Personality

Disorders
NATIA BADRIDZE,MD
Introduction
 These disorders refers to a pervasive,
persistent, relatively inflexible personality
trait that leads to functional impairment or
subjective distress.
Introduction cont’
 Diagnoses are divided into three “clusters”
based on similarities in symptom
presentation.
 Cluster A: Odd and Eccentric

 Cluster B: Dramatic and Emotional

 Cluster C: Fearful and Anxious

Introduction cont’
Cluster A: Cluster B: Dramatic/
Odd/Eccentric Emotional, or Erratic
Paranoid Borderline

Schizoid Narcissistic
Antisocial
Schizotypal
Histrionic
Introduction cont’
Cluster C:Anxious or
Fearful
Avoidant
Obsessive-compulsive
Dependent
Paranoid
 Pervasive mistrust and/or suspiciousness of
others.
 They may suspect others of having malevolent
motives;
 Be preoccupied with concerns about others;
 Be reluctant to confide in others;
 Be extremely sensitive to perceived criticisms
and/or bear grudges against others.
Schizoid
 Characterized by a general detachment
from social relationships.
 Restricted range of emotional expressions.
 Consistently prefer isolation to social
relationships, generally have few interests.
 Seldom engage in intimate relationships.
 Described as cold or emotionless.
Schizotypal
 Restricted interpersonal relationships
 Marked peculiarities in thinking and
perception, magical thinking.
 Similar but not as severe as one diagnosed
with schizophrenia.
 Ideas of reference vs. delusions of
reference.
Schizoid and Schizotypal Personality

 Schizoid and schizotypal personality disorders are

characterized by long-standing patterns of
detachment from social relationships and difficulty
in establishing and maintaining those relationships.

 Although the lack of close personal relationships

occur in both disorders (attributed to cluster A
disorders), each disorder has their own
characteristic symptoms.
Schizoid and Schizotypal Personality cont’

 Symptoms of schizotypal personality disorder can

include peculiar, eccentric or unusual-magical
thinking, peculiar style of speech, and limited or
inappropriate emotional responses.

 For example, a person with schizotypal PD may

have lasting suspicions or paranoid ideas, or
express anger at good news, and speak at irregular
intervals.
Schizoid and Schizotypal Personality

 In contrast, symptoms of schizoid personality

disorder include a high preference of being alone or
solitary activities, lack of understanding of social
cues, little desire for intimacy or sexual
relationships, indifference or lack of motivation at
school or work.

 Most of the symptoms for both these disorders

result in the individual's lack of close social
relationships or their difficulty to maintain them.
Schizotypal Personality Disorder vs. Schizophrenia

 Schizotypal personality disorder can easily be confused with

schizophrenia, a severe mental illness in which people lose
contact with reality (psychosis).

 While people with schizotypal personality disorder may

experience brief psychotic episodes with delusions or
hallucinations, the episodes are not as frequent, prolonged or
intense as in schizophrenia.
Schizotypal Personality Disorder vs. Schizophrenia

 Another key distinction is that people with schizotypal

personality disorder usually can be made aware of the
difference between their distorted ideas and reality. Those with
schizophrenia generally can't be swayed away from their
delusions.

 Despite the differences, people with schizotypal personality

disorder can benefit from treatments similar to those used for
schizophrenia.
 Schizotypal personality disorder is sometimes considered to
be on a spectrum with schizophrenia, with schizotypal
personality disorder viewed as less severe.
Antisocial
 This diagnosis is not given to clients under the
age of 18.
 Usually engage in illegal activities;
 Routinely practice deceit;
 Often aggressive and violent;
 Typically irresponsible
 Generally ignore the rights and feelings of others.
 Rarely show remorse
Borderline
 Typically demonstrate erratic interpersonal
relationships;
 Fluctuating self-image and/or affect;
 Marked impulsivity.
 Frequently engage in suicidal or self-
mutilating behaviors.
Borderline cont’
 They rarely see themselves or others in a
balanced way.
 These clients are the most likely of people
with personality disorders to seek
treatment.
Histrionic
 Characterized by emotionality and attention
seeking.
 Are only comfortable when they are the
“center of attention”.
 Will use physical appearance, speech, and
emotions to command others’ attention.
Narcissistic
 A grandiose sense of self-importance;
 A need for attention
 A reduced capacity for empathy
 Often seem to have an exaggerated sense
of entitlement
 Expect to be admired and obeyed by others.
 Usually seeks treatment when frustrated by
others.
Avoidant
 Demonstrate marked feelings of inadequacy that
are associated with hypersensitivity to negative
feedback and/or social inhibition.
 Seldom put themselves in “risky” or even new
situations in which they may perform poorly.
 Seldom develop intimate interpersonal
relationships.
 May constrain occupational choices based on fear
of negative judgments.
Dependent
 Seek someone to take care of them, even
to the extent of being submissive, clinging,
and fearful of separation.
 Avoid decisive action and encourage others
to make decisions for them.
 Subservience makes it quite difficult to
express disagreement, even when asked to
undertake unpleasant activities.
Dependent
 Fear being alone and quickly substitute a
new relationship if an old one is lost.
 They systematically underestimate
themselves and their ability to function
independently.
Obsessive-Compulsive
 Have well-controlled perfectionistic patterns of
behavior at the expense of spontaneity, flexibility,
and even efficiency.
 There is often such preoccupation with planning
and details that tasks are not completed.
 Difficulty delegating responsibilities and tend to
work long hours in order to meet their own
standards regarding productivity.
Obsessive-Compulsive
 Unlike obsessive-compulsive disorder,
individuals with OCPD do not necessarily
have obsessions or compulsions.
 Tendency is to be rigid in their actions and
thinking, adhering to strict and controlled
patterns of thought and behaviors.
 Differences Between OCD and
OCPD
 While there is considerable overlap between the two disorders,
there are four, basic ways to tell OCD and OCPD apart:

 OCD is defined by the presence of true obsessions and/or

compulsions. With OCPD, the behaviors are not directed by
thoughts you are unable to control or irrational behaviors you
repeat over and over again, often with no apparent aim.

 Persons with OCD are typically distressed by the nature of their

behaviors or thoughts however much they are unable to control
them.
 People with OCPD, by contrast, fully believe that their actions have
an aim and purpose.
 Differences Between OCD and
OCPD cont’
 Persons with OCD will often seek professional help to
overcome the irrational nature of their behavior and the
persistent state of anxiety they live under.
 Persons with OCPD will usually not seek help because
they don't see anything they are doing is particularly
abnormal or irrational.
 In persons with OCD, the symptoms tend to fluctuate in
association with the underlying anxiety. Because OCPD
is defined by inflexibility, the behaviors tend to be
persistent and unchanging over the long term.
Treatment of PD
 There is no specific medication to treat personality disorders.
However, antidepressant medications may be used to treat
associated conditions such as anxiety and depression, or to help
people cope with their symptoms. Less frequently, other types of
medications such as antipsychotics or mood stabilisers may be
prescribed.
 Psychotherapy is the most effective long-term treatment option for
personality disorders. Methods include:
 cognitive behaviour therapy (CBT)
 dialectical behaviour therapy (DBT)
 psychodynamic psychotherapy
 psychoeducation.
THANK YOU