PERSONALITY DIOSRDERS

Introduction
Personality disorders are long patterns of a maladaptive behavior. Personality refers to enduring
qualities of an individual shown in his ways of behaving in a wide variety of circumstances.
When these traits become inflexible and maladaptive such that they significantly impair their
individuals ability to function, they are called personality disorders. Personality disorders
constitute immature and in appropriate ways of coping with stress or solving problems. They are
usually evident by early adolescence and may continue throughout adult life.

Unlike people with effective or anxiety disorders, which also involve maladaptive behavior,
people who have personality disorders usually do not feel upset or anxious and are not motivated
to change the behavior. They do not lose contact with reality or display marked disorganization
of behavior, unlike individuals who have schizophrenia disorders. Personality disorders are
divided into three major types
 Individuals whose behavior appears odd or eccentric
 Individuals whose behavior appears fearful or anxious disorder
 Individuals whose behavior appears dramatic, emotional or erratic.

Classifying personality disorders

Personality disorders are longstanding disorders maladaptive, inflexible ways of relating to the
environment. These disorders are diagnosed on Axis II of DSM-IV. Many people with
personality disorders also have a diagnosis on Axis I. It should be noted that current
classification of personality disorders overlap with each other. It is likely that as more research is
done more conceptualization of the disorders may change.

CLUSTER A
Odd or eccentric behavior
Individuals whose behavior is considered odd and eccentric include the paranoid disorder, the
schizoid personality disorder, and the schiozotypal personality.

1. Paranoid Personality Disorder

These individuals have suspicious and sensitivity. Suspicious may be dismayed by constant look
out for attempts by others to take advantage of him, or trick him. Doubts the royalty, of others
and unable to put his trust in them. Finds it hard to make friend ship and avoids group
involvement. Little sense of humor with low capacity for enjoyment. Argumentative and
stubborn, overcautious, have strong sense of self importance with powerful inner conviction that
he is un usually talented and capable of great achievement. Take offence easily and see rebuffs
where none is intended, people find them difficult and unreasonable.

2.Schizoid Personality disorder

Those diagnosed with schizoid personality disorder are withdrawn and seclusive, prefer to work
alone, and do not seem interested in warm close relationships with others. The person have basic
disinterest in other i.e. restricted emotional reactions, limited emotional expressive and social
indifference are major symptoms.

3. Schiozotpal Personality Disorder

Schiozotypal personality disorder is associated with odd ways of thinking, perceiving
communicating and behaving although these deviations are not as extreme as those seen in
people diagnosed with a schizophrenic disorder. Idiosyncratic behavior and deficient social skills
are usually found. The symptoms are similar and may be a spectrum disorder. Some researchers
suggest that this disorder may be related to schizophrenia as a weak form of that disorder.

CLUSTR B- Drama, Emotional, or Erratic Behavior

Dramatic emotional behaviors are characterized by the following personality disorders –
histrionic, narcissistic, borderline and antisocial personality disorder.

1. Histrionic Personality Disorder

This is the personality disorder in which people seek to get attention by exaggerating situations
in their lives. They have stormy personal relationships and are attention seeking, demanding
excessively emotional and demand reassurance and praise. The people are manipulative.
Behavior includes tamper tantrums, crying, seductiveness and exaggerations
2. Narcissistic Personality Disorder
Closely related to the histrionic personality disorder. People with this disorder have an extreme
sense of self importance, and expectation of special favours, a constant need for attention, and
lack of caring for others and react to criticism with rage, shame, or humiliation. They are known
for fragility of self esteem and a lack of empathy for others.

3. Borderline Personality Disorder

Those diagnosed as having a borderline personality disorder have unstable personal
relationships, often threaten and frequently engage in self destructive behavior, are very
impulsive and tend to have relationships characterized by intense clinging dependency and
manipulation of others. Instability of mood, and poor self image. Relationships vacillate between
extreme closeness and distance. Because of the frequency of the borderline diagnosis, more work
is done on treatment of this disorder than on the other personality disorders.

