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Personality Disorders

 By:Dr. Akmal Mostafa Kamal
Assistant Professor of Psychiatry,
   Faculty of Medicine, Cairo
           .University
?What Is a Personality
• Personality is a relatively stable and
  enduring set of characteristic cognitive,
  behavioral and emotional traits.
• Over time, a person will interact with
  others in a reasonably predictable way.
• Personality changes with experience,
  maturity, and external demands in a way
  that promotes adaptation to the
  environment.
• It is affected by genetic and psychosocial
  factors.
The Trait Approach to
     Personality
•The trait approach to personality is
one of the major theoretical areas in
the study of personality.
•The trait theory suggests that
individual personalities are composed
broad dispositions.
•Consider how you would describe
the personality of a close friend.
•Chances are that you would list a
number of traits, such as outgoing,
kind and even-tempered.

•A trait can be thought of as a
relatively stable characteristic that
causes individuals to behave in
certain ways.
•Unlike many other theories of personality,
such as psychoanalytic or humanistic
theories, the trait approach to personality is
focused on differences between individuals.

•The combination and interaction of various
traits combine to form a personality that is
unique to each individual.

•Trait theory is focused on identifying and
measuring these individual personality
characteristics.
Gordon Allport‘s Trait Theory
•In 1936, psychologist Gordon
Allport found that one English-
language      dictionary    alone
contained more than 4,000 words
describing different personality
traits.
• He categorized these traits into
three levels:
Cardinal Traits:
•Traits that dominate an individual‘s
whole life, often to the point that the
person becomes known specifically for
these traits.

• People with such personalities often
become so known for these traits that
their names are often synonymous with
these qualities.
Cardinal Traits:
•Traits that dominate an individual‘s
whole life, often to the point that the
person becomes known specifically
for these traits.
• People with such personalities often
become so known for these traits that
their names are often synonymous
with these qualities.
•Consider the origin and meaning of
the following descriptive terms:
Freudian, Machiavellian, narcissism,
Don Juan, etc.

•Allport suggested that cardinal traits
are rare and tend to develop later in
life.
• Central Traits:
• The general characteristics that
form the basic foundations of
personality.

•These central traits, while not as
dominating as cardinal traits, are the
major characteristics you might use
to describe another person.

•Terms such as intelligent, honest,
shy and anxious are considered
central traits.
• Secondary Traits:
• Traits that are sometimes related
to attitudes or preferences and often
appear only in certain situations or
under specific circumstances.

•Some examples would be getting
anxious when speaking to a group
or impatient while waiting in line.
Raymond Cattell
•Trait theorist Raymond Cattell reduced
the number of main personality traits
from Allport‘s initial list of over 4,000
down to 171.
• Mostly by eliminating uncommon traits
and combining common characteristics.
•Next, Cattell rated a large sample of
individuals for these 171 different traits.
•Then, using a statistical technique known
as factor analysis, he identified closely
related terms and eventually reduced his
list to just 16 key personality traits.

•According to Cattell, these 16 traits are
the source of all human personality.

•He also developed one of the most widely
used personality assessments known as
the     Sixteen    Personality     Factor
Questionnaire (16PF).
Eysenck
•Eysenck’s Three Dimensions of Personality.
•British psychologist Hans Eysenck developed a
model of personality based upon just three
universal traits:
•
•                      Introversion/Extraversion:
•Introversion involves directing attention on inner
experiences, while extraversion relates to focusing
attention outward on other people and the
environment.
•So, a person high in introversion might be quiet
and reserved, while an individual high in
extraversion might be sociable and outgoing.
•   Neuroticism/Emotional     Stability:

•This dimension of Eysenck‘s trait
theory is related to moodiness versus
even-temperedness.

•Neuroticism refers to an individual‘s
tendency to become upset or
emotional, while stability refers to the
tendency    to   remain      emotionally
constant.
Psychoticism:
•Later, after studying individuals
suffering from mental illness,
Eysenck added a personality
dimension he called psychoticism to
his trait theory.
•Individuals who are high on this
trait tend to have difficulty dealing
with reality and may be antisocial,
hostile, non-empathetic and
manipulative.
The Five-Factor Theory
 The Five-Factor Theory of Personality
•Both Cattell‘s and Eysenck‘s theory have
been the subject of considerable
research, which has led some theorists to
believe that Cattell focused on too many
traits, while Eysenck focused on too few.

