personality disorders i (chapter 12) april 14, 2014 psyc 2340: abnormal psychology brett deacon,...

Personality Disorders I

(Chapter 12)

April 14, 2014

PSYC 2340: Abnormal Psychology

Brett Deacon, Ph.D.

Announcements

• Exam #3 returned today

• Remaining schedule:• Personality disorders – 2 classes• No class this Friday (Easter break)• 3 classes on psychotic disorders• Exam #4 is coming up soon! April 28th • I will email you your exam grade by 5 PM• You have until Wednesday to let me know if

you will be taking the final exam

Announcements

• Reminder of final exam grading policy• Exams 1-4 all count• Final exam is optional and cumulative• Only four out of the scheduled five exams

will count toward your final grade. Practically speaking, this means that the fifth exam is optional if you are satisfied with your grade after the first four exams.

Personality

• Nature of personality

• Characteristic ways of thinking and behaving

• Generally stable across situations

• Comprised of different traits

• Exist on continuum

• When is a trait “abnormal?”

Example Personality Traits

Suspiciousness

Sociability

Empathy

CompletelyTrusting

VeryExtraverted

Overly Caring

Paranoid/Mistrusting

PainfullyShy

Not at all Caring

Personality and Abnormality

• A woman is careful to lock her car and house

immediately after entering them because she

fears intruders.

• Would you consider this behavior abnormal?

Personality and Abnormality

• A car salesman lies to people to manipulate

them into buying a car, and feels no guilt

about making an unethical sale.

• Would you consider this behavior abnormal?

Personality and Abnormality

• A woman does not socialize with other

people. She communicates with people at her

job, but outside of work she has no social

contact with others, nor does she desire any.

• Would you consider this behavior abnormal?

Personality and Abnormality

• A man becomes upset when his wife rearranges his shirt drawer, does not have dinner ready on schedule, or in any way interferes with his rigidly planned work schedule.

• Would you consider this behavior abnormal?

Personality and Abnormality

• Personality characteristics are abnormal when:• Inflexible and maladaptive• Cause significant functional impairment, or• Cause subjective distress

Personality and Abnormality

• Personality pervades every aspect of a person’s life• It’s who you are

• Personality appears early in life, and is stable and chronic

Personality and Abnormality

• Personality disorders pervade every aspect of a person’s life• It’s who you are

• Personality disorders appear early in life, and are stable and chronic

Personality and Abnormality

• Are personality disorders “problems” from which people “suffer,” like anxiety or depression?

• Can you change your personality?

• Can a personality disorder be “treated?”

• If a personality disorder can be overcome or successfully modified in therapy, does that mean it wasn’t a personality disorder after all?

Personality Disorders

• Coded on Axis II of DSM-IV

• Categorical (DSM-IV) vs. dimensional approach

• Problems with categorical approach

• Reliability and validity of “personality disorders”

• Personality science vs. DSM-defined personality disorders

Gender and Personality Disorders

• Robert is 10 years old. He attends school, but is often in trouble because he is inattentive or rebellious towards the teacher. He has friends in class, but frequently gets into physical fights with them and on one occasion hurt a classmate. He teases his younger brother at home, and prefers to be outside playing baseball with friends rather than completing homework or chores.

• Is Robert’s behavior abnormal?

Gender and Personality Disorders

• Karen is a 35-year-old single woman. She is depressed because she wants to have children but has not found a suitable partner. Karen has recently quit her job and spends most of her time talking with friends on the telephone. She has no immediate plans to return to work, and will look to her family to provide for her during this difficult time.

• Is Karen’s behavior abnormal?

Gender and Personality Disorders

• Lisa is 10 years old. She attends school, but is often in trouble because she is inattentive or rebellious towards the teacher. She has friends in class, but frequently gets into physical fights with them and on one occasion hurt a classmate. She teases her younger brother at home, and prefers to be outside playing baseball with friends rather than completing homework or chores.

• Is Lisa’s behavior abnormal?

Gender and Personality Disorders

• Mark is a 35-year-old single man. He is depressed because he wants to have children but has not found a suitable partner. Mark has recently quit his job and spends most of his time talking with friends on the telephone. He has no immediate plans to return to work, and will look to his family to provide for him during this difficult time.

• Is Mark’s behavior abnormal?

Gender and Personality Disorders

• Gender bias and the stereotypical female

• Antisocial Personality Disorder – irresponsible and

reckless behavior, lack of empathy

• Histrionic Personality Disorder – sexually seductive

behavior, emotionally labile, overemphasis on physical appearance, dramatic emotional expression, easily influenced by others, thinks relationships are more intimate than they really are

• Criterion gender bias (Ford & Widiger, 1989): gender dramatically effects which personality disorder is diagnosed

Personality Disorder Clusters

• Cluster A: Odd or Eccentric

• Paranoid

• Schizoid

• Schizotypal

Personality Disorder Clusters

• Cluster B: Dramatic, Emotional, Erratic

• Antisocial

• Borderline

• Histrionic

• Narcissistic

Personality Disorder Clusters

• Cluster C: Anxious, Fearful

• Avoidant

• Dependent

• Obsessive-Compulsive

Personality Disorders and the DSM

• How do disorders make it into the DSM?

• A case study in the evolution of diagnoses: Axis II (personality) disorders throughout the 5 editions of the DSM

• What follows is a list of personality disorders in each DSM edition that were subsequently eliminated from the DSM• Diagnoses disappear (and reappear) at a

much higher rate in the personality disorder section than elsewhere in the DSM

• http://www.uccs.edu/~faculty/dsegal/pdfs/Evolution-of-PDs-1998.pdf

Personality Disorders and the DSM

• DSM-I (1952)• Emotionally Unstable Personality Disorder• Passive-Aggressive Personality Disorder• Inadequate Personality Disorder

• Cyclothymic Personality Disorder

• Alternating periods of depression and elation not attributable to external factors

Personality Disorders and the DSM

Defunct Personality Disorders from Previous Versions of the DSM

• DSM-II (1968)

• Explosive Personality Disorder

• outbursts of rage atypical of the individual’s normal personality

• Asthenic Personality Disorder

• being easily fatigued, having low energy, an inability to enjoy life, and oversensitivity to stress

Defunct Personality Disorders from Previous Versions of the DSM

• DSM-III (1980)

• Affective Personality Disorder

• DSM-III-R (1987)

• Personality Disorder Not Otherwise Specified:

• Immature Personality Disorder

• Sadistic Personality Disorder

• Self-Defeating Personality Disorder

Personality Disorders and the DSM

• Personality disorders currently “under study in

DSM-IV:

• Depressive Personality Disorder

• Negativistic Personality Disorder

Personality Disorders and the DSM

• What can we learn from the evolution of personality disorder diagnoses in the DSM?

• What does it mean that so many disorders come and go with new editions of the DSM?

• Personality disorders in DSM-5?• Massive overhaul of entire section originally

planned• Final version of DSM-5: no changes

whatsoever