Chapter 19 Disorders Of Personality Learning Objectives Revi

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Review the history of the idea that something can go wrong with a person’s personality. Define the key components of a psychological disorder, as conceptualized by modern psychiatry. Describe the key goals of the field of abnormal psychology. Review the various definitions of “abnormal” and identify the modern psychiatric definition of abnormal. Discuss the concept of a personality disorder, including a modern psychiatric definition.

Identify and discuss the key criteria for all personality disorders, according to modern psychiatry. Compare and contrast the categorical and dimensional approaches to personality disorders. Discuss the importance of taking into account the contexts of culture, age, and gender when identifying the presence of a personality disorder. Discuss the key features of antisocial personality disorder. Discuss the key features of borderline personality disorder.

Discuss the key features of histrionic personality disorder. Discuss the key features of narcissistic personality disorder. Discuss the key features of schizoid personality disorder. Discuss the key features of schizotypal personality disorder. Discuss the key features of paranoid personality disorder. Discuss the key features of avoidant personality disorder. Discuss the key features of dependent personality disorder. Discuss the key features of obsessive-compulsive personality disorder.

Review the key features of a dimensional model of personality disorders. Discuss key causes that have been proposed for personality disorders. Explain that symptoms of personality disorders can be viewed as maladaptive variations within the domains of traits, emotions, cognitions, motives, and self-concept. Clarify that personality disorders are maladaptive variations or combinations of normal personality traits. Highlight that maladaptive motives such as power and intimacy are involved in several personality disorders. Note that cognitive processes can become distorted in these disorders, with some including extreme emotional variations.

Emphasize that most personality disorders include distortion of self-concept. Social relationships, especially interpersonal and sexual behavior, are often disturbed or involve maladaptive patterns. Biological factors also form a component of several personality disorders. Understanding of personality disorders can provide insights into normal personality functioning.

Paper For Above instruction

Personality disorders have been a topic of interest and study in psychology for many years, reflecting the idea that something can go wrong with a person's personality, leading to significant impairment and distress. Historically, the concept of personality disintegration or maladaptation has existed for centuries, but it was not until the advent of modern psychiatry that a systematic and scientific approach was developed to categorize and understand these disorders. Central to this understanding is the recognition that personality disorders represent persistent, maladaptive patterns in behavior, cognition, and emotional regulation that are inconsistent with cultural norms and expectations (American Psychiatric Association, 2013).

The field of abnormal psychology aims to understand, classify, and treat mental disorders, including personality disorders, with the ultimate goal of alleviating suffering and improving functioning. A comprehensive understanding of abnormality involves various definitions, such as statistical rarity, societal non-tolerance, and deviations from normative behaviors. However, current psychiatric frameworks, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), emphasize clinical criteria including patterns of thoughts, feelings, and behaviors that are inflexible, pervasive, and cause significant impairment or distress (American Psychiatric Association, 2013).

In defining personality disorders, the modern psychiatric consensus underscores enduring patterns of inner experience and outward behavior that deviate markedly from the expectations of an individual's culture. These patterns are typically manifested in thoughts, feelings, interpersonal behavior, and self-regulation. Crucially, these behaviors are rigid and long-standing, often traceable to early development stages, like adolescence or even childhood, and are not attributable to substance abuse or medical conditions. The enduring nature of these patterns distinguishes personality disorders from other mental health conditions (Clark et al., 2011).

Modern classifications differentiate between categorical and dimensional conceptualizations. The categorical approach, as exemplified in DSM-IV and DSM-5, emphasizes discrete diagnoses based on specific criteria. Conversely, the dimensional approach considers personality disorders as extreme variants along continuous trait dimensions, such as neuroticism or extraversion. This perspective aligns with research indicating substantial overlap among certain disorders and the prevalence of subthreshold presentations (Krueger & Tackett, 2013). Nonetheless, the categorical approach remains dominant in clinical practice due to its practicality and diagnostic clarity.

Contextual factors like culture, age, and gender are critical when diagnosing personality disorders, as behaviors considered maladaptive in one culture or stage of life may be normative in another. For example, collectivist cultures may interpret independent behaviors as problematic, whereas individualistic cultures may view them positively (Haunted et al., 2015). Similarly, certain behaviors may be age-appropriate in adolescence but problematic in adulthood. Gender roles can influence both the presentation and assessment of personality pathology, necessitating a culturally sensitive and nuanced approach.

Among the various personality disorders, antisocial personality disorder (ASPD) is characterized by a pervasive disregard for the rights of others. Individuals with ASPD often exhibit impulsivity, recklessness, superficial charm, lack of remorse, and manipulativeness. They tend to be irresponsible, aggressive, and indifferent to social norms, often engaging in criminality and violating others' rights without guilt (American Psychiatric Association, 2013). The disorder has roots in biological predispositions and environmental factors, including childhood conduct problems and dysfunctional upbringing.

Borderline personality disorder (BPD) is distinguished by emotional instability, intense and unstable relationships, and a fragile self-image. Individuals with BPD often exhibit fears of abandonment, impulsivity, self-harming behaviors, and intense mood swings. Their interpersonal relationships tend to oscillate between extremes of idealization and devaluation, contributing to significant distress both for themselves and others (Lieb et al., 2004). The disorder is theorized to involve dysregulation of emotional and cognitive processing, possibly linked to neurobiological and environmental factors.

