Personality Disorders

Jeanette Klaber

DSM-IV-TR
Axis II- Chronic, long lasting
Cluster A:Odd and Eccentric Behavior Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Cluster B: dramatic or erratic behavior Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Nassisitic Personality Disorder Cluster C: Anxious and fearful behavior Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder

Cluster A
‡ Paranoid Personality Disorder:
± distrusting, suspicious that others ant to cause harm

‡ Schizoid Personality Disorder:
± detachment from social relationships and limited emotional expression

‡ Schizotypal Personality Disorder:
± uncomfortable in close relationships, cognitive/perceptual distortions, eccentric

Cluster B
‡ Antisocial Personality Disorder:
± disregard and violations of others rights

‡ Borderline Personality Disorder:
± unstable relationships, self-image, and affects, impulsive

‡ Histrionic Personality Disorder:
± emotional, dramatic, attention seeker

‡ Narcissistic Personality Disorder:
± Grandiosity, lack empathy

evaluations ‡ Dependent Personality Disorder: ± submissive or clingy behavior. control. hypersensitive to neg.Cluster C ‡ Avoidant personality Disorder: ± socially inhibited. perfection . excessive need to be taken care of ‡ Obsessive Compulsive Personality Disorder: ± order. feelings of inadequacy.

They may lie. Antisocial personality disorder is sometimes known as sociopathic personality disorder.Antisocial Personality Disorder Antisocial personality disorder is a type of chronic mental illness in which a person's ways of thinking. . work or school. May not be able to fulfill responsibilities to family. perceiving situations and relating to others are abnormal and destructive. and have drug and alcohol problems. A sociopath is a particularly severe form of antisocial personality disorder. behave violently.

Antisocial Symptoms Antisocial personality disorder symptoms may include: Disregard for right and wrong Persistent lying or deceit Using charm or wit to manipulate others Recurring difficulties with the law Repeatedly violating the rights of others Child abuse or neglect Intimidation of others Aggressive or violent behavior Lack of remorse about harming others Impulsive behavior Agitation Poor or abusive relationships Irresponsible work behavior antisocial .

This approach aims to raise awareness of unconscious thoughts and behaviors and by bringing them to light change their negative impact. But in some cases.. they can increase impulsive behavior. ± Mood-stabilizing medications. replace unhealthy behaviors with healthy. ± Psycho education. including treatments. agitation or insomnia. ± Anti-anxiety medications. coping strategies and problem-solving skills.Cause ‡ ‡ The cause is unknown genetic and environmental factors ± Adoption studies indicate that incidences of antisocial personality disorder are reduced in children of parents with antisocial personality disorder if they are adopted ± physically or sexually abused and antisocial personality disorder caregivers Treatment ‡ Psychotherapy ± Cognitive behavioral therapy. Stress and anger management skills Medications ± Antidepressant medications. positive ones. help with anxiety. ± Antipsychotic medications. This education-based therapy teaches about all aspects of a condition. helpful if symptoms include losing touch with reality (psychosis) Hospitalization ‡ ‡ ‡ . ± Psychodynamic psychotherapy.

evaluated 320 newly incarcerated men and women. Loveless. and instrumental activities of daily living (IADL). Allen. A study by Black. work. and Sieleni (2009). with an emphasis on finances (Reed. Gunter. 113 (35. OT socialization. activities of daily living (ADL). leisure. . Of the 320. 2001).3%) could be categorized as having antisocial personality disorder. with symptoms dissipating by 40.Antisocial Prognosis Symptoms tend to peak during the late teenage years and early 20's. Individuals rarely seek treatment or and no know effective treatment is currently available.

Avoidant Personality Disorder People with avoidant personality disorder are preoccupied with their own shortcomings. Loss and rejection are so painful that these people will choose to be lonely rather than risk trying to connect with others. . They form relationships with others only if they believe they will not be rejected.

persons feel inhibited and overcome with feelings of inadequacy and minimal self confidence (DSM-TR-IV. 2000). ‡ Avoidant personality disorder . rejection and disapproval (DSM-IV-TR. ‡ Social risks and new activities are done only when the individuals is assured acceptance.Symptoms ‡ Avoids jobs or activities that would involve interpersonal contact. 2000). ‡ Interactions with other people are limited to instances where the individual is assured the other person will like the individual (Fundukian & Wilson. ‡ Preoccupation with being criticized and rejected (DSM-TR-IV. 2000). due to fears of criticism. ‡ When meeting unfamiliar people or placed in new situations. 2000). ‡ Persistent fears of shame and ridicule from intimate relationships (DSM-TR-IV. 2008). socially inept. and minimal humiliation or embarrassment (DSM-TR-IV. 2000). ‡ Self perceptions are unappealing. 2000). and inferior to others (DSM-TR-IV.

