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What we mean by the word PERSONALITY?
 refers to the collection of characteristics
or traits that we have developed as we
have grown up and which make each of
us an individual.
 These include the ways that we:
 think
 feel
 behave
What is Personality Disorder?
- an enduring pattern of inner experience
and behavior that deviates markedly
from cultural expectations, is inflexible
and pervasive, has its onset
in adolescence or early adulthood, is
stable over time, and leads to distress or
impairment.
What is Personality Disorder?
Personality Disorder common features include:
 being overwhelmed by negative feelings such as distress,
anxiety, worthlessness or anger
 avoiding other people and feeling empty and emotionally
disconnected
 difficulty managing negative feelings without self-harming or,
in rare cases, threatening other people
 odd behaviour
 difficulty maintaining stable and close
relationships, especially with partners, children and
professional carers
 sometimes, periods of losing contact with reality
Different kinds of personality
disorders
Personality disorders tend to fall into three
groups, according to their emotional
'flavour':
 Cluster A: 'Odd or Eccentric
 Cluster B: 'Dramatic, Emotional, or
Erratic'
 Cluster C: 'Anxious and Fearful'
'Odd and Eccentric'
Cluster A: 'Odd and Eccentric'
Paranoid PD
- is a mental
disorder characterized by
paranoia and a
pervasive, long-standing
suspiciousness and
generalized mistrust of
others.
PPD Symptoms:
 may be hypersensitive, easily feel
slighted, and habitually relate to the
world by vigilant scanning of the
environment for clues or suggestions
that may validate their fears or
biases.
 They think they are in danger and
look for signs and threats of that
danger.
 tend to be guarded and suspicious
and have quite constricted emotional
lives.
 They may or may not have a
tendency to bear grudges,
suspiciousness, tendency to interpret
Cluster A: 'Odd and
Eccentric'
PPD Causes:
- A genetic contribution to
paranoid traits and a possible
genetic link between this
personality disorder and
schizophrenia exist.
Psychosocial theories
implicate projection of
negative internal feelings and
parental modeling. Cognitive
theorists believe the disorder
to be a result of an underlying
belief that other people are
deceptive/malevolent in
combination with a lack in self-
confidence.
PPD Treatment:
Because of reduced levels of
trust, there can be challenges
in treating PPD.
However, psychotherapy, antidep
ressants,
antipsychotics and anti-
anxiety medications can play a
role when an individual is
receptive to intervention
Cluster A: 'Odd and Eccentric'
Schizoid PD
- is a personality
disorder characterized by
a lack of interest in social
relationships, a tendency
towards a solitary
lifestyle, secretiveness,
emotional coldness,
and apathy.
SPD Symtoms:
 often aloof, cold and indifferent
 have trouble establishing
personal relationships
 may remain passive in the face
of unfavorable situations.
 When the individual's personal
space is violated, they feel
suffocated and feel the need to
free themselves
 It is not people as such that they
want to avoid, but emotions both
negative and positive, emotional
intimacy, and self disclosure
Cluster A: 'Odd and Eccentric'
SPD Causes:
There is some evidence to suggest that there is an
increased prevalence of schizoid personality disorder in
relatives of people with schizophrenia or schizotypal
personality disorder. To Sula Wolff, who did extensive
research and clinical work with children and teenagers
with schizoid symptoms, "schizoid personality has a
constitutional, probably genetic, basis. Other
researchers had hypothesized that unloving,
neglectful, or excessively perfectionist parenting could
play a role.Twin studies with schizoid personality
disorder traits, low sociability and low warmth, suggest
these traits are inherited. Because of this, there is
indirect evidence linking the heritability of schizoid
personality disorder
Cluster A: 'Odd and
Eccentric'
SPD Treatment:
 Medication
 Psychotherapy
 Modalifinil
 Socializations Groups
Cluster A: 'Odd and Eccentric'
Schizotypal PD
- is a personality disorder
characterized by a
need for social
isolation, anxiety in
social situations, odd
behavior and thinking,
and often
unconventional
beliefs.