•As a result, a new trait theory often
referred to as the "Big Five" theory
emerged.
•McCrae and Costa (1999) describe
five    trait   characteristics   of
personality, which consist of a
person's level of agreeableness,
conscientiousness,     extraversion,
neuroticism, and openness.

•This five factor model of personality
represents five core traits that
interact to form human personality.
Agreeableness:
• Refers to how you interact with other
  people, and it involves the level of
  intimacy you maintain in your
  personal relationships and how
  helpful and sympathetic you are.

•   Characteristics of an agreeable
    personality      include     trust,
    straightforwardness,     altruism,
    compliance, modesty, and tender-
    mindedness.
Conscientiousness:
• Refers to your work style.
• It involves your general
dedication to activities; how hard
you work and how efficient and
focused you are.
•Conscientious       people     are
typically    competent,     orderly,
dutiful, achievement striving, self-
disciplined, and deliberate.
•Extraversion:
• Refers to how         you   express
yourself.

•This trait considers your sociability,
positive emotionality, assertiveness,
and activity or energy level.

•If you are extraverted, you're
probably      warm,       gregarious,
assertive, active, seek excitement,
and tend toward positive emotions.
•Neuroticism:
•Refers to your emotional style.

•It involves the extent to which you
experience negative emotions such
as worry, self-doubt, stress and
tension.

•Most neurotic personalities display
anxiety, angry hostility, depression,
self-consciousness, impulsiveness,
or vulnerability (or some combination
of these characteristics).
•Openness:
•Describes your intellectual style -
the extent to which you are open to
new     ideas     and     innovative
approaches, and have an active
imagination.

•Some characteristics of openness
include fantasy, appreciation of art,
the tendency to have a variety of
emotions, action (not reaction), and
individual ideas and values.
•While most agree that people can
be described based upon their
personality traits, theorists continue
to debate the number of basic traits
that make up human personality.
•While trait theory has objectivity that
some personality theories lack (such
as Freud‘s psychoanalytic theory), it
also has weaknesses.
•Some of the most common criticisms of
trait theory center on the fact that traits
are often poor predictors of behavior.
•
•While an individual may score high on
assessments of a specific trait, he or she
may not always behave that way in every
situation.

•Another problem is that trait theories do
not address how or why individual
differences in personality develop or
emerge.
What is a Personality
             ?Disorder
•A personality disorder is an extreme set of
characteristics that goes beyond the range
found in most people.
•It could be defined as:
•An      enduring pattern of inner experiences
and behavior that deviates markedly from the
expectations of the individual's culture.
•It is pervasive and inflexible.
•It has an onset in adolescence or early
adulthood.
•It is stable over time.
•A personality disorder is an extreme set
of characteristics that goes beyond the
range found in most people.
•It could be defined as:
•An enduring pattern of inner experiences
and behavior that deviates markedly from
the expectations of the individual's culture.
•It is pervasive and inflexible.
•It has an onset in adolescence or early
adulthood.
•It is stable over time.
Why Recognize Personality
         ?Disorders
•- In the psychiatric setting:
•They are considered axis II disorders and can
present concurrently with any other psychiatric
disorders.
•Their presence affects markedly the prognosis,
compliance to treatment and choice of therapy.
•They are egosyntonic in the majority of eases, i.e..
the patient does not think of them as maladaptive
or bad.
•They are either discovered during treatment, or
the family complains of them.
Personality Disorders
DSM groups personality disorders into
three clusters:
– Cluster A (Exhibits odd or eccentric
behavior).
– Cluster B (Exhibits dramatic, emotional,
or erratic behavior).
– Cluster C (Exhibits anxious or fearful
behavior).
Cluster A (Exhibits odd or eccentric behavior)

– Paranoid Personality Disorder
  Pervasive distrust and suspiciousness of others such
that their motives are interpreted as malevolent.

– Schizoid Personality Disorder
       Pervasive pattern of detachment from social
relationships and a restricted range of expression of
emotions in interpersonal settings.

– Schizotypal Personality Disorder
   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.
Cluster B (Exhibits dramatic, emotional, or erratic behavior)

– Antisocial Personality Disorder
   Pervasive pattern of disregard for and violation of the
rights of others occurring since age 15 years.

– Borderline Personality Disorder
      Pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked
impulsivity beginning by early adulthood and present in a
variety of contexts

– Histrionic Personality Disorder
     Pervasive pattern of excessive emotionality and
attention seeking

– Narcissistic Personality Disorder
      Pervasive pattern of grandiosity (in fantasy or
behavior), need for admiration, and lack of empathy
Cluster C (Exhibits anxious or fearful behavior)
– Avoidant Personality Disorder
    Pervasive pattern of social inhibition, feelings of
inadequacy, & hypersensitivity to negative evaluation.

