Personality

Disorders
Personality
✘ A pattern of relatively permanent
traits and unique characteristics that
give both consistency and individuality
to a person’s behavior.

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Personality Disorder
✘ A personality disorder is a persistent pattern
of emotions, cognitions and behavior that
results in enduring emotional distress form the
person affected and/or for others and may
cause difficulties with work and relationship
(American Psychiatric Association, 2013)

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Personality Disorder
✘ Pervades every aspect of a person’s life;
common and chronic
✘ Ego-syntonic; Far more likely to refuse
psychiatric help
✘ A predisposing factor for other psychiatric
disorders (Ex: substance use, suicide, affective
disorders, impulse-control disorders, eating
disorders, and anxiety disorders).

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Origins
✘ Begin in childhood
✗ Can remit but is replaced by other personality disorder
✘ High comorbidity
✘ Poorer prognosis

Gender Differences
✘ MEN: Aggressive, structured, self-assertive and detached
✘ WOMEN: More submissive, emotional and insecure

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Big Five
1. OPENNESS TO EXPERIENCE (imaginative, curious, and
creative versus shallow and imperceptive)
2. CONSCIENTIOUSNESS (organized, thorough, and reliable
versus careless, negligent, and unreliable)
3. EXTROVERSION (talkative, assertive, and active versus
silent, passive, and reserved)
4. AGREEABLENESS (kind, trusting, and warm versus
hostile, selfish, and mistrustful)
5. NEUROTICISM (even-tempered versus nervous, moody,
and temperamental)

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Five Main Psychopathology Domains

1. PSYCHOTICISM (versus Openness)

2. DISINHIBITION (versus Conscientiousness)
3. DETACHMENT (versus Extraversion)
4. ANTAGONISM (versus Agreeableness)
5. NEGATIVE EMOTIONALITY (versus
Emotional Stability)

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 Personality Disorder
are divided into
three clusters:
✘ Cluster A (Weird)
✘ Cluster B (Wild)
✘ Cluster C (Worried)

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Cluster A (Weird)
Personality Disorders
are characterized by odd, eccentric thinking or
behavior. Includes:

Paranoid Personality Disorder

Schizoid Personality Disorder

Schizotypal Personality Disorder.

Paranoid Personality Disorder
is a mental disorder characterized by
paranoia and a pervasive, long-standing
suspiciousness and generalized
mistrust of others.
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A person who has a Paranoid
Personality Disorder:
✘ Beginning by early adulthood and present in a variety of
contexts, as indicated by four (or more) of the following:
✘ They believe that other people are chronically trying to
deceive or exploit them and are preoccupied with
concerns about the loyalty and trustworthiness of
others.
✘ Reads hidden demeaning or threatening meanings into
benign remarks or events
✘ Perceives attacks on his/ her character that is not
apparent to others and is quick to react angrily
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A person who has a Paranoid
Personality Disorder:
✘ Beginning by early adulthood and present in a variety of
contexts, as indicated by four (or more) of the following:
✘ has recurrent suspicions, without justification, regarding
fidelity of spouse or sexual partner
✘ High rates of schizophrenia with relatives
✘ Persons with this disorder externalize their own emotions
and use the defense mechanism of projection; they
attribute to others the impulses and thoughts that they
cannot accept in themselves.

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Schizoid Personality Disorder
They lack the desire to form
interpersonal relationships and are
emotionally cold (show little emotions)
in their interactions with others.
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A person who has a Schizoid
Personality Disorder:
✘ Aloof, reclusive, and detached or as dull,
uninteresting, and humorless
✘ Has little, if any, interest in engaging in sexual
relationships
✘ Appear unaffected by praise, criticism
✘ Unable or unwilling to express emotion
✘ No thought disorder

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Schizotypal Personality Disorder
✘ Psychoticism characterized by
eccentricity, cognitive and perceptual
dysregulation, and unusual beliefs and
experiences
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A person who has a Schizotypal
Personality Disorder:
✘ Peculiar dress, thinking, beliefs, speech or behavior
✘ Odd perceptual experiences, such as hearing a voice whisper
your name
✘ Flat emotions or inappropriate emotional responses
✘ Social anxiety and a lack of or discomfort with close
relationships
✘ Indifferent, inappropriate or suspicious response to others
✘ "Magical thinking" — believing you can influence people and
events with your thoughts (Clairvoyance and telepathy)
✘ Belief that certain casual incidents or events have hidden
messages meant only for you; superstitions
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Cluster B (Wild)
Personality Disorders
are characterized to be manipulative, volatile, and uncaring
in social relationships. They are prone to impulsive,
sometimes violent behaviors. Includes:

Antisocial personality disorder

Borderline personality disorder

Histrionic personality disorder.