in an effort to improve individuals self confidence and social functioning ‡ Medication ± Monoamine oxidase inhibitors (MAOIs) are used to decrease feelings of unease when in now social situations.Cause ‡ Cause is unknown ‡ Combination of social. . genetic and biological factors ‡ children who are victims of chronic parental criticism and rejections Treatment ‡ psychodynamically oriented therapy ‡ cognitive behavioral therapy ‡ group therapy ± focus on social skill training.

and this can be improved with treatment. as such clients may benefit from the use of social skills training (ot ref ) . Without treatment. a person with avoidant personality disorder may seek total isolation and or develop a second psychiatric disorder such as substance abuse or a mood disorder OT ‡ Social ‡ Work ‡ leisure ‡ cluster C diagnosis is in the area of socialization.Prognosis People with this disorder may develop some ability to relate to others.

Causing feelings of worthless or broken. impulsivity and frequent mood swings that push others away.Borderline Personality Disorder Self image is distorted. even though loving relationships are desire (mayo) . Prone to anger.

such as risky driving. unsafe sex. gambling sprees or illegal drug use ‡ Strong emotions that wax and wane frequently ‡ Intense but short episodes of anxiety or depression ‡ Inappropriate anger. sometimes escalating into physical confrontations ‡ Difficulty controlling emotions or impulses ‡ Suicidal behavior ‡ Fear of being alone ‡ Borderline video .Symptoms ‡ Impulsive and risky behavior.

± twins and families Studies suggest inheritance. ± Transference-focused psychotherapy (TFP). antipsychotic and anti-anxiety medications. ± changes in certain areas of the brain involved in emotion regulation. uses a skills-based approach to teach you how to regulate your emotions. You can then use what you have learned in other relationships. understand the emotions and difficulties that develop in that relationship. ‡ ‡ Hospitalization . Brain abnormalities.. a combination Treatments and drugs Psychotherapy ± Dialectical behavior therapy (DBT). impulsivity and aggression. Environmental factors: ± history of childhood abuse. Medications may include antidepressant.but they can help associated problems.Causes ‡ ‡ ‡ ‡ ‡ ‡ Factors that seem likely to play a role include: Genetics. brain chemicals like serotonin Most likely. tolerate distress and improve relationships. Medications ± Medications can't cure . neglect and separation from caregivers or loved ones.

High risk for suicide!! What Occupational Therapists can do ‡ Work ‡ Leisure ‡ Social ‡ Activities of daily living (ADL) and IADL s ‡ Be aware of suicide= 8-10% will successfully commit suicide .Prognosis Onset of symptoms usually observable in young adulthood and trend toward stabilization after age 30.

submissive and have a constant need for reassurance and to be taken care of One of the most frequently diagnosed personality disorders. and usually appears in early to middle adulthood.Dependent Personality Disorder Marked by feelings of nervousness and fear. It appears to occur equally in men and women. helplessness. .

substance abuse. Mood instability as the result of short lived but intense episodic dysphoria. Suicidal behavior. reckless driving.com/watch?v=eHEvXKh15xg .. paranoia and or severe dissociative symptoms such as feeling disconnected from oneself. Impulsive self-damaging behavior in at least two areas (e.g. identity disturbance: markedly and persistently unstable selfimage or sense of self.Symptoms ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ frantic efforts to avoid real or imagined abandonment.youtube. sex. threats or gestures or self mutilating behavior that is recurrent. (suicidal risk should be assessed) Persistent feelings of emptiness. Difficulty regulating anger or inappropriately intense anger that may result in recurrent fights Stress related . A pattern of unstable and intense interpersonal relationships characterized by alternating between extreme idealization and devaluation. irritability or anxiety. spending. brief. Similar to a love-hate relationship. http://www. binge eating).

