Chapter 13

What is are the three clusters of personality disorders marked by?

1. Odd or eccentric behavior- consists of the paranoid, schizoid, and schizotypal personality disorders 2. Dramatic behavior- consists of the antisocial, borderline, histrionic and narcissistic personality disorders 3. A high degree of anxiety- includes the avoidant, dependent, and obsessive-compulsive personality disorders

What does the categorical approach of personality disorders assume?

1. Problematic personality traits are either present or absent in people 2. A personality disorder is either displayed or not displayed by a person 3. A person who suffers from a personality disorder is not markedly troubled by personality traits outside of that disorder.

Have clinicians been successful in determining the causes or how to treat odd-cluster personality disorders?

No, but they have learned a lot about the symptoms

What behaviors are odd personality disorders marked by?

Odd or eccentric behaviors that are similar to but not as extensive as those seen in schizophrenia, including extreme suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving things. These behaviors often leave the person isolated.

What does cognitive-behavioral therapy do for paranoid personality disorder?

On the behavioral side, therapists help clients to master anxiety-reduction techniques and to improve their skills at solving interpersonal problems. On the cognitive side, therapists guide the clients to develop more realistic interpretations of other people's words and actions and to become more aware of other people's points of view.

How do cognitive-behavioral therapists treat schizoid personality disorder?

On the cognitive end, their techniques include presenting clients with lists of emotions to think about or having them write down and remember pleasurable experiences. On the behavioral end, therapists sometimes succeed by teaching social skills to clients, using role-playing, exposure techniques, and homework assignments as tools.

What is the odd cluster of personality disorders?

Paranoid, schizoid, and schizotypal personality disorders.

What are personality traits?

Particular characteristics that lead us to react in a predictable manner

Example of schizotypal eccentricities?

Repeatedly arranging cans to align their labels, organizing closets extensively, wearing an odd assortment of clothing, flat humorless or inappropriate emotions

What do biological studies suggest about antisocial personality disorder? pt 2

Research participants with this disorder often respond to warnings or expectations of stress with low brain and bodily arousal. It is believed that such underarousal may enable people with the disorder to readily tune out threatening or emotional situatons and be unaffected by them. This explains why people with this disorder feel less anxiety than others, are unable to learn from negative life experiences and are unable to tune into emotional cues, and explains why they take more risks and seek more thrills than others.

What support has been given for the psychodynamic explanation of antisocial personality disorder?

Researchers have found that people with the disorder are more likely than others to have had significant stress in their childhoods, mainly in forms of poverty, violence, abuse, and parental conflict or divorce.

What is the biological explanation for schizotypal personality disorders?

Researchers have linked this disorder to some of the same biological factors found in schizophrenia, such as high activity of the neurotransmitter dopamine, enlarged brain ventricles, smaller temporal lobes, and loss of gray matter.

What is the evidence for the behavioral theory for antisocial personality disorder?

Researchers point to the higher rate of antisocial personality disorder found among the parents and close relatives of people with this disorder. The modeling explanation is also supported by studies of friends and associates of people with antisocial disorder. One study found that middle school students who were attracted to antisocial peers went on to engage in antisocial behavior themselves in order to gain acceptance.

People with an odd-cluster personality disorder often qualify for an additional diagnosis of what?

Schizophrenia; otherwise they have close relatives with schizophrenia

What personality disorder is listed twice in DSM-5?

Schizotypal personality disorder- once under the schizophrenia spectrum and also under the personality disorders

How are substance abuse and alcoholism related to antisocial personality disorder?

Studies and clinical observations also indicate that people with this disorder have higher rates of alcoholism and other substance use disorders than the rest of the population. Therefore, some theorists speculate that the disorder along with substance use disorders have the same cause, such as a deep-seated need to take risks. These people also display gambling disorder

What do biological studies suggest about antisocial personality disorder?

