It explains about what is personality, give a brief introduction about personality disorder, describes three clusters of personality disorder with detailed explanations about the 10 personality disorder starting from cluster A disorder paranoid personality disorder to anti social personality disorder from cluster B to Obsessive compulsive personality disorder
4. According to Gordon Allport (1937),
“Personality is the dynamic organisation
within the individual of those psycho-
physical systems that determine his unique
adjustment to his environment”
5. PERSONALITY DISORDERS
Personality disorders are diagnosed when personality traits
become
Inflexible (unwilling to change) and
maladaptive and
significantly interfere with how a person functions in
society or
cause the person emotional distress – emotional
sufferings like Dx or Anxiety.
6. Clinical features of personality
disorders
According to general DSM-5 criteria for diagnosing a
personality disorder,
the person’s enduring pattern of behavior must be
pervasive and inflexible,
as well as stable and of long duration.
It must also cause either clinically significant distress
or impairment in functioning and be manifested in at
least two of the following areas: cognition, affectivity,
interpersonal functioning, or impulse control.
7. Contd….
Personality disorders typically do not stem from
debilitating reactions to stress in the recent past, as do
posttraumatic stress disorder (PTSD) or many cases of
major depression.
Rather, these disorders stem largely from the gradual
development of inflexible and distorted personality and
behavioral patterns that result in persistently maladaptive
ways of perceiving, thinking about, and relating to the
world.
8.
9. Cluster A: Odd &
Eccentric(unconventional)
Includes
paranoid,
schizoid, and
schizotypal personality disorders.
People with these disorders often seem odd or eccentric,
with unusual behavior ranging from distrust and
suspiciousness to social detachment
10. Cluster B: Dramatic, emotional &
Erractic
Includes
histrionic,
narcissistic,
antisocial, and
borderline personality disorders.
Individuals with these disorders share a tendency
to be dramatic, emotional, and erratic.
11. Cluster C: ANXIOUS & FEARFUL
Includes
avoidant,
dependent, and
Obsessive compulsive personality disorders.
In contrast to the other two clusters, people with these
disorders often show anxiety and fearfulness
15. Individuals with paranoid personality disorder have a pervasive
suspiciousness and distrust of others, leading to numerous interpersonal
difficulties.
They tend to see themselves as blameless, instead blaming others for their
own mistakes and failures—even to the point of ascribing evil motives to
others.
They are often preoccupied with doubts about the loyalty of friends and
hence are reluctant to confide in others.
They commonly bear grudges, refuse to forgive perceived insults and slights,
and are quick to react with anger and sometimes violent behavior.
16. Criteria for Paranoid Personality
Disorder
A. A pervasive distrust and suspiciousness of others such that their
motives are interpreted as malevolent, beginning by early adulthood
and present in a variety of contexts, as indicated by four (or more) of
the following:
1. Suspects, without sufficient basis, that others are exploiting,
harming, or deceiving him or her.
2. Is preoccupied with unjustified doubts about the loyalty or
trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear
that the information will be used maliciously against him or her
17. Contd..
4. Reads hidden demeaning or threatening meanings into benign remarks
or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or
slights).
6. Perceives attacks on his or her character or reputation that are not
apparent to others and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of
spouse or sexual partner
B. Does not occur exclusively during the course of schizophrenia, a bipolar
disorder or depressive disorder with psychotic features, or another psychotic
disorder and is not attributable to the physiological effects of another
medical condition.
18. Contd…
Note: If criteria are
met prior to the onset
of schizophrenia, add
“premorbid,” i.e.,
“paranoid personality
disorder
(premorbid).”
19. Contd..
More common in men than in women
Treatments
Psychotherapy –
Interpersonal psychotherapy
Psychoanalytical psychotherapy
Group therapy
Behavioral therapy
Psychopharmacology •
Antipsychotics for psychotic symptoms
22. Individuals with schizoid personality disorder are usually unable to form
social relationships and usually lack much interest in doing so.
Consequently, they tend not to have good friends, with the possible exception
of a close relative.
Such people are unable to express their feelings and are seen by others as
cold and distant.
