Psychology
Personality Disorders
Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from the expectations of an individual's culture, causing distress or impairment. They typically manifest in adolescence or early adulthood and can lead to difficulties in relationships, work, and social functioning. There are ten specific types of personality disorders, each with its own unique characteristics and symptoms.
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11 Key excerpts on "Personality Disorders"
eBook - PDF- Kanter, Jonathan W., Woods, Douglas W.(Authors)
- 1(Publication Date)
- Context Press(Publisher)
Personality Disorders 297 Chapter 11 Personality Disorders Scott T. Gaynor & Susan C. Baird Western Michigan University Description of Problem The term personality is generally used descriptively; that is, as a summary label for how someone has behaved and is likely to behave. For example, when it is said that someone has an extroverted personality what is meant is that in the past this person has been very outgoing and talkative and is likely to be so again. Thus, when psychologists and laypersons alike refer to personality what is often being communicated is the presence of a somewhat predictable pattern of behavior that is consistent across time and situations. This is apparent in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Asso- ciation, 2000) which describes personality traits as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts” (p. 686). According to the DSM (APA, 2000), personality traits become Personality Disorders (PDs) when the patterns of behavior deviate markedly from cultural norms and are so rigid and stable over time and across situations that they cause significant subjective distress or impairment in an important area of functioning. The DSM further clarifies that these patterns must be manifested in two (or more) of the following areas: cognition, affectivity, interpersonal functioning, and impulse control. Cognition is specified to mean perceiving and interpreting self, others, and events. Affect includes the range, intensity, and appropriateness of the emotional response. The DSM further specifies that a PD diagnosis requires report of a long- term pattern of similar functioning to ensure that the particular personality feature has been evident since adolescence or early adulthood.
- Michael B. First, Allan Tasman(Authors)
- 2013(Publication Date)
- Wiley(Publisher)
CHAPTER 42 Personality Disorders Everybody has a personality, or a characteristic manner of thinking, feeling, behaving, and relating to others. Some persons are typically introverted and withdrawn; others are more extraverted and outgoing. Some persons are invariably conscientiousness and efficient, whereas others might be consistently undependable and negli- gent. Some persons are characteristically anxious and apprehensive, whereas others are typically r\elaxed and unconcerned. These personality traits are often felt to be integral to each person’s sense of self, as they involve what persons value, what they do, and what they are like most every day throughout much of their lives. It is, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), “when personality traits are inflexible and maladaptive and cause significant func- tional impairment or subjective distress [that] they constitute Personality Disorders.” DSM-IV-TR provides the diagnostic criteria for 10 Personality Disorders. Two additional diagnoses are placed within an appendix to DSM-IV-TR for criterion sets provided for further study (passive-aggressive and depressive). Personality disorder Definition A personality disorder is defined in DSM-IV-TR as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the in- dividual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” Personality Disorder is the only class of mental disorders in DSM-IV-TR for which an explicit defini- tion and criterion set are provided. A general definition and criterion set can be useful to mental health pro- fessionals because one of the most common personality disorder diagnosis in clinical practice is often the diagnosis “not otherwise specified” (NOS).
eBook - PDF- Cavaiola, Alan A.(Authors)
- 1(Publication Date)
- New Harbinger Publications(Publisher)
Personality Disorders are separate and distinct from other types of mental disor- ders in a number of ways that we will address shortly. Identifying, defining, and diagnosing Personality Disorders can be a tricky business. Mental-health professionals often conceptualize mental disorders from different theoretical perspectives, using dif- ferent technical vocabularies. This can often be very confusing to professionals, let alone the lay person. Consequently, there is a refer- ence guide that we use to eliminate a lot of the confusion. The Diag- nostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is a book that sets the guidelines for diagnosing mental disorders. It is “The Bible” of all abnormal psychology texts in that it provides what are considered the standard and universally accepted definitions of mental disorders. It allows mental health professionals to communicate with each other about various disorders without resorting to pet theories or faddish terminologies. In short, if it isn’t in DSM-IV, it probably isn’t a legitimate disorder. DSM-IV defines a personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the expectation 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 (American Psychiatric Associa- tion 1994, 633).” Additionally, DSM-IV states that, in order to be diagnosed as having a personality disorder, one has to have “. . . impairment in social, occupational, or other important areas of func- tioning.” It is precisely the area of occupational functioning that this book addresses. In the chapters that follow, we’ll attempt to describe the symptoms of each specific personality disorder. This chapter will deal with symptoms that are common to all or most Personality Disorders.