Treatment ‡ Psychodynamic Therapy ± Visit # predetermined to limit attachments ‡ Cognitive behavioral therapy ± Social skills training ± interpersonal therapy. ‡ Medication ± rare anti-depressant or anti-anxiety medication . ± group therapy and family and marital therapy ‡ increase the individuals ability to function independently and autonomy.Cause ‡ No known cause ‡ Environmental ± caregiver is overly involved and intrusive or caregivers that reinforce their Childs dependency and shun attempts for freedom and or independence ± A history of social humiliations during developmental years has also been linked to dependent behaviors.

even better for those who have a significant relationship with at least one parent. OT ‡ Social ‡ work ‡ leisure ‡ benefit from the use of social skills training .Dependent Prognosis generally good. Through the use of therapy individuals learn how to become autonomous and function independently.

They have an overwhelming desire to be noticed. unstable emotions and distorted selfimages. The word histrionic means dramatic or theatrical. and often behave dramatically or inappropriately to get attention.Histrionic intense. their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. For people with histrionic personality disorder. Cleveland clinic .

often with the goal being attention or protection not the act of having sexual relations. ‡ Physical appearance is consistently used to gain attention of others. ‡ Emotional expressions are shallow and frequently shifting. ‡ Verbal communications often lack detail and are aimed at pleasing and impressing others. ‡ The level of intimacy within personal relationships is overestimated. ‡ Dramatic and exaggerated displays of emotion ‡ Individuals are easily influenced. Anna nicole video .Symptoms ‡ Experience feelings of discomfort when not the center of attention. ‡ Displays of sexually provocative and inappropriate behavior toward others.

± repeating learned behavior ± lack of criticism or punishment as a child. positive reinforcement that is given only when a child completes certain approved behaviors ± unpredictable attention given to a child by his or her parent(s Treatment ‡ Psychodynamic Therapy ‡ Cognitive behavioral therapy ‡ Medication ± rarely to treat symptoms depression and anxiety that may cooccur with this diagnosis. .Cause ‡ Cause unknown ‡ learned and inherited factors ± run in families suggests that a genetic susceptibility for the disorder might be inherited.

might experience significant problems in their daily lives. ‡ Work ‡ Leisure ‡ Social . OT ‡ identify thoughts and personal feelings and then identify appropriate responses to those emotions. however. Those with severe cases.Prognosis Many people with this disorder are able to function well socially and at work.

But behind this mask of ultra-confidence lies a fragile selfesteem. http://www.Narcissistic Personality Disorder inflated sense of their own importance and a deep need for admiration.mayoclinic.com/health/narcissisticpersonality-disorder/DS00652 . vulnerable to the slightest criticism. Those with narcissistic personality disorder believe that they're superior to others and have little regard for other people's feelings.

‡ Frequent feels envious of others and believes others are consistently envious of him or herself. . unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.(gale and dsm-iv-tr) ‡ He or she thinks of themselves as special and unique and can only be understood or associated with others or institutions who are of the same caliber and status.Symptoms ‡ Individuals aggregated accomplishments and demands other to recognize their superiority. Unable to be empathetic. power. ‡ has a sense of entitlement. ‡ Demands excessive amounts of praise and admiration from others. DSM-IV-TR) ‡ Exploits others for own personal gains. He or she has a grandiose sense of selfimportance (Gale encyclopedia) ‡ Preoccupied with fantasies of exceptional success.. ‡ Frequently behaves or has an attitude of haughtily or arrogant. genius and ideal love. ‡ Lacks the ability to recognize or identify the feelings and needs of others.e. i.

depression and low self-esteem.Cause ‡ ‡ ‡ ‡ ‡ ‡ ‡ Cause unknown dysfunctional childhood excess pampering extremely high expectations abuse or neglect genetics or psychobiology Societal pressures Treatment ‡ cognitive behavioral therapy ‡ group and family therapy ± Short term goals of these therapies often include. ± Long term goals often focus on reshaping self-image and creating healthy patterns of thinking(mayo clinic) ‡ Psychotherapy ± relate to others creating meaningful more intimate relationships. addressing issues of substance abuse. ‡ Medication ± lessen or eliminate symptoms of anxiety and depression .

Prognosis The younger someone is at the onset of treatment the more likely they are to diminish their symptoms older they become increasingly depressed especially during the retirement years OT Approach should be consistent and firm with clearly defined limits from the beginning .

Paranoid Personality Disorder People with paranoid personality disorder are highly suspicious of other people. They are usually unable to acknowledge their own negative feelings towards other people .

insulting or demeaning. ‡ Confide and share as little personal information as possible due to fears that the information will be used maliciously. ‡ Unwillingness to forgive others for real or imagined slights or insults. ‡ Misreading benign comments or remarks as threatening. harm. ‡ Aggressive and or hostile responses to incorrectly perceived attacks by others. ‡ Preoccupation with thoughts that friends are not worthy of trust or incapable of offering loyalty.Symptoms ‡ Suspicions that others are trying to exploit. or deceive with out justification for the suspicions. ‡ Unfounded suspicions about spouses or sexual partners fidelity .