THey indiate that individuals with the disorder display deficient functioning in their prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, and temporal cortex-- brain structures that help people follow rules, plan and execute realistic strategies, and display sympathy, judgment, and empathy.

What is the psychodynamic explanation for antisocial personality disorder?

That it begins with an absence of parental love during infancy, leading to a lack of basic trust. The children respond to the inadequacies by becoming emotionally distant, and they bond with others through power and destructiveness.

What is the cognitive-behavioral explanation for schizoid personality disorder?

That people with this suffer from deficiencies in their thinking. Their thoughts tend to be vague, empty, and without much meaning, and they have trouble scanning the environment to arrive at accurate perceptions. Unable to pick up emotional cues, they cannot respond to emotions. This predicts children with schizoid personality disorder develop language and motor skills very slowly, whatever their level of intelligence.

What is the biological explanation for paranoid personality disorder?

That this disorder has genetic causes; one widely reported study that looked at self-reports of suspiciousness in 3,810 Australian twin pairs found that if one twin was excessively suspicious, the other had an increased likelihood of also being suspicious. It is important to note though that these similarities between twins might also be the result of common environmental experiences.

What flexibility do people with personality disorder not have?

The flexibility to try out various responses to see which feel better and are more effective.

What are object relations therapist?

The psychodynamic therapists who give center stage to relationships

Why are the assumptions about the categorical approach of personality disorders wrong?

The symptoms of the disorders overlap in DSM-5 making it difficult for clinicians to distinguish one disorder from another leading to disagreements about diagnosis, and diagnosticians sometimes even determine that particular people have more than one personality disorder. This lack of agreement has raised questions about the validity and reliability of the 10 DSM personality disorder categories

How do schizoid personality disorder patients feel about treatment?

Their social withdrawal prevents most of them from entering therapy unless some other disorder, such as alcoholism, makes treatment necessary. They are likely to remain emotionally distant from the therapist, seem not to care, and make limited progress at best.

What are symptoms of schizoid personality disorder?

They are often described as loners, make no effort to start or keep friendships, take little interest in having sexual relationships, seem indifferent to their families, seek jobs that require little or no contact with others, form work relations to a degree when necessary but keep to themselves, live by themselves, weak social skills, lack of interest if they marry causes marital or family problems, focus on themselves, unaffected by praise or criticism, rarely show any feelings, express neither joy nor anger, seem to have no need for attention or acceptance, are viewed as cold humorless or dull, succeed in being ignored.

Are antisocial personality disorder treatments successful?

They are typically ineffective. The obstacles include: individual's lacking a conscience, a desire to change, or respect for therapy. Many people in therapy have been forced into it or they come to the attention for therapists when they develop another psychological disorder.

How are schizoid and paranoid personality disorder patients similar?

They do not have close ties with other people; but people with schizoid personality disorder just prefer to be alone whereas paranoid personality disorder patients have distrust, paranoia or suspicion.

What is the cognitive-behavioral treatment for antisocial personality disorder?

They guide clients to think about moral issues and about the needs of others. Research has not found this approach to be particularly helpful.

How are people with personality disorders different from others?

They have personality traits that are much more extreme and dysfunctional than those of most other people in their culture, leading to significant problems and psychological pain for themselves or others.

What do hospitals and prisons do to treat antisocial personality disorder?

They have tried to create a therapeutic community for people with this disorder, a structured environment that teaches responsibility toward others. Some individuals profit from this but others do not.

Is medication helpful for antisocial personality disorder?

They have used psychotropic medications, particularly antipsychotic drugs, to treat people, but research has not found medication to be consistently useful in addressing the overall antisocial pattern.

When do symptoms begin and how long do they last for personality disorder?

They last for years and typically become recognizable in adolescence or early adulthood, some start during childhood.

What are the characteristics of people with antisocial personality disorder?