eBook - PDFBehavioral and Emotional Disorders in Adolescents
Nature, Assessment, and Treatment
- David A. Wolfe, Eric J. Mash, David A. Wolfe, Eric J. Mash(Authors)
- 2013(Publication Date)
- The Guilford Press(Publisher)
V PERSONALITY AND HEALTH-RELATED DISORDERS 13 Personality Disorders Jeffrey G. Johnson Elizabeth Bromley Robert F. Bornstein Joel R. Sneed According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association [APA], 2000), “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 im- pairment” (p. 685). Personality Disorders (PDs) are widely recognized as being common, chronic psychiatric conditions that tend to be associated with considerable impairment and distress and poor long-term outcomes. There has been a substantial increase in research on PDs since 1980, when specific diagnostic crite- ria for Personality Disorders were introduced in DSM-III. PD research accelerated considerably following the development and validation of structured diagnostic interviews such as the Personality Disorder Examination (PDE; Loranger et al., 1994) and the Structured Clini- cal Interview for DSM-IV Personality Disor- ders (SCID-II; First, Spitzer, Gibbon, & Wil- liams, 1995a). Most of what is currently known about PDs is based on research conducted with adults. This research has indicated that PDs are rela- tively common in the general population. Prev- alence estimates from studies of representative community samples, using DSM diagnostic cri- teria (DSM-III [APA, 1980]; DSM-III-R [APA, 1987]; and DSM-IV [APA, 1994]), have ranged from approximately 7–15% of the adult popu- lation, depending on the diagnostic procedures used and the range of PDs assessed (Klein et al., 1995; Maier, Lichtermann, Klingler, Heun, & Hallmayer, 1992; Moldin, Rice, Erlenmeyer- Kimling, & Squires-Wheeler, 1994; Samuels et al., 2002; Torgerson, Kringlen, & Cramer, 2001).
eBook - PDF- V. Durand, David Barlow, Stefan Hofmann, , V. Durand, David Barlow, Stefan Hofmann(Authors)
- 2018(Publication Date)
- Cengage Learning EMEA(Publisher)
In this chapter, we look at a number of Personality Disorders. First, we examine how we conceptualize Personality Disorders and the issues related to them; then we describe the disorders themselves. Aspects of Personality Disorders Unlike many of the disorders we have discussed, person- ality disorders are chronic; they do not come and go but originate in childhood and continue throughout adulthood (Widiger, 2012). Because these problems affect personality, they pervade every aspect of a person’s life. For example, if a woman is overly suspicious (a sign of a possible paranoid personality disorder), this trait will affect almost everything she does, including her employment (she may change jobs often if she believes co-workers conspire against her), her relationships (she may not be able to sustain a relationship if she can’t trust anyone), and even where she lives (she may move often if she suspects her landlords are out to get her). A personality disorder is therefore a persistent pat- tern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and rela- tionships (American Psychiatric Association, 2013). Note that individuals with Personality Disorders may not feel subjective distress; indeed, it may be others who acutely feel distress because of the actions of the person with the STUDENT LEARNING OUTCOMES* Use scientific reasoning to interpret behavior: c Identify basic biological, psychological, and social components of behavioral explanations (e.g., inferences, observations, operational definitions, and interpretations) (APA SLO 2.1a) (see textbook pages 416–419, 423–425, 428–429, 431, 433–435, 437) Engage in innovative and integrative thinking and problem solving: c Describe problems operationally to study them empirically.
- Lorelle J. Burton, Drew Westen, Robin M. Kowalski(Authors)
- 2022(Publication Date)
- Wiley(Publisher)
Major revisions were proposed for DSM-5 with regard to Personality Disorders but were ultimately not included, with the old classifications being retained. However, in its emerging measures and models section, DSM-5 proposes an alternative way of classifying Personality Disorders according to personality functioning and traits, and so this area may be reconceptualised at some point in the future. TABLE 18.3 DSM-5 Personality Disorders Personality disorder Description Paranoid Distrust and suspiciousness Schizoid Detachment from social relationships; restricted range of emotional expression Schizotypal Acute discomfort in close relationships; cognitive or perceptual distortions; eccentricity Antisocial Disregard for and violation of the rights of others Borderline Impulsivity and instability in interpersonal relationships, self-concept and emotion Histrionic Excessive emotionality and attention seeking Narcissistic Grandiosity, need for admiration and lack of empathy Avoidant Social inhibition and avoidance; feelings of inadequacy; hypersensitivity to negative evaluation Dependent Submissive and clinging behaviour and excessive need to be taken care of Obsessive–compulsive Preoccupation with orderliness, perfectionism and control Source: Adapted from American Psychiatric Association (2013, p. 645). Pdf_Folio:958 958 Psychology MAKING CONNECTIONS Personality refers to enduring patterns of thought, feeling, motivation and behaviour that are activated in particular circumstances (e.g., when interacting with peers, authority fgures and others; chapter 14). A key feature of Personality Disorders is that these patterns are often not only socially peculiar or inappropriate but also relatively infexible, so the person cannot tailor the way they respond to the circumstance. Borderline personality disorder The movie Fatal Attraction portrayed a disturbed woman (played by Glenn Close) who took revenge on a married man with whom she had had an affair.
