Personality

Disorders
Introduction
 Personality is composite of behavioral traits and
attitudes that identify one as an individual.
 Personality is unique pattern of thoughts,
attitudes, values, and behaviors each individual
develops to adapt to a particular environment and
its standards.
 In short, our personalities define who we are.
Differences Between Self and
Personality
 Self and personality are related but distinct
concepts.
 Self is broader and more encompassing,
including an individual's sense of their own
identity.
 Internal view of an individual
 Personality refers specifically to their
continuing patterns of thoughts, feelings, and
behaviors.
 Combination of behavior and mental structure.
Personality Throughout Life Cycle
 Human personality is shaped and influenced
through-out life.
 Personality is established early in

childhood and molded through experience.

Infants
 Do not see themselves as separate beings until
about 18 months.
 When needs for food, comfort, warmth, safety, and
love and care are consistently met, infants develop
a sense of trust and self-worth.
 Infants who are denied unconditional love and
nurturing have difficulties in forming and
maintaining significant relationships in
adulthood because they have not learned to trust
others.
Toddlerhood
 Personality is still fluid, changeable, and
undefined.
 Toddlers begin to learn to separate from their
caregivers and explore the world around them.
 During this time, they develop a sense of object
constancy.
 Toddlers often seek out their parents for support,
encouragement, and approval.
 If responses to independent exploratory behaviors
are positive, children build a solid sense of self
and develop capacity for interacting successfully
with others.
School Age
 During early school years, children learn about
cooperation, competition, and compromise.
 Peer relationships begin to assume more
importance, and approval from persons outside
family is sought.
 Feelings of morality begin to develop between 6
and 10 years.
 These years are marked by:
 Preoccupation with self.

 Strong sense of right and wrong.

 Interactions with peers.

School Age
 Trust grows into capacity for empathy
(understanding feelings and behaviors of others).
 Thinking moves from here and now to thoughts of
the future, from concrete to abstract.
 Conflicts with parents begin to occur in later
childhood as the child's search for independence
is tempered by parents' limits on behavior.
 Without support and encouragement, children's
needs for guidance and approval go unmet, this
helps set stage for numerous problems later in life.
Personality in Adolescence
 Personality is well established.
 Relationships with others (especially their peers)
help adolescents affirm their independence from
their parents.
 Best friend relationships offer chances for
sharing, clarifying values, and learning about
differences in people.
 Within their peer group, adolescents support each
other in their struggles to assert themselves and
cope with distresses of becoming adults.
Personality in Adulthood
 By young adulthood, most persons are making decisions,
self-sufficient, and involved in give-and-take
relationships.
 Occupational choices are made, and families started.
 Self-awareness grows as individuals learn to balance
between personal independence and meeting needs of
others.
 Sensitivity to and an acceptance of feelings of other
persons is a critical characteristic of mature relationships
in adulthood.
 By middle adulthood, most persons are comfortable
enough with themselves and their personalities to
encourage independence in others.
Personality in Adulthood
 Many experts believe that, once established,
personality remains stable and constant.
 However, adulthood offers many opportunities for
individuals to look within and decide which
aspects of their personality they wish to keep and
develop, and which aspects they would like to
change.
 People are dynamic, always in physical or
psychological motion, and change does occur-
even within one's "well-established" personality.
Personality in Older Adulthood
 Older adults must cope with loss and change:
 Old friends are lost,

 Family members move away,

 Occupational careers end,

 Friendships from workplace fade as time passes.

 Personality, however, remains intact as individuals age.

 Older adults with strong, integrated personalities can cope
with their losses by maintaining what independence they
can and accepting their limitations.
 An important reminder about older adults: a sudden
change in personality is not a normal sign of aging.
 Patterns of thinking and behaving remain intact till death.
Personality Disorders

 Long-standing, maladaptive patterns of behaving

and relating.
 All personality disorders are characterized by:
 Persistent difficulties in interpersonal

relations.
 Many individuals have maladaptive behaviors
but are not diagnosed as mentally ill. Why?
 Actions do not deviate from or go beyond the

limits of society's expectations.