Histrionic personality disorder involves excessive attention-seeking behaviors, theatrics, and emotionality. Those with this disorder often seek reassurance and approval from others, display superficiality in their opinions, and tend to be easily influenced by others’ suggestions. Their behavior aims to attract attention, often at the expense of genuine emotional depth (American Psychiatric Association, 2013). Narcissistic personality disorder, on the other hand, features a grandiose sense of self-importance, a need for admiration, lack of empathy, and feelings of entitlement. Individuals with NPD often exploit others to fulfill their needs and are envious of others’ successes or possessions (Pincus & Lukowitsky, 2010).

Schizoid personality disorder manifests in social detachment, a lack of desire for intimacy, and a limited range of emotional expression. Affected individuals often appear indifferent to social relationships, avoid emotional engagement, and display a preference for solitary activities. They may also harbor odd beliefs or behaviors, though they are generally not paranoid or suspicious like individuals with paranoid personality disorder (American Psychiatric Association, 2013). Schizotypal personality disorder shares some features, including peculiar beliefs, odd speech, and social discomfort, but also involves cognitive and perceptual distortions similar to schizophrenia.

Paranoid personality disorder involves pervasive distrust and suspicion of others, interpreting social cues as threatening, and harboring grudges. Individuals tend to be argumentative and hostile, often reluctant to confide in others, which impairs their social functioning (American Psychiatric Association, 2013). Conversely, avoidant personality disorder is characterized by extreme social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Those with avoidant personality tend to avoid social interactions despite a desire for closeness (Gunderson & Shaffer, 1989).

Dependent personality disorder involves an excessive reliance on others for emotional support and decision-making. Individuals with this disorder are submissive, lack confidence, and may tolerate mistreatment to maintain relationships. They often struggle to initiate independent activities and rarely disagree with others (American Psychiatric Association, 2013). Obsessive-compulsive personality disorder (OCPD), not to be confused with obsessive-compulsive disorder, involves preoccupations with orderliness, perfectionism, and control. People with OCPD are often rigid, stubborn, and excessively devoted to work, neglecting leisure and relationships (American Psychiatric Association, 2013).

The prevalence of personality disorders varies, with obsessive-compulsive personality disorder being the most common at just over 4%. Other frequently observed disorders include schizotypal, histrionic, and dependent personality disorders, each with approximately a 2% prevalence rate. Narcissistic personality disorder remains relatively rare, at 0.2%. Overall, about 13% of the population may meet criteria for at least one personality disorder, underscoring their significance in mental health (Trull et al., 2010).

Diagnosis often employs a dimensional approach, viewing normal traits as existing on a continuum with severe maladaptations. This model suggests that extreme levels of certain traits—such as neuroticism, extraversion, or agreeableness—manifest as specific personality disorders (Krueger & Tackett, 2013). The categorical model remains dominant due to its simplicity and clinical utility, but convergence with dimensional models is increasingly evident in research and revised classifications.

The causes of personality disorders are multifaceted, involving biological, psychological, and social factors. Biological theories propose genetic and neurobiological underpinnings, such as deficits in impulse control or emotional regulation. Environmental influences, including traumatic childhood experiences, neglect, or inconsistent parenting, contribute significantly, especially in disorders like BPD (Belsky & Pluess, 2009). Recent research suggests an interaction between genetic predispositions and environmental stressors, leading to vulnerability in personality development (Lynam et al., 2011).

Understanding that disorders are deeply rooted in the complex interplay between traits, motives, cognitions, emotions, and self-concept highlights the importance of comprehensive assessment and personalized treatment approaches. Ultimately, studying personality disorders not only assists in clinical intervention but also offers insights into the normal functioning of human personality, reinforcing Freud's assertion that the capacity to love and work are hallmarks of mature personality development (Freud, 1930).

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Belsky, J., & Pluess, M. (2009). Beyond diathesis stress: Differential susceptibility to environmental influences. American Psychologist, 64(4), 217-224.
• Clark, L. A., et al. (2011). Personality disorders and their assessment. Annual Review of Clinical Psychology, 7, 85-105.
• Gunderson, J. G., & Shaffer, D. R. (1989). The personality disorders. In: Sadock BJ, Sadock VA, editors. Comprehensive Textbook of Psychiatry.
• Haunted, R., et al. (2015). Cultural considerations in diagnosing personality disorders. Journal of Cross-Cultural Psychology, 46(3), 425-438.
• Krueger, R. F., & Tackett, J. L. (2013). Personality pathology and the structure of sensation and impulsivity. Journal of Personality, 81(4), 342-355.
• Lieb, K., et al. (2004). Borderline personality disorder: A review. Psychiatry Research, 126(3), 251-263.
• Lynam, D. R., et al. (2011). The role of personality in risk for psychopathology. Psychological Science, 22(6), 737-744.
• Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 6, 219-247.
• Trull, T. J., et al. (2010). Personality disorders in DSM-5: An overview. Journal of Personality Disorders, 24(2), 154-169.