STPD Symptoms:
 feel extreme discomfort with
maintaining close relationships
with people, so they avoid
forming them.
 Peculiar speech mannerisms
and odd modes of dress
 may react oddly in
conversations, not respond, or
talk to themselves
 frequently misinterpret
situations as being strange or
having unusual meaning for
them
Cluster A: 'Odd and
Eccentric'
STPD Causes:
 Biological/Genetics
 Social and Environmental
Factors
STPD Treatment:
 Pharmacological
In order to decide which type of
medication should be used,
Paul Markovitz distinguishes
two basic groups of
schizotypal patients:
o Schizotypal patients who appear
to be almost schizophrenic in their
beliefs and behaviors (aberrant
perceptions and cognitions) - they
are usually treated with low doses
of antipsychotic medications,
e.g. thiothixene. However, it must
be mentioned that long-term
efficacy of neuroleptics is doubtful.
o Schizotypal patients who are
more obsessive-compulsive in
their beliefs and behaviors - in this
case SSRIs, e.g.Sertraline,
appear to be more effective.
‘Dramatic, Emotional and Erratic’
Cluster B: 'Dramatic,
Emotional and
Erratic'
Antisocial, or Dissocial
- is characterized by a long-
standing pattern of a
disregard for other people’s
rights, often crossing the line
and violating those rights.
- “Charming Psychopath”
ASPD Symptoms:
 don't care much about the feelings
of others
 easily get frustrated
 tend to be aggressive
 commit crimes
 find it difficult to make close
relationships
 impulsive - do things on the spur
of the moment without thinking
about them
 don’t feel guilty about things
you've done
 don’t learn from unpleasant
experiences
Cluster B: 'Dramatic,
Emotional and
Erratic'
ASPD Causes:
 Biological Factors
 Genetic Factors
 Environment Factors
ASPD Treatment:
 Medications
 Long-term structured
residential settings
 Psychotherapy along with
Behaviour modification
techniques
 Self-help groups or pro-
social reform
organizations.
Cluster B: 'Dramatic,
Emotional and
Erratic'
Borderline, or
Emotionally Unstable
- is a pervasive pattern of
instability in interpersonal
relationships, self-image
and emotions.
- Lack of sense of self
Borderline Symptoms:
 impulsive - do things on the spur
of the moment
 find it hard to control your
emotions
 feel bad about yourself
 often self-harm,
 feel 'empty’
 make relationships quickly, but
easily lose them
 can feel paranoid or depressed
 when stressed, may hear noises
or voices
Cluster B: 'Dramatic,
Emotional and
Erratic'
BPD Causes:
 Biological
 Social Stressors
 Ways of thinking
BPD Treatment:
 Counseling and
Therapy
 Medicines
 Healthy habits
 Partial Hospitalization
Cluster B: 'Dramatic,
Emotional and
Erratic'
Histrionic PD
- exhibit excessive
emotionalism--a tendency
to regard things in an
emotional manner--and
are attention seekers.
- lack a sense of self-worth
HPD Symptoms:
 over-dramatise events
 self-centered
 have strong emotions which
change quickly and don't last
long
 can be suggestible
 worry a lot about your
appearance
 crave new things and
excitement
 can be seductive
Cluster B: 'Dramatic,
Emotional and
Erratic'
HPD Causes:
 Genetic Factors
 Neurochemical/physiologic
al causes
 Developmental causes
 Biosocial learning causes
 Sociocultural causes
 Personal variables
HPD Treatment:
 Psychodynamic therapy
 Cognitive-behavioral
therapy
 Group therapy
 Family therapy
 Medications
Cluster B: 'Dramatic,
Emotional and
Erratic'
Narcissistic PD
- is a personality
disorder in which a
person is excessively
preoccupied with
personal
adequacy, power,
prestige and vanity,
mentally unable to
see the destructive
damage they are
causing to themselves
and others
NPD Symptoms:
 Exaggerated feelings
of self-importance
 They have a sense of
entitlement and
demonstrate
grandiosity in their
beliefs and behavior
 Strong need for
admiration, but lack
feelings of empathy
Cluster B: 'Dramatic,
Emotional and
Erratic'NPD Causes:
The cause of this disorder is unknown, however listed below the following
factors to be identified possibilities:
 An oversensitive temperament (personality traits) at birth.