eBook - PDFPersonality Disorder and Serious Offending
Hospital treatment models
- Christopher Newrith, Clive Meux, Pamela Taylor(Authors)
- 2006(Publication Date)
- CRC Press(Publisher)
The official classification systems, DSM-IV and ICD-10, differ slightly in their wording of the definition of personality disorder, but they and almost all other definitions include sev-eral key concepts, one of which is that the onset is usually in childhood or adolescence and the disorder is persistent over a long time into adulthood. This is the key feature in dif-ferentiating Personality Disorders from Axis I mental disorders. The following are other features common to all definitions. • There are enduring maladaptive and inflexible patterns of thinking (i.e. ways of perceiving and interpreting self, other people and events), feeling (i.e. the range, intensity, lability and appropriateness of emotional responses), behaving (e.g. impulse control) and relating to others. These differ from the way the average person in the same culture thinks, feels and acts. • Several of these different areas of psycho-logical functioning are abnormal. • The disorder is pervasive. This means it is manifest across a broad range of personal and social situations. • The disorder is associated with a sub-stantial degree of personal distress and/or problems in occupational and social performance (De Girolamo and Reich, 1993). IDENTIFYING PERSONALITY DISORDER IN CLINICAL PRACTICE It is the associated distress and impairment in personal functioning that bring individuals 10 PRESENTING CHARACTERISTICS OF PERSONALITY DISORDER with personality disorder to the attention of services. The task for a practitioner is then to recognize whether or not the distress and functional impairment are caused by a per-sonality disorder. Some of the presentations discussed below may raise the index of suspicion that an individual has a personality disorder, but the only way to be sure is to take a longitudinal approach. A one-off assessment is just a snap-shot in time of a person’s functioning.
No longer available |Learn moreCritiquing Personality Disorder
A Social Perspective
- Julia Warrener(Author)
- 2017(Publication Date)
- Critical Publishing(Publisher)
However, the World Health Organization characterises personality disorder within the same domain as the other forms of mental ill-ness (WHO, 1992 ). These principal ways of classifying personality disorder are founded on 1 Personality disorder: classifications, myths and risks 2 • Critiquing Personality Disorder: A Social Perspective completely different ideas about its nature and its relationship to normal personality and other forms of mental disorder. It is perhaps not surprising therefore that personality disor-der is often poorly understood by mental health professionals (National Institute for Mental Health [NIMHE], 2003 ). Moreover, a number of perspectives offer alternative explanations of the diagnosis. The psychiatric attention to classification, diagnosis and form (Jaspers, 1963 ) can be coun-tered by explanations which prioritise broader dimensions of peoples’ reality: the subjective, the social (Livesley, 1998 ; Tew, 2005 ) and, perhaps most importantly, the experience of distress (Castillo, 2003 ). A psychological perspective sees a relationship between maladap-tive and adaptive personality and the extent of the former’s impact on the self, relationships with others and society in general (Livesley, 1998 ; Ro et al., 2012 ). The social context and relationships within this, as both a consequence and a contributor to mental distress, are central to a social perspective. Here health and illness are seen as multifactorial, related to a person’s social context, position and experience of power and powerlessness (Duggan, 2002 ; Plumb, 2005 ). A service user perspective offers a depth of detail about the experi-ence of distress and most importantly offers us insight into the reasons as to why people might think, feel and behave as they do (Castillo, 2003 ). These different perspectives and explanations contribute a richness of information about personality disorder.
