weeks but will
eventually feel better.
- A person with depression might suffer a major depressive episode that lasts a few weeks or months, while
an individual with a personality disorder must deal with their problems for years.
- In fact, one requirement for diagnosis of a personality disorder is that the characteristic behavior patterns of
a patient with a personality disorder must be able to be traced back to adolescence or early adulthood.
- Can a personality disorder be diagnosed in an individual under 18 years?

For a personality disorder to be diagnosed in an individual younger than 18 years, the personality patterns must have
been present for at least 1 year, with the exception of ASPD which cannot be diagnosed before age 18

- While the person with PD has unhappiness and often other clinical disorders, the person is not likely to feel
conflicted about his or her traits.
- They are EGO SYNTONIC thoughts, impulses, attitudes, and behavior that are felt to be acceptable and
consistent with the self- conception.
- Individuals with PD have difficulty meeting the expectations of others at work, in school, and in
relationships.
- They resist “giving in” to others and to what they perceive as unfair or arbitrary demands.
- They are generally described as resistive to treatment and unresponsive to therapeutic strategies.
- They are far more likely to seek therapy or to be brought to the attention of therapists and social workers
due to their non-conforming behavior.
- PD can co-exist with many other disorders – the most common are substance use disorders, mood and
anxiety disorders, and eating disorders.
- The expression of PD is heavily influenced by culture and gender.
- An individual can have more than one PD diagnosis.

WHAT ARE THE MOST ‘BASIC’ EXPECTATIONS OF OUR CULTURE

1. Independence
2. Follow the rules
3. Maintain long-term relationships

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PERSONALITY DISORDER

- Manifested in at least two areas (cognition, affectivity, interpersonal functioning, and impulse control)
- Evident in various personal and social situations
- Causes distress or impairment

DIAGNOSTIC FEATURES OF PERSONALITY DISORDER

• COGNITION – ways of perceiving self, other people, and events

• AFFECTIVITY – range, intensity, and appropriateness of emotional expression
• INTERPERSONAL FUNCTIONING
• IMPULSE CONTROL

CAUSES OF PERSONALITY DISORDERS

- Personality disorders begin in childhood and continue into adulthood.

- For this reason, it is often difficult to determine exactly when the disorder began.
- Most likely, personality disorders emerge slowly over a period of several years. It is not uncommon for
personality disorders to go untreated for a long time, because these behaviours become so much a part of
the person’s identity that it is difficult for him or her to realize that something is wrong.

BIOLOGICAL INFLUENCES

- There are ample data to suggest that personality traits are heritable, or passed down from one generation
to the next.
- Perhaps your mother tells you that you have your father’s temper or your grandmother’s sense of humour.
- Often it is possible to trace one’s personality back to childhood.
- For example, your mother might tell you that you have always been gregarious and outgoing (or, perhaps,
you have always been both outgoing and private, needing time to yourself to read, make things, etc.).
- we may observe a hint of future adult personality in young children
- the foundation of adult personality, as it is observed in infants, is called temperament
- TEMPERAMENT
- An infant’s “temperament” is the way the infant responds to environmental stimuli
- Babies differ in how they respond to various situations.
- For example, some infants are startled by bright light or loud noises, while others are less affected by these
kinds of sensory stimuli.
- Some infants cling to their mothers, whereas others seem comfortable with a wide variety of caregivers.
- By observing the way infants respond to stimuli in their environments, researchers can predict how they
might respond to stimuli in adulthood.
- some researchers believe that temperament in infancy may be related to personality as described in the
Five- Factor Model
- For example, infants who are often fearful or irritable may be anxious or fearful as adults, or considered
highly neurotic.
- While infants who are happy and energetic may be highly extroverted and relaxed as adults.
- If temperament is the foundation of normal adult personality, it is not surprising that temperament might
predict psychopathology in adulthood.
- Kagan and his colleagues at Harvard University have found that infants who are behaviourally inhibited, or
significantly fearful, are more likely to develop anxiety disorders as children and as adults.
- children who show little fear of threats, or are behaviourally uninhibited, might have difficulty learning
appropriate behavior and have been shown to exhibit more aggressive and delinquent behavior when
observed by researchers at age 13

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PSYCHOLOGICAL INFLUENCES

- Biology may build the foundation for personality disorders, but many researchers believe that psychological
factors are crucial for their development.
- Human cognition—the processes by which we acquire, process, and retrieve information, may help explain
how personality disorder symptoms develop and are maintained.

ATTACHMENT

- The Austrian-born physician and zoologist KONRAD LORENZ (1903–1989) was the first to study imprinting
behavior.
- In birds, imprinting behavior is observed when the new born baby observes and forms a strong bond with an
object, usually its mother. This occurs shortly after birth in what is called the critical period.
- Although human infants do not exhibit imprinting exactly, they do show a wide range of complex
attachment behaviors.
- In the 1950s the British psychoanalyst JOHN BOWLBY described attachment behaviors as those that are
intended to keep the mother close to the child. By keeping the mother close, the infant is protected for the
first year of life.
- The infant develops an “internal working model” that is an idea of an attachment figure based on the
availability and responsiveness of the attachment figure (usually the mother).
- Attachment guides children’s behavior, feelings, and processing of social information.
- This means that the relationship between the primary caregiver and the child serves as the foundation for
future interpersonal relationships.
- Some researchers believe that attachment patterns in infancy may be integral to the development of
personality disorders in general, and borderline personality disorder specifically.

LEARNING

- Learning by classical conditioning – Classical conditioning is learning that occurs when a stimulus precedes a
rewarding event
- Learning through operant conditioning
- Observational Learning

SCHEMAS

- A cognitive theory of mental disorders might add to our understanding of what causes and maintains
personality disorder symptoms.
- A cognitive theory of mental disorders suggests that errors in thinking contribute to mental illness
- A specific error in thinking, called a schema, is an underlying mental “map” that guides how we think about
people and events.
- Someone who has a “depressive schema” might attend to, linger on, and remember negative information.
- Perhaps you know someone who is pessimistic, always expecting the worst. A person with a depressive
schema might be extremely pessimistic, always looking on the bad side of things, seeking evidence to
confirm his negative expectation

SOCIOECONOMIC STATUS

- One personality disorder in which socioeconomic status must be considered is antisocial personality
disorder.
- ASPD is largely described by a lifetime of unlawful behaviors such as theft, vandalism, and violence.
- These behaviors may begin at a very early age and continue into adulthood.
- Children who are raised in poverty are more likely to consume drinking water that has levels of lead high
enough to cause mild or severe brain damage.