 Excessive admiration that is never balanced with realistic feedback.
 Excessive praise for good behaviors or excessive criticism for bad
behaviors in childhood.
 Overindulgence and overvaluation by parents, other family members, or
peers.
 Being praised for perceived exceptional looks or abilities by adults.
 Severe emotional abuse in childhood.
 Severe emotional abuse in childhood.
 Learning manipulative behaviors from parents or peers.
 Valued by parents as a means to regulate their own self-esteem.
Cluster B: 'Dramatic,
Emotional and
Erratic'
NPD Treatment:
 Psychotherapy is used to treat NPD.
 a form of therapy developed by Jeffrey Young that integrates
several therapeutic approaches (psychodynamic, cognitive,
behavioral etc.), also offers an approach for the treatment of
NPD
 Pattern change strategies, over a long period of time, are for
narcissists to work on increasing their ability to become more
empathetic in everyday relationships.
 psychoanalytic psychotherapy has a higher success rate.
Therapists must recognize the patient’s traits and use caution
in tearing down narcissistic defenses too quickly.
‘Anxious and Fearful’
Cluster C: 'Anxious and
Fearful'
Obsessive-Compulsive Personality Disorder:
- is a pervasive, enduring, and inflexible pattern of maladaptive
inner experiences and pathological behavior. The essential
features include a pattern of impulsivity and instability
of behaviors, interpersonal relationships, and self-image. The
pattern is present by early adulthood and occurs across a
variety of situations and contexts.
 intense fears of abandonment
 intense anger
 irritability
 often engage in idealization and devaluation of others,
alternating between high positive regard and great
disappointment.
Cluster C: 'Anxious and
Fearful'
OCPD Symptoms:
 Splitting
 Chaos in relationships
 Markedly disturbed sense of identity
 Intense or uncontrollable emotional triggers
 Unstable interpersonal relationships and self-esteem
 Concerns about abandonment
 Self-damaging behavior
 Impulsivity
 Frequently accompanied by depression, anxiety, anger,
substance abuse or rage
Cluster C: 'Anxious and
Fearful'
OCPD Cause:
 childhood trauma can be a contributing factor,but less
attention has historically been paid to investigating the
causal roles played by congenital brain abnormalities,
genetics, neurobiological factors, and environmental
factors other than trauma.
 Social factors include how people interact in their early
development with their family, friends, and other
children.
 Psychological factors include the individual's personality
and temperament, shaped by his or her environment
and learned coping skills that deal with stress.
OCPD Treatment:
 Therapy
Cluster C: 'Anxious and
Fearful'
Avoidant PD
- characterized by marked
avoidance of both social
situations and close
interpersonal
relationships due to an
excessive fear of
rejection by others.
- Anxious Personality
Disorder
Avoidant PD Symptoms:
 very anxious and tense
 worry a lot
 feel insecure and inferior
 have to be liked and accepted
 extremely sensitive to criticism
Cluster C: 'Anxious and
Fearful'
APD Causes:
 Biological Factors
 Genetic Factors
 Social Factors
 Painful experiences
 Rejections
APD Treatment:
 Psychodynamically
oriented therapies
 Cognitive-behavioral
therapy
 Group therapy
 Family and Marital
therapy
 Medications
Cluster C: 'Anxious and
Fearful'
Dependent PD
- is characterized by an
excessive need to be
taken care of or depend
upon others. Persons
with this disorder are
typically submissive and
display clinging behavior
toward those from whom
they fear being
separated.