Personality Disorders

 Most important criterion: behaviors are inflexible,

maladaptive and cause significant functional
impairment or subjective distress.
 Inflexible, ineffective behavior patterns must
occur throughout a broad range of occupational,
social, and personal situations.
 Onset of maladaptive patterns can be traced back
to childhood or adolescence.
 No medical or other mental health problem can
account for them.
Personality Disorders
 Personality disorders are grouped into three
clusters based on similar behaviors:
 Eccentric,

 Erratic,

 Fearful.
Eccentric Cluster

 Characterized by odd or strange behaviors.

 Persons with problems in this cluster find it
difficult to relate to others or socialize
comfortably.
 Live in isolation. Interact only when necessary.

 Diagnoses in this cluster include:

 Paranoid,

 Schizoid,

 Schizotypal disorders.
Paranoia
 Distrust and suspiciousness; sees others' motives
as unkind (intend to do harm).
 Automatically assume that everyone is out to
harm, deceive, or exploit them.
 Loyalty and trustworthiness of friends are often
questioned for hostile intentions.
 Search for hidden meanings can turn a casual
remark into a conflict.
 Sharing information or becoming close to
someone is avoided because it may provide
information (ammunition) that may be used
against them.
 Very short-tempered.
 Unwilling to forgive even slightest error.
Paranoia
 Feelings of tenderness or respect are nonexistent.
 Many suffer from pathological, (extreme)
jealousy.
 Problem solving is difficult.
 Resist changes due to high anxiety levels.
 Diagnosed in up to 2.5% of the population.
 Men are diagnosed more often.
 10% - 30% of all psychiatric inpatients are
diagnosed with paranoid personality disorders.
Schizoid Personality Disorders

 Inability to develop and maintain

relationships with other people.
 Lack desire or willingness to become

involved in close relationships.

 They are emotionally restricted and unable

to take pleasure in activities, friendships, or

social relationships.
Schizoid Personality Disorders
 Often individuals communicate:
 Emotional detachment,

 Coldness,

 Lack of concern for others.

 Slightly more common in men and families.

 Occur in adults who experienced cold, neglectful
and unsatisfactory relationship in early
childhood.
Schizotypal Personality Disorder
 Have same interaction pattern of avoiding people
as schizoid personalities, but behaviors are
characterized by distortions and eccentricities
(odd, strange, or peculiar actions).
 Often have ideas of reference (incorrect

perceptions of causal events as having great or

significant meaning).
 Commonly find special, personal messages in

everyday events.
 Often superstitious or believe in paranormal

(events outside human understanding).

Schizotypal Personality Disorder
 Many think they have special powers to predict
events or read people's minds.
 Speech is often loose and vague, but it can be
understood.
 Use words in odd combinations or unusual ways.
 Prefer wearing clothing that appears odd to other
people (much larger sizes or colors that do not
match).
 More frequently in men.
Erratic Cluster
 Main characteristic is dramatic behavior.
 Each disorder in this cluster is associated with a
dramatic quality in the way they live and conduct
their lives.
 Erratic cluster consists of four separate disorders:
 Antisocial,

 Borderline,

 Histrionic,

 Narcissistic.
Antisocial Personality Disorders
(Psychopath)
 Disregard, violate rights of others.
 Rely on lying and manipulation to get their way.
 Lack conscience and have no feelings for others.
 Rooted in childhood.
 Some children have trouble controlling their
impulses, so they become disruptive and antisocial
as a way of coping.
 Many of these maladaptive behaviors can be seen
as early as 4 years of age.
Antisocial Personality Disorders
(Psychopath)
 During adolescence, maladaptive behaviors
become well established (cut school, open
disregard for rules, and thrill-seeking behaviors).
 Fighting and physical and verbal abuses are
common in adolescents with antisocial
personalities.
 By adulthood, psychopaths are usually adept at
manipulating and deceiving others.
 They gain money, power, or influence at expense
of others and feel no guilt.
Antisocial Personality Disorders
(Psychopath)
 Decisions are made with no thought to consequences.
 Able to inflict great pain and suffering in others and
feel no guilt.
 Have a remarkable ability to rationalize actions.
 Lack of guilt ability to rationalize actions → ignore
responsibility for their behaviors.
 Men are more affected than women.
 Fail to become self-supporting and spend years
being impoverished, homeless, or institutionalized.
Borderline Personality Disorder:

 Unstable mood, thinking, self-image, behavior,

and personal relationships.
 Intense fears of being abandoned motivate these
persons to avoid being alone.
 Relationships with others are marked by rapid
shifts from adoring and idealizing to devaluing
and cruel punishment.
 Extreme shifts are also seen in area of self-image.
 May gamble, abuse food or drugs, spend money
irresponsibly, and engage in self-mutilating or
suicidal behaviors.
Borderline Personality Disorder:

 Cutting; burning, pulling out hair, or scratching

oneself is very common (8% - 10% commit
suicide).
 Emotions range from great joy to deep
depression and frequently change within minutes
or hours.
 During stressful times, individuals with borderline
personality disorder may develop paranoid
delusions and feelings of depersonalization (loss
of contact with self) .
Histrionic Personality Disorder
 A pattern of excessive emotional expression
accompanied by attention-seeking behaviors.
 Histrionic persons may be flash or dramatic in
style of dress, mannerisms, and speech.
 More common in women.
Narcissistic Personality Disorder
 Self-centered, self-absorbed with no empathy
 Need to be admired.
 Believe they are special, unique, or extra
important.
 Fantasize about unlimited money, power, or
love.
 Take advantage of others without guilt.
 50% to 75% are men.
Fearful Cluster

 The common characteristic is anxiety.

 Three personality disorders in fearful or anxious
cluster are:
 Avoidant,

 Dependent,

 Obsessive-compulsive.

 Each disorder is related to certain expressions of

anxiety.
Avoidant Personality Disorder

 Anxiety is related to a fear of rejection and

humiliation.
 To prevent possible rejection, individuals narrow
their interests to a small range of activities.
 Have minimal support system because they are
so afraid of reactions of others.
 Suffer from general anxiety, depression, or
hypochondria.
Dependent Personality Disorder
 Anxiety is associated with separation and
abandonment.
 People with this problem carry a deep fear of
rejection, which expresses itself as the need to be
cared for.
 To avoid turning people away, they become over-
cooperative and passive and do not make
demands or disagree with others.
 When alone, they feel helpless and will go to great
lengths to find someone to care for them.
 Refuse to take responsibility for their own
actions.
Dependent Personality Disorder

 Unwilling to begin a task alone, take any

independent actions, or assume responsibility
for their activities of daily living.
 Feelings of worthlessness often motivate them to
seek out overprotective, dominating, or abusive
relationships.
 Men and women are equally diagnosed, although
some studies show a higher incidence in women.
 Cultural factors must be considered before a
diagnosis is made because many societies consider
certain dependent roles as appropriate.
Obsessive-compulsive Personality
Disorder
 Anxiety to uncertainty about future.
 Extremely preoccupied with details that little
is accomplished.
 Delegating tasks to others is impossible
because no one "can do it as well."
 Commonly these individuals are devoted to
work, have few leisure activities, and are
consumed by the need for perfection.
 About two-thirds of compulsive personalities
are men.
Therapeutic Intervention

 Treatment for individuals with personality

disorders is complex because these individuals
have extremely diverse treatment needs, and no
single treatment is appropriate for every client.
 Unfortunately, many do not seek treatment or
refuse to accept it when it is recommended:
 Basic mistrust of others intentions.
 Most of these patients are unable to recognize the
problem.
 A combination of various psychotherapies and
medications are used only after any physical
causes are ruled out.
Therapeutic Intervention

 Goals of care for clients with personality

disorders:
 To help clients identify and then become

responsible for their own behaviors.

 To assist clients in developing satisfactory

interpersonal relationships.
 Cure is not the goal of therapy.

 Care providers can hope only to make patients

more aware of how their habits affect their

lives, modifying their behavior.