They lie repeatedly, cannot work consistently at a job, are absent frequently and likely to quit their jobs, careless with money, failure to pay debts, impulsive, irritable, aggressive, quick to start fights, little regard for their safety, little regard for the safety of others, self-centered, likely to have trouble maintaining close relationships, develop a knack for gaining personal profit at the expense of others, clinicians say they lack a moral conscience, think of their victims as week and deserving of being conned robbed or physically harmed.

What do psychodynamic theorists, particularly object relations theorists say explains schizoid personality disorder?

They propose that it has its roots in an unsatisfied need for human contact. The parents of people with this disorder, like those with paranoid personality disorder, are believed to have been unaccepting or abusive. People with schizoid personality disorder are left unable to give or receive love, they cope by avoiding all relationships.

What is the psychodynamic explanation for paranoid personality disorder?

They trace the pattern to early interactions with demanding parents, particularly distant, rigid fathers and overcontrolling, rejecting mothers which cause people to view their environments as hostile and puts them on alert because they cannot trust others, and are likely to develop feelings of extreme anger. They also project these feelings onto others and feel increasingly persecuted as a result.

What do object relations therapists do for paranoid personality disorders?

They try to see past the patient's anger and work on what they view as his or her deep wish for a satisfying relationships.

What is cognitive-behavioral treatment for schizotypal personality disorder?

They try to teach clients to evaluate their unusual thoughts or perceptions objectively and to ignore the inappropriate ones. They may keep track of the client's odd or magical predictions and point out their inaccuracy. Behavioral methods are speech lessons, social skills training, and tips on appropriate dress and manners, which have sometimes helped clients learn to blend in better and be more comfortable around others.

How do people with paranoid personality disorder feel about treatment?

They typically do not see themselves as needing help and few come to treatment willingly. Those in treatment view the role of patient as inferior and distrust and rebel against their therapists. This is why therapy for this disorder has limited effect and moves slowly.

How does age play a role in antisocial personality disorder?

DSM-5 stipulates a person must be at least 18 to receive this diagnosis, but most people with the disorder displayed some patterns of misbehavior before they were 15, including truancy, running away, cruelty to animals or people, and destroying property.

How are personality disorders currently classified in DSM-5?

Despite the inadequacies of a categorical approach and the growing enthusiasm for a dimensional one, the framers decided to retain a classic 10-disorder categorical approach, but acknowledged the likely future direction of personality disorder classifications by also describing an alternative dimensional approach.

What are the goals for schizotypal personality disorder therapy?

Help the clients reconnect with the world and recognize the limits of their thinking and powers, set clear limits-ex, punctuality-, increase positive social contacts, ease loneliness, reduce overstimulation, and help the individuals become more aware of their personal feelings.

What are the dramatic personality disorders?What

antisocial, borderline, histrionic, narcissistic; their behaviors are so dramatic, emotional, or erratic that it is almost impossible for them to have giving and satisfying relationships.

What percent of people distrust?

internet-98%, mass media-68%, congressional members-51%, judges- 47%, journalists-41%, stockbrokers-39%, lawyers-37%, scientists-33%, bankers-30%, professors-18%, clergymen-13%, police officers-13%, doctors-7%

Have theories proposed about paranoid personality disorders received a lot of systematic research?

no, they have received little systematic research

What is the cognitive-behavioral explanation for paranoid personality disorder?

people with paranoid personality disorder generally hold broad maladaptive assumptions such as "people are evil"

How are crime and antisocial personality disorder related?

people with this disorder are often arrested. 35% of people in prison meet the diagnostic criteria for this disorder. The criminal behavior of many people with this disorder declines after the age of 40, but some continue this activity for the rest of their lives

What are the most difficult psychological disorders to treat?

personality disorders

What is more severe, paranoid, schizoid or schizotypal personality disorder?

schizotypal

What are bodily illusions?

sensing an external "force" or presence

What has difficult therapy in a way similar to that for schizotypal personality disorders?

Cases of paranoid and schizoid personality disorders

What is reliability?

Consistency

What is the Dx checklist for personality disorder?