DPD Symptoms:
 passive
 rely on others to
make decisions for you
 do what other people want you
to do
 find it hard to cope with daily
chores
 feel hopeless and incompetent
 easily feel abandoned by
others
Cluster C: 'Anxious and
Fearful'
DPD Causes:
 Over-involvement and
intrusive behavior
 Socially humiliated by
others in their
developmental years
 Biopsychosocial Model
of Causation
DPD Treatment:
 Psychodynamically
oriented therapies
 Cognitive-behavioral
therapy
 Interpersonal therapy
 Group therapy
 Family and marital
therapy
 Medications

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Personality disorders

  • 1.
  • 2. What we mean by the word PERSONALITY?  refers to the collection of characteristics or traits that we have developed as we have grown up and which make each of us an individual.  These include the ways that we:  think  feel  behave
  • 3. What is Personality Disorder? - an enduring pattern of inner experience and behavior that deviates markedly from cultural expectations, is inflexible and pervasive, has its onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.
  • 4. What is Personality Disorder? Personality Disorder common features include:  being overwhelmed by negative feelings such as distress, anxiety, worthlessness or anger  avoiding other people and feeling empty and emotionally disconnected  difficulty managing negative feelings without self-harming or, in rare cases, threatening other people  odd behaviour  difficulty maintaining stable and close relationships, especially with partners, children and professional carers  sometimes, periods of losing contact with reality
  • 5. Different kinds of personality disorders Personality disorders tend to fall into three groups, according to their emotional 'flavour':  Cluster A: 'Odd or Eccentric  Cluster B: 'Dramatic, Emotional, or Erratic'  Cluster C: 'Anxious and Fearful'
  • 7. Cluster A: 'Odd and Eccentric' Paranoid PD - is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. PPD Symptoms:  may be hypersensitive, easily feel slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases.  They think they are in danger and look for signs and threats of that danger.  tend to be guarded and suspicious and have quite constricted emotional lives.  They may or may not have a tendency to bear grudges, suspiciousness, tendency to interpret
  • 8. Cluster A: 'Odd and Eccentric' PPD Causes: - A genetic contribution to paranoid traits and a possible genetic link between this personality disorder and schizophrenia exist. Psychosocial theories implicate projection of negative internal feelings and parental modeling. Cognitive theorists believe the disorder to be a result of an underlying belief that other people are deceptive/malevolent in combination with a lack in self- confidence. PPD Treatment: Because of reduced levels of trust, there can be challenges in treating PPD. However, psychotherapy, antidep ressants, antipsychotics and anti- anxiety medications can play a role when an individual is receptive to intervention
  • 9. Cluster A: 'Odd and Eccentric' Schizoid PD - is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and apathy. SPD Symtoms:  often aloof, cold and indifferent  have trouble establishing personal relationships  may remain passive in the face of unfavorable situations.  When the individual's personal space is violated, they feel suffocated and feel the need to free themselves  It is not people as such that they want to avoid, but emotions both negative and positive, emotional intimacy, and self disclosure
  • 10. Cluster A: 'Odd and Eccentric' SPD Causes: There is some evidence to suggest that there is an increased prevalence of schizoid personality disorder in relatives of people with schizophrenia or schizotypal personality disorder. To Sula Wolff, who did extensive research and clinical work with children and teenagers with schizoid symptoms, "schizoid personality has a constitutional, probably genetic, basis. Other researchers had hypothesized that unloving, neglectful, or excessively perfectionist parenting could play a role.Twin studies with schizoid personality disorder traits, low sociability and low warmth, suggest these traits are inherited. Because of this, there is indirect evidence linking the heritability of schizoid personality disorder
  • 11. Cluster A: 'Odd and Eccentric' SPD Treatment:  Medication  Psychotherapy  Modalifinil  Socializations Groups
  • 12. Cluster A: 'Odd and Eccentric' Schizotypal PD - is a personality disorder characterized by a need for social isolation, anxiety in social situations, odd behavior and thinking, and often unconventional beliefs. STPD Symptoms:  feel extreme discomfort with maintaining close relationships with people, so they avoid forming them.  Peculiar speech mannerisms and odd modes of dress  may react oddly in conversations, not respond, or talk to themselves  frequently misinterpret situations as being strange or having unusual meaning for them
  • 13. Cluster A: 'Odd and Eccentric' STPD Causes:  Biological/Genetics  Social and Environmental Factors STPD Treatment:  Pharmacological In order to decide which type of medication should be used, Paul Markovitz distinguishes two basic groups of schizotypal patients: o Schizotypal patients who appear to be almost schizophrenic in their beliefs and behaviors (aberrant perceptions and cognitions) - they are usually treated with low doses of antipsychotic medications, e.g. thiothixene. However, it must be mentioned that long-term efficacy of neuroleptics is doubtful. o Schizotypal patients who are more obsessive-compulsive in their beliefs and behaviors - in this case SSRIs, e.g.Sertraline, appear to be more effective.