4. Antisocial Personality Disorders

The four main features include:
Failure to make loving relationships, impulsive actions, lack of guilt and failure to learn from
adverse experiences. Others include self contendness and heartlessness. In the extreme the
person may be callous enough to inflict cruel, painful, or degrading acts on others. They posses a
charm that enables them to form shallow passing relationships without inner feelings. They
engage in sex without tender feelings, marriage is often marked by lack of concern for the
partner and sometimes by physical violence- many marriages end with separation or divorce.
Pattern of life devoid of plan or persistent striving towards a goal. Lack of guilt or remorse,
repeated offences against the law which begin in adolescence with petty acts of delinquency,
lying and vandalism. The behavior is made more extreme by the effects of alcohol or drugs,
these people make inadequate parents, with neglect and child abuses.

CLUSTER C- Anxious or fearful behavior

Persons show shyness, inhibition, fearfulness, and loneliness. This is generalized to a form of
social phobia. This is exhibited by the following personality disorders –depend personality
disorders, obsessive personality disorder, avoidant personality and passive aggressive personality
disorder

1.Avoidant Personality disorder

People diagnosed as having avoidant personality have low esteem, worry about negative
evaluation by others, and avoid social interactions. Although they desire affection and close
relationship, fear of rejection seems to keep those people from seeking such relationships.

2. Passive Aggressive Personality Disorder

Persons with this disorder resent demands placed on them by others and passively resist them.
They may act slowly or ineffectively. They express their hostility indirectly e.g. demanding
wrong doers to be punished.

3. Dependent Personality Disorder

Individuals who allow other people to make all important decisions in their lives characterize the
dependent personality disorder. They feel they cannot function independently. To ensure that
such dependency is maintained, they subordinate, and affectionate to keep their protectors. The
try to appear pleasant and agreeable to others.

Theoretical explanation or personality disorders

Traditional Freudian theory (psychodynamic theory) focuses on oedipal problems as the
foundation for many psychological disorders including personality disorders. Faulty resolution of
the Oedipus complex might lead to antisocial personality disorder since the moral conscience, or
super ego is believed to depend on proper resolution of this conflict. Learning theorists suggest
that childhood experiences can contribute to maladaptive ways relating with others. Cognitive
psychologists suggest that antisocial individuals encode social information in ways that bolster
their misdeeds.

Treatment
Requires considerable time. Drugs have little part to play except for occasional anxiolytics or
major tranquillizers given for short time at periods of unusual stress.
Psychotherapy – benefits those young people who lack confidence, have difficult in making
relationships and are uncertain of the direction their lives ought to take.
Supervision and support are beneficial, making changes in the patient’s circumstances so that he
has less contact with situations that provoke his difficulties. Giving opportunities to develop
assets in his personality.

Revision questions
1. Define personality disorders
2. List some of the common personality disorders
3. How would you treat a client with a named personality disorder.

EATING DISORDERS
What are eating disorders?
Some people have maladaptive eating behavior which lead to poor social image .for some of
them eating becomes a primary source of pleasure, they consume more energy than they expend
and this causes obesity or overweight. Other eat very little so that they may keep a slim shape
leading to self –starvation, this condition is known as anorexia nervosa .While others engage in
eating binges and then include vomiting, take laxatives and exercise excessively to avoid weight
gain –this leads to a condition known as bulimia nervosa We are going to discuss two eating
disorders that are anorexia nervosa and bulimia nervosa .Obesity, which is influenced by eating
habits is also discussed.

Anorexia nervosa
Anorexia nervosa is self-included starvation that occurs even though the person has both
physiological and cognitive feelings of hunger. Such people “feel fat” and seem to have distorted
body images that lead them to have an obsessive preoccupation with weight loss. Anorexia is
most common in middle –and upper –class adolescent females. Some individuals with an
anorexic disorder lose weight by limiting food intake; others (the binge-eating/purging type)use
vomiting and laxatives’ as well as caloric restriction to maintain a significantly lower than
average body weight .Depression is often a long term-problem for people with anorexia.
Treatment approaches most commonly used include behavioral method and family therapy
.Treatment can lead to long-term improvement. Typically, Anorexia nervosa patients are
hospitalized and may need to be forced-fed on a liquid diet. In a structured hospital setting,
weight gain with anorexic patients is usually successful. However to, archive a weight gain
certain conditions seem necessary. There must be a reinforcing environment, staff members need
to be present during meal time and individual and family therapy are often key ingredients
(Hsu,1986) .Patients may be forced to eat and rewarded for eating by gaining privileges when
they consume specific quantities of food ,they may regain needed body weight and avoid
permanent damaged to their healthy self-image and body weight.