– Dependent Personality Disorder
   Pervasive & excessive need to be taken care of that
leads to submissive & clinging behavior & fears of
separation.

– Obsessive Compulsive Personality Disorder
   Pervasive pattern of preoccupation with orderliness,
perfectionism, and mental and interpersonal control, at
the expense of flexibility, openness, and efficiency.

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Presentation of personality

  • 1. Personality Disorders By:Dr. Akmal Mostafa Kamal Assistant Professor of Psychiatry, Faculty of Medicine, Cairo .University
  • 2. ?What Is a Personality • Personality is a relatively stable and enduring set of characteristic cognitive, behavioral and emotional traits. • Over time, a person will interact with others in a reasonably predictable way. • Personality changes with experience, maturity, and external demands in a way that promotes adaptation to the environment. • It is affected by genetic and psychosocial factors.
  • 3. The Trait Approach to Personality
  • 4. •The trait approach to personality is one of the major theoretical areas in the study of personality. •The trait theory suggests that individual personalities are composed broad dispositions. •Consider how you would describe the personality of a close friend.
  • 5. •Chances are that you would list a number of traits, such as outgoing, kind and even-tempered. •A trait can be thought of as a relatively stable characteristic that causes individuals to behave in certain ways.
  • 6. •Unlike many other theories of personality, such as psychoanalytic or humanistic theories, the trait approach to personality is focused on differences between individuals. •The combination and interaction of various traits combine to form a personality that is unique to each individual. •Trait theory is focused on identifying and measuring these individual personality characteristics.
  • 7. Gordon Allport‘s Trait Theory •In 1936, psychologist Gordon Allport found that one English- language dictionary alone contained more than 4,000 words describing different personality traits. • He categorized these traits into three levels:
  • 8. Cardinal Traits: •Traits that dominate an individual‘s whole life, often to the point that the person becomes known specifically for these traits. • People with such personalities often become so known for these traits that their names are often synonymous with these qualities.
  • 9. Cardinal Traits: •Traits that dominate an individual‘s whole life, often to the point that the person becomes known specifically for these traits. • People with such personalities often become so known for these traits that their names are often synonymous with these qualities.
  • 10. •Consider the origin and meaning of the following descriptive terms: Freudian, Machiavellian, narcissism, Don Juan, etc. •Allport suggested that cardinal traits are rare and tend to develop later in life.
  • 11. • Central Traits: • The general characteristics that form the basic foundations of personality. •These central traits, while not as dominating as cardinal traits, are the major characteristics you might use to describe another person. •Terms such as intelligent, honest, shy and anxious are considered central traits.
  • 12. • Secondary Traits: • Traits that are sometimes related to attitudes or preferences and often appear only in certain situations or under specific circumstances. •Some examples would be getting anxious when speaking to a group or impatient while waiting in line.
  • 13. Raymond Cattell •Trait theorist Raymond Cattell reduced the number of main personality traits from Allport‘s initial list of over 4,000 down to 171. • Mostly by eliminating uncommon traits and combining common characteristics. •Next, Cattell rated a large sample of individuals for these 171 different traits.
  • 14. •Then, using a statistical technique known as factor analysis, he identified closely related terms and eventually reduced his list to just 16 key personality traits. •According to Cattell, these 16 traits are the source of all human personality. •He also developed one of the most widely used personality assessments known as the Sixteen Personality Factor Questionnaire (16PF).
  • 15. Eysenck •Eysenck’s Three Dimensions of Personality. •British psychologist Hans Eysenck developed a model of personality based upon just three universal traits: • • Introversion/Extraversion: •Introversion involves directing attention on inner experiences, while extraversion relates to focusing attention outward on other people and the environment. •So, a person high in introversion might be quiet and reserved, while an individual high in extraversion might be sociable and outgoing.
  • 16. Neuroticism/Emotional Stability: •This dimension of Eysenck‘s trait theory is related to moodiness versus even-temperedness. •Neuroticism refers to an individual‘s tendency to become upset or emotional, while stability refers to the tendency to remain emotionally constant.
  • 17. Psychoticism: •Later, after studying individuals suffering from mental illness, Eysenck added a personality dimension he called psychoticism to his trait theory. •Individuals who are high on this trait tend to have difficulty dealing with reality and may be antisocial, hostile, non-empathetic and manipulative.