  • 15. Cluster B: 'Dramatic, Emotional and Erratic' Antisocial, or Dissocial - is characterized by a long- standing pattern of a disregard for other people’s rights, often crossing the line and violating those rights. - “Charming Psychopath” ASPD Symptoms:  don't care much about the feelings of others  easily get frustrated  tend to be aggressive  commit crimes  find it difficult to make close relationships  impulsive - do things on the spur of the moment without thinking about them  don’t feel guilty about things you've done  don’t learn from unpleasant experiences
  • 16. Cluster B: 'Dramatic, Emotional and Erratic' ASPD Causes:  Biological Factors  Genetic Factors  Environment Factors ASPD Treatment:  Medications  Long-term structured residential settings  Psychotherapy along with Behaviour modification techniques  Self-help groups or pro- social reform organizations.
  • 17. Cluster B: 'Dramatic, Emotional and Erratic' Borderline, or Emotionally Unstable - is a pervasive pattern of instability in interpersonal relationships, self-image and emotions. - Lack of sense of self Borderline Symptoms:  impulsive - do things on the spur of the moment  find it hard to control your emotions  feel bad about yourself  often self-harm,  feel 'empty’  make relationships quickly, but easily lose them  can feel paranoid or depressed  when stressed, may hear noises or voices
  • 18. Cluster B: 'Dramatic, Emotional and Erratic' BPD Causes:  Biological  Social Stressors  Ways of thinking BPD Treatment:  Counseling and Therapy  Medicines  Healthy habits  Partial Hospitalization
  • 19. Cluster B: 'Dramatic, Emotional and Erratic' Histrionic PD - exhibit excessive emotionalism--a tendency to regard things in an emotional manner--and are attention seekers. - lack a sense of self-worth HPD Symptoms:  over-dramatise events  self-centered  have strong emotions which change quickly and don't last long  can be suggestible  worry a lot about your appearance  crave new things and excitement  can be seductive
  • 20. Cluster B: 'Dramatic, Emotional and Erratic' HPD Causes:  Genetic Factors  Neurochemical/physiologic al causes  Developmental causes  Biosocial learning causes  Sociocultural causes  Personal variables HPD Treatment:  Psychodynamic therapy  Cognitive-behavioral therapy  Group therapy  Family therapy  Medications
  • 21. Cluster B: 'Dramatic, Emotional and Erratic' Narcissistic PD - is a personality disorder in which a person is excessively preoccupied with personal adequacy, power, prestige and vanity, mentally unable to see the destructive damage they are causing to themselves and others NPD Symptoms:  Exaggerated feelings of self-importance  They have a sense of entitlement and demonstrate grandiosity in their beliefs and behavior  Strong need for admiration, but lack feelings of empathy
  • 22. Cluster B: 'Dramatic, Emotional and Erratic'NPD Causes: The cause of this disorder is unknown, however listed below the following factors to be identified possibilities:  An oversensitive temperament (personality traits) at birth.  Excessive admiration that is never balanced with realistic feedback.  Excessive praise for good behaviors or excessive criticism for bad behaviors in childhood.  Overindulgence and overvaluation by parents, other family members, or peers.  Being praised for perceived exceptional looks or abilities by adults.  Severe emotional abuse in childhood.  Severe emotional abuse in childhood.  Learning manipulative behaviors from parents or peers.  Valued by parents as a means to regulate their own self-esteem.
