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Personality Disorders (Summary)

Remedial Blog Post for missed quiz on Personality Disorders.

By Ragini Chatterjee

Personality Disorders are inflexible, pervasive, distorted behavior patterns and traits that result in maladaptive ways in perceiving, thinking about or relating to other people and the environment. They are formally known as character disorders. People diagnosed with these disorders tend to have problems in interpersonal relationships and having a stable ‘sense of self'. There have been difficulties in doing research on personality disorders as there are difficulties in diagnosing these disorders and studying cases of personality disorders. It is difficult to diagnose these disorders as the criteria for diagnosis isn't as sharply defined. This is because their diagnosis depends on inferred traits rather that objective behavioral standards (like with the case of panic attacks). The difficulties in studying personality disorders stem from high levels of comorbidity associated with personality disorders. Therefore, it is hard to pinpoint the exact causes of personality disorders. Most studies conducted are retrospective instead of being prospective. However, the most influential model for diagnosing these disorders is through the 5-factor model that defines ‘normal' personality along 5 dimensions – Openness to experience, extraversion /introversion, Agreeableness, Neuroticism, Conscientiousness. Possible biological factors include infants' temperament, that lay down the foundation for the individual's personality.

Personality Disorders are clubbed into 3 main groups- Cluster A disorders, where the unusual behavior is defined as being suspicious, socially detached, distrustful and are often perceived as odd and eccentric. The disorders under this category include Paranoid personality disorder characterized by a pervasive suspiciousness and distrust for others. They often blame others for their failures. Another disorder to fall under this cluster is Schizoid Personality Disorder, wherein there is a pervasive pattern of detachment from social relationships. People with this disorder display flattened affectivity. The last disorder to fall into this category is the Schizotypal Personality disorder, this disorder is classified by excessive introversion, social and interpersonal deficits coupled with cognitive and perceptual distortions. Their treatment is also the hardest.

The next group of Personality Disorders is Cluster B. People with this disorder tend to show high levels of impulsivity and display an affective instability. They are perceived to be dramatic, emotional and erratic. The personality disorders that are classified under this group are Histrionic Personality Disorder, Narcissistic Personality Disorder, Antisocial Personality Disorder and Borderline Personality Disorder. The first, can be identified in people who show a pervasive pattern of excessive emotionality and attention seeking. There is some evidence of a genetic link that predisposes women to Histrionic Personality Disorder, which in men manifests itself in Antisocial Personality Disorder. Narcissistic Personality Disorder can be identified by a pervasive pattern of grandiosity, need for admiration and lack of empathy. They also have a sense of entitlement. There are two subtypes of this disorder, grandiose narcissism, and vulnerable narcissism. The former is characterized by grandiosity, aggression, and dominance. For the latter, the arrogance and condescension are merely a façade for the intense shame and hypersensitivity to rejection and criticism. Borderline Personality Disorder is characterized by impulsivity and instability in interpersonal relationships, self-image, and moods. The central characteristic is affective instability and impulsiveness. They go out of their way to avoid real or imagined abandonment. Dialectic Behavior Therapy is especially effective in treating this disorder.

Antisocial Personality Disorder manifests itself in a lack of moral and ethical development. There is an inability to follow approved patterns of behavior. People diagnosed with this disorder usually have a history of conduct problems during childhood. There is a link between Psychopathy and ASPD. Psychopathy shows two different dimensions of traits- an affective (reflecting lack of remorse or guilt, lack of empathy, superficial charm, grandiose sense of self-worth, pathological lying). And another dimension, correlated with ASPD -antisocial, parasitic lifestyle, irresponsible, impulsive and deviant behavior. Psychopaths show more emotional deficits like lack of fear and anxiety. Treatment for ASPD psychopaths is difficult as they don't think that they have a problem and shift the blame onto other people.

The last set of Personality Disorders are categorized under Cluster C. Avoidant Personality Disorder, Dependent Personality Disorder, Obsessive-Compulsive Personality Disorder. These are characterized by overt fearfulness or tension. Children with inhibited temperaments are at high risk. Avoidant Personality Disorder shows itself in a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. They avoid social interaction, as they view themselves to be inadequate. Dependent Personality Disorder is characterized by a pervasive and excessive need to be taken care of. Which leads to submissive and clingy behavior. They have irrational fears of being left alone and go to excessive lengths to prevent the breaking up of relationships. Obsessive Compulsive Personality disorder involves perfectionism and an excessive concern with maintaining order and control. They have a preoccupation with maintaining mental and interpersonal control. However, OCPD differs from OCD as the latter is classified under Axis one and involves rituals to relieve them from anxiety-inducing thought processes. Only 20% of those with OCD also have OCPD.



 





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