Unfortunately as many as 50 % of treated patients have relapses within one year. The causes of
the disorder are still not clear, but researchers are convicted that such cultural factor as a
preoccupation with weight and being thin are predisposing factors (Hsu,1986).Let us focus our
attention on bulimia nervosa another eating disorder.

Bulimia nervosa
People who have bulimia nervosa practice binge eating although they are to be depressed and
self-critical about such behavior .The binge eating occurs at least twice a week and usually
accompanied by laxatives use or self-include vomiting for weight control as part of a binge –
purge cycle .Binge eaters are also likely to be on weight reducing diet from which their binges
represent relapses. Individuals with bulimia may be average or above average in weight .Bulimia
is thought by some researchers to be form of depression in which the binges are used to get relief
from anxiety and depression .It does not simply represent an eating problems but is associated
with poor overall adjustment .Binge behavior often appears to be triggered by stressful
interpersonal interaction with close family members.

Bulimics have a distorted body image, perceiving themselves as larger than they really are. In
addition they have lower self-esteem than people who eat normally, many of them come from
families perceived as having poor relationship and a high level of conflict. Researchers believed
that these purges reduce post binge anguish. Although bulimia is seldom in participating, various
physical changes such as dehydration and electrolytic imbalances can occur, particularly if the
patient is already underweight. Bulimia is treated with a variety of cognitive and behavioral
techniques, group therapy and antidepressant drugs.

12.18 Overeating
Overeating is problem behavior. It occurs more frequently in some situation than in others. For
example watching television is stimulus for eating for many people. As soon as they sit down in
front of a television set, they start to eat .Such habits may become very persistent because the
enjoyment of watching television reinforces eating. One possible treatment for overeating then,
would be to reduce the number of discriminative stimuli for eating .A number of ways for doing
this have been suggested by Charles Ferster, John Numberger, and Eugene Levitt (1962):They
instructed their clients to:-
 Make eating a pure experience by engaging in no other activity while eating
 Slow down the rate of eating by placing only a small amount of food in the mouth at a
time and place the cutler on the table until one has swallowed
 Before engaging in eating behaviors the clients were instructed to reapeat,”I can only
control my eating by engaging in other activities which I enjoy.”

The treatment was found effective in the modification of overeating behavior.

12.19 Obesity
Obesity is characterized having excessive body fat .Over eating or consuming large quantities of
food mainly causes it. Obesity is not an eating disorder but it can lead to health problems for
example ,cardiovascular diseases, diabetes and respiratory problems .Are view of the literature
confirms the perception of the negative stereotype of obesity ,which ranges from criticism and
public ridicule accorded to obese children to the active prejudice ,particularly against obese
females in occupational settings. Obese individuals can expect to be teased and taunted, treated
as less intelligent than they are ,and rejected from training or jobs in favor of less qualified but
similar individuals. At a personal level, excess weight is associated with low self-esteem and low
body satisfaction .Embarrassment about body shape can make over weight individuals reluctant
to engage into sexual relationships or take part in activities which their body shape is exposed
taking a further toll on physical and emotion well-being (Wardle,1989)
On all the areas of life style changes losing and maintaining weight loss is undoubtedly the most
difficult and perplexing area .Weight loss is a life style change because it requires more than
simply losing weight or changing eating behaviors .Often ,the changes require altering a person’s
life well beyond diet modification .For example ,just one relatively simple dietary changes such
as reducing daily consumption of certain foods might involve a series of unexpected change:
changes in shopping habits to modify the routine purchase of food; the development of
assertiveness skills to handle well-meaning friends who continue to prefer certain foods;
acquisition of time –management skills and some experimentation and emotional considerations
in finding a suitable replacement for the fattening food .It is no exaggeration ,to suggest that
weight loss is a complex ,difficult life –style changes(Ibid,1989)