  • 18. The Five-Factor Theory The Five-Factor Theory of Personality •Both Cattell‘s and Eysenck‘s theory have been the subject of considerable research, which has led some theorists to believe that Cattell focused on too many traits, while Eysenck focused on too few. •As a result, a new trait theory often referred to as the "Big Five" theory emerged.
  • 19. •McCrae and Costa (1999) describe five trait characteristics of personality, which consist of a person's level of agreeableness, conscientiousness, extraversion, neuroticism, and openness. •This five factor model of personality represents five core traits that interact to form human personality.
  • 20. Agreeableness: • Refers to how you interact with other people, and it involves the level of intimacy you maintain in your personal relationships and how helpful and sympathetic you are. • Characteristics of an agreeable personality include trust, straightforwardness, altruism, compliance, modesty, and tender- mindedness.
  • 21. Conscientiousness: • Refers to your work style. • It involves your general dedication to activities; how hard you work and how efficient and focused you are. •Conscientious people are typically competent, orderly, dutiful, achievement striving, self- disciplined, and deliberate.
  • 22. •Extraversion: • Refers to how you express yourself. •This trait considers your sociability, positive emotionality, assertiveness, and activity or energy level. •If you are extraverted, you're probably warm, gregarious, assertive, active, seek excitement, and tend toward positive emotions.
  • 23. •Neuroticism: •Refers to your emotional style. •It involves the extent to which you experience negative emotions such as worry, self-doubt, stress and tension. •Most neurotic personalities display anxiety, angry hostility, depression, self-consciousness, impulsiveness, or vulnerability (or some combination of these characteristics).
  • 24. •Openness: •Describes your intellectual style - the extent to which you are open to new ideas and innovative approaches, and have an active imagination. •Some characteristics of openness include fantasy, appreciation of art, the tendency to have a variety of emotions, action (not reaction), and individual ideas and values.
  • 25. •While most agree that people can be described based upon their personality traits, theorists continue to debate the number of basic traits that make up human personality. •While trait theory has objectivity that some personality theories lack (such as Freud‘s psychoanalytic theory), it also has weaknesses.
  • 26. •Some of the most common criticisms of trait theory center on the fact that traits are often poor predictors of behavior. • •While an individual may score high on assessments of a specific trait, he or she may not always behave that way in every situation. •Another problem is that trait theories do not address how or why individual differences in personality develop or emerge.
  • 27. What is a Personality ?Disorder •A personality disorder is an extreme set of characteristics that goes beyond the range found in most people. •It could be defined as: •An enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual's culture. •It is pervasive and inflexible. •It has an onset in adolescence or early adulthood. •It is stable over time.
  • 28. •A personality disorder is an extreme set of characteristics that goes beyond the range found in most people. •It could be defined as: •An enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual's culture. •It is pervasive and inflexible. •It has an onset in adolescence or early adulthood. •It is stable over time.
  • 29. Why Recognize Personality ?Disorders •- In the psychiatric setting: •They are considered axis II disorders and can present concurrently with any other psychiatric disorders. •Their presence affects markedly the prognosis, compliance to treatment and choice of therapy. •They are egosyntonic in the majority of eases, i.e.. the patient does not think of them as maladaptive or bad. •They are either discovered during treatment, or the family complains of them.
  • 30. Personality Disorders DSM groups personality disorders into three clusters: – Cluster A (Exhibits odd or eccentric behavior). – Cluster B (Exhibits dramatic, emotional, or erratic behavior). – Cluster C (Exhibits anxious or fearful behavior).
  • 31. Cluster A (Exhibits odd or eccentric behavior) – Paranoid Personality Disorder Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. – Schizoid Personality Disorder Pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. – Schizotypal Personality Disorder 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.
  • 32. Cluster B (Exhibits dramatic, emotional, or erratic behavior) – Antisocial Personality Disorder Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years. – Borderline Personality Disorder Pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts – Histrionic Personality Disorder Pervasive pattern of excessive emotionality and attention seeking – Narcissistic Personality Disorder Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy
  • 33. Cluster C (Exhibits anxious or fearful behavior) – Avoidant Personality Disorder Pervasive pattern of social inhibition, feelings of inadequacy, & hypersensitivity to negative evaluation. – Dependent Personality Disorder Pervasive & excessive need to be taken care of that leads to submissive & clinging behavior & fears of separation. – Obsessive Compulsive Personality Disorder Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.