1. individual displays a long-term, rigid, and wide-ranging pattern of inner experience and behavior that leads to dysfunction in at least two of the following realms: cognition, emotion, social interactions, impulsivity. 2. The individual's pattern is significantly different from ones usually found in his or her culture. 3. Individual experiences significant distress or impairment.

How many personality disorders does DSM-5 recognize?

10

How many US adults display personality disorder at some point in their lives?

ARound 15%

What is validity?

Accuracy

What percent of adults have schizoid personality disorder?

3.1%; men are slightly more likely to experience this than women.

How many US adults have antisocial personality disorder?

3.6% in the US; it is four times more common in men than women

What percent of adults have schizotypal personality disorder?

3.9%; slightly more males than females

How many adults have paranoid personality disorder?

4.4%; it is more common in men than in women

What percent of adults believe in some form of the paranormal?

73%

What percent of people with borderline personality disorder have another psychological disorder?

85% have another disorder such as major depressive disorder or an eating disorder.

What is the DSM's listing of 10 personality disorders called?

A categorical approach

What are the 10 personality disorders characterized by?

A group of problematic personality symptoms.

What is borderline personality disorder?

A personality disorder characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior

What is schizoid personality disorder?

A personality disorder featuring persistent avoidance of social relationships and little expression of emotion.

What is paranoid personality disorder?

A personality disorder marked by a pattern of distrust and suspiciousness of others.

Is the theory that schizophrenia and schizotypal personality disorder have similar factors causing them supported?

A range of studies have supported this

What is personality?

A set of uniquely expressed characteristics that influence our behaviors, emotions, thoughts, and interactions.

Example of paranoid personality disorder

A woman might avoid confiding in someone for fear of being hurt, a husband might, without and justification, persist in questioning his wife's faithfulness

What is personality disorder?

An enduring, rigid pattern of inner experience and outward behavior that repeatedly impairs a person's sense of self, emotional experiences, goals, capacity for empathy and/or capacity for intimacy.

What is intermittent explosive disorder?

An impulse-control disorder featuring repeated, unprovoked verbal and/or behavioral outbursts.

What disorder, aside from substance use disorders, is most closely linked to adult criminal behavior?

Antisocial personality disorder

What mood disorders do people with schizotypal personality disorders have?

Around two-thirds of them also suffer from major depressive disorder or bipolar disorder at some point in their lives

How are traits viewed in a dimensional approach?

As varying along a continuum extending from nonproblematic to extremely problematic.

What do research patients with schizotypal symptoms do poorly on?

Backward masking, a laboratory test of attention that requires a person to identify a visual stimulus immediately after a previous stimulus has flashed on and off the screen. People with these disorders have a hard time shutting out the first stimulus in order to focus on the second.

Why is schizotypal personality disorder not similar to schizophrenia?

Because it has been linked to disorders of mood; this is why it is not tied only to schizophrenia

Why do people with paranoid personality disorder shun close relationshios?

Because they believe that everyone intends them harm. They trust in their own ideas and abilities though and that can be excessive.

What is the cognitive-behavioral explanation of antisocial personality disorder?

Behavioral- they suggest that the symptoms may be learned through principles of conditioning, particularly modeling, or imitation. operant conditioning. Some parents unintentionally teach antisocial behavior regularly by rewarding a child's aggressive behavior. Cognitive- People with this disorder often hold attitudes that trivialize the importance of other people's needs. A number of cognitive-behavioral theorists propose that people with this disorder have genuine difficulty recognizing points of view or feelings other than their own.

What are the symptoms of schizotypal personality disorder?

Being anxious around others, seeking isolation, having few close friends, feeling intensely lonely, disturbed thoughts and behaviors, ideas of reference, seeing themselves as having extrasensory abilities, believing they have magical control over others, great difficulty keeping their attention focused, digressive and vague conversation sprinkled with loose associations, aimlessly drifting, lead an unproductive life, likely to choose undemanding jobs where they can work below their capacity and are not required to interact with others, and bodily illusions

What are ideas of reference?