  • 23. Cluster B: 'Dramatic, Emotional and Erratic' NPD Treatment:  Psychotherapy is used to treat NPD.  a form of therapy developed by Jeffrey Young that integrates several therapeutic approaches (psychodynamic, cognitive, behavioral etc.), also offers an approach for the treatment of NPD  Pattern change strategies, over a long period of time, are for narcissists to work on increasing their ability to become more empathetic in everyday relationships.  psychoanalytic psychotherapy has a higher success rate. Therapists must recognize the patient’s traits and use caution in tearing down narcissistic defenses too quickly.
  • 25. Cluster C: 'Anxious and Fearful' Obsessive-Compulsive Personality Disorder: - is a pervasive, enduring, and inflexible pattern of maladaptive inner experiences and pathological behavior. The essential features include a pattern of impulsivity and instability of behaviors, interpersonal relationships, and self-image. The pattern is present by early adulthood and occurs across a variety of situations and contexts.  intense fears of abandonment  intense anger  irritability  often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment.
  • 26. Cluster C: 'Anxious and Fearful' OCPD Symptoms:  Splitting  Chaos in relationships  Markedly disturbed sense of identity  Intense or uncontrollable emotional triggers  Unstable interpersonal relationships and self-esteem  Concerns about abandonment  Self-damaging behavior  Impulsivity  Frequently accompanied by depression, anxiety, anger, substance abuse or rage
  • 27. Cluster C: 'Anxious and Fearful' OCPD Cause:  childhood trauma can be a contributing factor,but less attention has historically been paid to investigating the causal roles played by congenital brain abnormalities, genetics, neurobiological factors, and environmental factors other than trauma.  Social factors include how people interact in their early development with their family, friends, and other children.  Psychological factors include the individual's personality and temperament, shaped by his or her environment and learned coping skills that deal with stress. OCPD Treatment:  Therapy
  • 28. Cluster C: 'Anxious and Fearful' Avoidant PD - characterized by marked avoidance of both social situations and close interpersonal relationships due to an excessive fear of rejection by others. - Anxious Personality Disorder Avoidant PD Symptoms:  very anxious and tense  worry a lot  feel insecure and inferior  have to be liked and accepted  extremely sensitive to criticism
  • 29. Cluster C: 'Anxious and Fearful' APD Causes:  Biological Factors  Genetic Factors  Social Factors  Painful experiences  Rejections APD Treatment:  Psychodynamically oriented therapies  Cognitive-behavioral therapy  Group therapy  Family and Marital therapy  Medications
  • 30. Cluster C: 'Anxious and Fearful' Dependent PD - is characterized by an excessive need to be taken care of or depend upon others. Persons with this disorder are typically submissive and display clinging behavior toward those from whom they fear being separated. DPD Symptoms:  passive  rely on others to make decisions for you  do what other people want you to do  find it hard to cope with daily chores  feel hopeless and incompetent  easily feel abandoned by others
  • 31. Cluster C: 'Anxious and Fearful' DPD Causes:  Over-involvement and intrusive behavior  Socially humiliated by others in their developmental years  Biopsychosocial Model of Causation DPD Treatment:  Psychodynamically oriented therapies  Cognitive-behavioral therapy  Interpersonal therapy  Group therapy  Family and marital therapy  Medications