Narcissistic personality disorder.

Antisocial Personality Disorder
an ingrained pattern of behavior in which
individuals consistently disregard and violate
the rights of others around them.

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A person who has an Antisocial
Personality Disorder:
✘ Disregard for others' needs or feelings and safety of
self or others
✘ Persistent lying, stealing, using aliases, conning others
✘ Recurring problems with the law
✘ Repeated violation of the rights of others
✘ Impulsive, aggressive, often violent behavior
✘ Consistently irresponsible
✘ Lack of remorse for behavior
✘ There is evidence of Conduct Disorder

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A person who has an Antisocial
Personality Disorder:
✘ Patients with antisocial personality disorder can
fool even the most experienced clinicians. In an
interview, patients can appear composed and
credible, but beneath the veneer (or, to use
Hervey Cleckley's term, the MASK OF SANITY)
lurks tension, hostility, irritability, and rage.
✘ These patients often impress opposite-sex
clinicians with the colorful, seductive aspects of
their personalities, but same-sex clinicians may
regard them as manipulative and demanding.
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Borderline Personality Disorder
is a mental health disorder that impacts the way you
think and feel about yourself and others, causing
problems functioning in everyday life. It includes a
pattern of unstable intense relationships, distorted
self-image, extreme emotions and impulsiveness.

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A person who has an Borderline
Personality Disorder:
✘ Object relations theorists attribute to “splitting”
and cognitive theorists attribute to
“dichotomous thinking”
✘ Ex: Tries to label staff nurses as “caring
nurse” and “boring nurse”
✘ Stand on the border between neurosis and
psychosis
✘ Key feature is instability (unstable mood,
unstable self-concept, unstable relationships)

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A person who has an Borderline
Personality Disorder:
✘ Characterized by out-of-control emotions that cannot
be smoothed
✘ The painful nature of their lives is reflected in repetitive
self-destructive acts. Such patients may slash their
wrists and perform other self-mutilations to elicit
help from others, to express anger, or to numb
themselves to overwhelming affect.
✘ They often complain about chronic feelings of
emptiness and boredom

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A person who has an Borderline
Personality Disorder:
✘ IDENTITY DIFFUSION: lack of a consistent
sense of identity
✘ Frantic avoidance of abandonment
✘ Describes emptiness that leads them to cling
to new acquaintances to fill the void
✘ They worry about abandonment and
misinterpret other people’s innocent actions as
desertion or rejection.
✘ Persons with borderline personality disorder
almost always appear to be in a state of crisis.
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A person who has an Borderline
Personality Disorder:
✘ Impulsivity in at least 2 areas that are potentially self-
damaging: spending, sex, substance abuse, reckless
driving, binge eating, problems with anger, transient
dissociative and paranoid symptoms, and suicidal
behavior
✘ High rates of mood disorders with relatives
✘ Patients can have short-lived psychotic episodes (so-
called MICROPSYCHOTIC EPISODES) rather than full-
blown psychotic breaks, and the psychotic symptoms
of these patients are almost always circumscribed,
fleeting, or doubtful.
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Histrionic Personality Disorder
characterized by a pattern of excessive
attention-seeking emotions, usually beginning in
early adulthood, including inappropriately
seductive behavior and an excessive need for
approval.
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A person who has an Histrionic
Personality Disorder:
✘ Shares features with borderline personality
disorder, including rapidly shifting emotions
and intense, unstable relationships
✘ People with Histrionic PD want to be the center
of attention.
✘ The person with BPD may desperately cling to
others as an expression of self-doubt and
need, but the person with histrionic personality
disorder simply wants the attention of others.