Beliefs that unrelated events pertain to them in some important way

What are some symptoms of paranoid personality disorder?

Ever on guard, cautious, seeing threats everywhere, finding hidden meanings which are usually belittling or threatening, quick to challenge the loyalty or trustworthiness of acquaintances, cold, distant, inaccurate and inappropriate suspicions (they are not delusional that they are removed from reality.), critical of weakness and fault in others, unable to recognize their own mistakes, extremely sensitive to criticism, repeatedly bear grudges, blaming others for things going wrong in their lives

What are schizotypal symptoms, like schizophrenic patterns, linked to?

Family conflicts and psychological disorders in parents along with defects in attention and short-term memory

What is the biological explanation for antisocial personality disorder?

Genetic research suggests that the disorder may be linked to particular genes. Researchers have also found that antisocial people, particularly those who are highly impulsive and aggressive, have lower serotonin activity than others. Impulsivity and aggression have been linked to low serotonin activity. Additionally, many theorists now believe it is related to poor functioning by a brain circuit consisting of the structures mentioned (prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, and temporal cortex). Poor interconnectivity between those structures in the circuit may produce chronic low reactions to stress by the two brain-body pathways-the sympathetic nervous system pathway and the hypothalamic-pituitary-adrenal pathway- leading to low arousal, weak stress reactions, poor empathy for the pain of others, etc. This theory has limited research.

Is group therapy helpful for schizoid personality disorder?

Group therapy is helpful when it offers a safe setting for social contact, although they may resist taking part.

What are clusters?

Groups of personality disorders; there are 3

Are antipsychotic drugs helpful in treating schizotypal personality disorder?

In low doses they appear to help some people, usually by reducing certain of their thought problems.

How were personality traits viewed in the nineteenth-century?

In phrenology, Franz Joseph Gall suggested that the brain had distinct portions that were each responsible for some aspect of personality. Phrenologists tried to assess personality by feeling bumps and indentations on a person's head

What are the characteristics of a person with borderline personality disorder?

Instability, major shifts in mood, unstable self-image, impulsivity, swinging in and out of very depressive, anxious and irritable states that last anywhere from a few hours to a few days or more, emotional conflicts, bouts of anger which sometimes cause physical aggression and violence, direct impulsive anger inward and inflict bodily harm on themselves, troubled by deep feelings of emptiness.

IS antipsychotic drug therapy helpful for paranoid personality disorder?

It is of limited help

Is drug therapy helpful for schizoid personality disorder?

It is of limited help

Are schizophrenia and schizotypal personality disorder directly related?

It is unknown

Is cognitive-behavioral therapy helpful for schizoid personality disorder?

It sometimes has been able to help people experience more positive emotions and more satisfying social interactions

What are people with antisocial personality disorder described as?

Psychopaths or sociopaths.

What is pseudocommando?

This is a pattern where a mass murderer kills in public, often in the daytime, plans his offense well in advance, and comes prepared with a powerful arsenal of weapons. He has no escape planned and expects to be killed during the incident.

What is autogenic?

This is a self-generated massacre where individuals kill people indiscriminately to fulfill a personal agenda.

What is comorbidity?

This is where a person with a personality disorder also suffers from another disorder.

What is dimensional approach?

This is where theorists have challenged the use of a categorical approach to personality disorders; they believe they differ more in DEGREE than in TYPE of dysfunction and should instead be classified by the SEVERITY of personality traits rather than by the presence or absence.

What was found in the early study of patients with paranoia?

When required to role-play, participants with paranoia were more likely than control participants to read hostile intentions into the actions of others. They also more often chose anger as the appropriate role-play response.

What is schizotypal personality disorder?

a personality disorder characterized by extreme discomfort in close relationships, odd forms of thinking and perceiving, and behavioral eccentricities

What is antisocial personality disorder?

a personality disorder marked by a general pattern of disregard for and violation of other people's rights