Cause ‡ No known cause ‡ Familial ± families where a member sufferers from schizophrenia or delusional disorder ± Twin studies have also shown a genetic link with the disorder. Treatment ‡ Psychotherapy ‡ group therapy ‡ self-help groups ± gaining the trust of the patient and eliminating unfounded thoughts of deception. ‡ Medications ± anti-anxiety medications ± anti-psychotics ± anti-depressants .

Some symptoms of paranoia can be controlled with treatment but not significantly OT ‡ Work ‡ Leisure ‡ social ‡ Focus on trust building .Prognosis The prognosis of paranoid personality disorder is poor as it is considered ca chronic lifeline disorder.

Spend a lot of time daydreaming or fantasizing as opposed to talking or acting as they have no desire for actual relationships with others.Schizoid Personality Disorder Often described as introverted. unwilling or fearful of intimacy with others(Merck). prefer to be alone. Have been know to show very little emotion .

‡ Most always chose activities that require no additional persons. ‡ Emotionally detached with tendencies to seem emotionally cold or aloof . ‡ Has little to no desire to engage in sexual activities with another person.Symptoms ‡ Avoid nor desire close relationships. nor maintain familial relationships. ‡ Neither negative or positive comments invoke any sort of emotional response. ‡ Lacks close or intimate relationships with people outside the persons immediate family. ‡ Daily tasks or activities provide little or no pleasure. They rarely date or marry.

Cause ‡ No known cause ‡ Environment ± Children cared for by individuals that show inadequate amounts of affection and emotional stimulation are prone to a disinterest in development close meaningful relationships in the future ± Children of parents with ineffective communication have been shown to imitate this style and or fail to learn how to effectively socialize Treatment ‡ Cognitive behavioral therapy ± social skills training and role playing ‡ psychodynamic ‡ group therapy. ‡ Medication ± anti-anxiety and anti-depressant medications are often used to manage symptoms of anxiety and depression. . through enhancing the individuals selfawareness and sensitivities to others and the environment. ± The goal of treatment for someone with schizoid personality disorder is to combat habits to retreat from society.

Prognosis rare that individuals with schizoid personality disorder independently initiate seeking treatment. as such overall prognosis is poor Those who successfully complete treatment often relapse and return to withdrawal behaviors if no support system is in place OT ‡ courteous. honest and respectful as well as be tolerant of silence or level of involvement the client is willing to participate ‡ Eventual social skill training may be utilized once a therapeutic relationship is developed ‡ Sensory Integration techniques ‡ Work ‡ leisure ‡ social .

behavior. . thought and perception that resemble symptoms of someone with schizophrenia but are less severe.Schizotypal Personality Disorder Schizotypal personality disorder is characterized by odd patterns of communication.

. Odd thinking and speech Suspiciousness or paranoid ideation inappropriate or constricted affect behavior or appearance that is odd. Odd beliefs or magical thinking that influences behavior and is inconsistent with culture norms Unusual perceptual experience. eccentric or peculiar Lack of close friends Excessive social anxiety that does not diminish with familiarity .‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Symptoms Ideas of reference Meaning they incorrectly interpret events. including bodily illusions. Bodily illusions are most often tactile and can be the feeling that an arm is missing.

environment. ± Seen more commonly in children of individuals with schizophrenia and or form of modeling of the relationship with parent Treatment ‡ ‡ ‡ ‡ ‡ ‡ Psychodynamic therapy cognitive-behavior therapy interpersonal therapy group therapy family and marital therapy Medications ± antipsychotics such as Amoxapine ± anti-depressants like fluoxine (Prozac) .Cause ‡ no known cause ‡ bio-psycho-social model ± combination of genetics. and psychological factors that lead to the disorder.

OT ‡ ADL ‡ IADL ‡ Leisure ‡ Work ‡ Sensory Integration .Prognosis poor due to the inflexibility and ingrained patterns of behavior associated with the disorder.

As Occupational Therapists . ‡ We treat the person NOT the diagnosis ‡ Be knowledgeable. increase safety and awareness . safety of your patient and your safety ‡ It is not our job to change their personality but we can supply ways to ease access. modify the environment.

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