eBook - PDF- Jonathan Haslam(Author)
- 2009(Publication Date)
- Yale University Press(Publisher)
CHAPTER 5: Problems in the Classification of Personality Disorders Classifying Personality Disorders is problematic for several reasons. One is quantitative: How intense must the disturbance be to warrant calling it a disorder? Another is semantic: A variety of terms—character neuro-ses, neurotic characters, character disorders, personality trait distur-bances, personality pattern disturbances, Personality Disorders (the term used in the Diagnostic and Statistical Manual-Ill) —have been applied to the same clinical syndromes. And behind these semantic differences loom important conceptual, clinical, and ideological issues—for exam-ple, the wish to eliminate the term psychoneuroses from a classification system, as stated in the introduction to DSM-III. One's choice of termi-nology can thus arise from theoretical assumptions regarding the deter-minants of personality organization. For example, a psychodynamic rather than a behavioristic frame of reference will strongly influence the observer's ordering or grouping of pathological personality features. In clinical psychiatric practice the terms character and personality have been used interchangeably. For the purpose of this discussion I am using the term Personality Disorders to refer to constellations of abnormal or pathological character traits of sufficient intensity to imply significant disturbance in intrapsychic and/or interpersonal functioning. Regardless of the theoretical assumptions of psychoanalysis, the data derived from close involvement with patients supply, in my view, the strongest clin-ical evidence available for use in connection with any effort to classify Personality Disorders. This viewpoint is theoretically in harmony with the criteria spelled out by Spitzer in the introduction to DSM-III: There is no assumption that each mental disorder is a discrete entity with sharp boundaries (discontinuity) between it and other mental disorders, as well as between it and No Mental Disorder.
eBook - PDFThe Troubled Mind
A Handbook of Therapeutic Approaches to Psychological Distress
- Susy Churchill(Author)
- 2020(Publication Date)
- Red Globe Press(Publisher)
An alternative conceptualisation is the TA view of personality adapta-tions . This takes a ‘non-pathological’ view in suggesting that we all have negative personality features. Each of us will tend towards a particular pattern, and they suggest six types which mirror six of the nine PD diagnostic categories. Joines (2004) describes how these patterns are developed in childhood, and were the best strategies that could be found at the time to meet the expectations of parents and other authority figures, and for the individual’s sense of psychological survival. In adult-hood these behaviour patterns will emerge unconsciously in response to particular feelings. We can draw on any of these overlapping ideas about personality when we consider how best to work with someone whose personality has predomi-nant negative features. Let us now consider the current psychiatric classifica-tions of disturbed personalities. PSYCHIATRIC CLASSIFICATIONS OF Personality Disorders DSM gives general characteristics indicating a personality disorder: patterns that would be regarded as unusual within the individual’s culture CLIENTS DESCRIBED AS HAVING A PERSONALITY DISORDER 159 in the arenas of interpersonal relationships, impulse control, emotional responses or interpretations of self, others and events. In order to be diag-nosable, these patterns must be enduring and inflexible, and have existed since early adulthood or before. The key diagnostic features include the idea that this diagnosis is ‘enduring’, ‘stable’, affects the individual in many situations, and dates back to an early stage in the individual’s life. What does research indicate? 1. Enduring stable pattern Shea et al. (2002) demonstrated that when people with a diagnosis of personality disorder were retested after a year, more than half did not receive the same diagnosis.
- Carl W. Lejuez, Kim L. Gratz(Authors)
- 2020(Publication Date)
- Cambridge University Press(Publisher)
For dis- orders where complex treatments are recommended (Department of Health, 2009), it is also important to spe- cify the severity of the personality disorder and probably forgo long-term treatments if the disorder is only mild in severity. Finally, the place of borderline personality disorder is, at least temporarily, assured. There are some who would prefer all categories to be excluded in what is otherwise a dimensional system, but the arguments for inclusion of a “borderline pattern descriptor” have been strong and many will be pleased to recognize familiar words in this pattern below, now accepted in ICD-11: The Borderline pattern descriptor may be applied to individ- uals whose pattern of personality disturbance is characterized by a pervasive pattern of instability of interpersonal relation- ships, self-image, and affects, and marked impulsivity, as indicated by many of the following: Frantic efforts to avoid real or imagined abandonment; A pattern of unstable and intense interpersonal relationships; Identity disturbance, manifested in markedly and persistently unstable self-image or sense of self; A tendency to act rashly in states of high negative affect, leading to potentially self-damaging behav- iours; Recurrent episodes of self-harm; Emotional instability due to marked reactivity of mood; Chronic feelings of 116 P. TYRER emptiness; Inappropriate intense anger or difficulty control- ling anger; Transient dissociative symptoms or psychotic-like features in situations of high affective arousal. (World Health Organization, 2018) However, if the dimensional view of personality classifica- tion becomes the norm, the borderline pattern may merge imperceptibly into the general structure of personality disorder, provided that clinicians can embrace its positive attributes. This is not yet certain (Tyrer, 2018). A few years ago, I was in Long Island in a meeting concentrating almost entirely on borderline personality disorder.
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