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A person who has an Histrionic
Personality Disorder:
✘ They pursue others’ attention by being highly
dramatic and overtly seductive and by emphasizing
the positive qualities of their physical appearance.
✘ Others see them as self-centered and shallow,
unable to delay gratification, demanding, and overly
dependent.
✘ They display temper tantrums, tears, and
accusations when they are not the center of
attention or are not receiving praise or approval.

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Narcissistic Personality Disorder
a long-term pattern of abnormal behavior
characterized by exaggerated feelings of self-
importance, excessive need for admiration, and
a lack of empathy.

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A person who has an Narcissistic
Personality Disorder:
✘ Belief that you're special and more important than
others
✘ Fantasies about power, success and attractiveness
✘ Failure to recognize others' needs and feelings
✘ Exaggeration of achievements or talents
✘ Expectation of constant praise and admiration
✘ Arrogance
✘ Unreasonable expectations of favors and advantages,
often taking advantage of others
✘ Envy of others or belief that others envy you.
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Cluster C (Worried)
Personality Disorders
are characterized by anxious, fearful thinking or
behavior. Includes:

Avoidant personality disorder

Dependent personality disorder

Obsessive-Compulsive personality
disorder.
Avoidant Personality Disorder
are marked by feelings of nervousness and fear.
People with avoidant personality disorder have
poor self-esteem. They also have an intense
fear of rejection and being negatively judged by
others.
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A person who has an Avoidant
Personality Disorder:
✘ Detachment characterized by withdrawal, intimacy
avoidance, and anhedonia
✘ They choose occupations which are socially isolated, are
terrified of saying something silly or doing something that
will embarrass themselves, and tend to be depressed and
lonely.
✘ Fears social evaluation and is very similar to social phobia
✘ When interacting with others, they are restrained, nervous,
and hypersensitive to signs of being evaluated or criticized.
✘ While they may crave relationships with others, they feel
unworthy of these relationships and isolated themselves.
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Dependent Personality Disorder
characterized by an inability to be alone. People
with DPD develop symptoms of anxiety when
they're not around others. They rely on other
people for comfort, reassurance, advice, and
support.
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A person who has an Avoidant
Personality Disorder:
✘ Asthenic Personality Disorder
✘ Anxious about interpersonal interactions, but their anxiety
stems from a deep need to be cared for by others, rather
than from a concern that they will be criticized.
✘ Person tends to subordinate their needs to those of
others to assume responsibility
✘ Denies any of their own thoughts and feelings that might
displease others, to submit to even the most
unreasonable demands, and to cling frantically to other,
can only function within a relationship and deeply fear
rejection and abandonment and may allow themselves to
be exploited and abused rather than lose relationships.
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 Obsessive- Compulsive Personality Disorder
characterized by a general pattern of excessive concern with
orderliness, perfectionism, attention to details, mental and
interpersonal control, and a need for control over one's
environment, which interferes with personal flexibility, openness to
experience, and efficiency, as well as interfering with relationships.

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A person who has an Obsessive-
Compulsive Personality Disorder:
✘ Self-control, attention to detail, perseverance,
and reliability are highly valued in many
societies but some people carry these traits to
an extreme and become rigid, perfectionistic,
dogmatic, ruminative, and emotionally blocked.
✘ Workaholics (see no need for leisure or
friendship)
✘ Stubborn, stingy, possessive, moralistic, and
officious
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A person who has an Obsessive-
Compulsive Personality Disorder:
✘ They tend to related to others in terms of
ranks or status and are ingratiating and
deferential to “superiors” but dismissive,
demeaning, or authoritarian toward “inferiors”
✘ Although they are extremely concerned with
efficiency, their perfectionism and obsession
about following rules often interfere with their
completion of tasks.

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PERSONALITY DISORDER MAIN BELIEF
PARANOID I cannot trust people.
SCHIZOTYPAL It’s better to be isolated from others.
SCHIZOID Relationships are messy, undesirable.
HISTRIONIC People are thereto serve or admire me.
NARCISSISTIC Since I am special, I deserve special rules.
BORDERLINE I deserve to be punished.
ANTISOCIAL I am entitled to break rules.
If people knew the “real” me,
AVOIDANT
they will reject me.
DEPENDENT I need people to survive, be happy.
OBSESSIVE-COMPULSIVE People should do better, try harder.
Thank you and
God bless!