They often lack social skills and can be classified as loners or introverts, with
solitary interests and occupations, although not all loners or introverts have
schizoid personality disorder.
23. People with this disorder tend not to take pleasure in many activities,
including sexual activity, and rarely marry.
27. A pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings,
beginning by early adulthood and present in a variety of contexts, as
indicated by four (or more) of the following
Neither desires nor enjoys close relationships, including being part of a
family.
Almost always chooses solitary activities.
Has little, if any, interest in having sexual experiences with another
person.
Takes pleasure in few, if any, activities
Lacks close friends or confidants other than first-degree relatives.
Appears indifferent to the praise or criticism of others.
Shows emotional coldness, detachment, or flattened affectivity.
28. Contd…
B. Does not occur exclusively during the course of
schizophrenia, a bipolar disorder or depressive disorder
with psychotic features, another psychotic disorder, or
autism spectrum disorder and is not attributable to the
physiological effects of another medical condition.
Note: If criteria are met prior to the onset of
schizophrenia, add “premorbid,” i.e., “schizoid
personality disorder (premorbid).”
30. Difference between schizoid and
avoidant personality disorder
Avoidant personality disorder shares the symptom of lack of
social contact with schizoid and schizotypal disorders, but
the reasons for that lack of contact are very different:
The avoidant person wants social contact but is afraid
of rejection, whereas the schizoid or schizotypal person
is completely indifferent to such contact.
33. Individuals with schizotypal personality disorder
are also excessively introverted and have
pervasive social and interpersonal deficits (like
those that occur in schizoid personality
disorder), but in addition they have cognitive
and perceptual distortions, as well as oddities
and eccentricities in their communication and
behavior.
Cognitive distortions are thoughts that cause
individuals to perceive reality inaccurately.
34. criteria for Schizotypal Personality
Disorder
. A pervasive pattern of social and interpersonal deficits marked
by acute discomfort with, and reduced capacity for, close
relationships as well as by cognitive or perceptual distortions
and eccentricities of behavior, beginning by early adulthood and
present in a variety of contexts, as indicated by five (or more)
of the following:
Ideas of reference* (excluding delusions of reference).
Odd beliefs or magical thinking that influences behavior and
is inconsistent with subcultural norms (e.g.,
superstitiousness, belief in clairvoyance, telepathy, or “sixth
sense”; in children and adolescents, bizarre fantasies or
preoccupations).
35. idea of reference
An idea of reference—sometimes called a delusion of reference—is the false belief that
irrelevant occurrences or details in the world relate directly to oneself.
Example:
• Bob believes every time a certain song plays on the radio, his long-lost lover is thinking
about him.
• Ken walks past a group of teens while walking through the mall food court. He hears them
laugh a few seconds after he passes. He is convinced they were laughing at him.
Jennifer thinks everybody is staring and judging the food choices she
makes while at the grocery store. Because of this, she only shops late
at night when there aren't many people out shopping.
36. Contd….
Unusual perceptual experiences, including bodily
illusions.
Odd thinking and speech (e.g., vague, circumstantial,
metaphorical, overelaborate, or stereotyped)
Suspiciousness or paranoid ideation.
Inappropriate or constricted affect.
Behavior or appearance that is odd, eccentric, or
peculiar.
Lack of close friends or confidants other than first-
degree relatives.
37. Contd…
Excessive social anxiety that does not diminish with
familiarity and tends to be associated with paranoid fears
rather than negative judgments about self
B. Does not occur exclusively during the course of schizophrenia,
a bipolar disorder or depressive disorder with psychotic features,
another psychotic disorder, or autism spectrum disorder.
Note: If criteria are met prior to the onset of schizophrenia, add
“premorbid,” e.g., “schizotypal personality disorder
(premorbid).”
41. criteria for Histrionic Personality
Disorder
A pervasive pattern of excessive emotionality and attention
seeking, beginning by early adulthood and present in a
variety of contexts, as indicated by five (or more) of the
following:
Is uncomfortable in situations in which he or she is not
the center of attention.
Interaction with others is often characterized by
inappropriate sexually seductive or provocative behavior.
Displays rapidly shifting and shallow expression of
emotions.
Consistently uses physical appearance to draw attention
to self.
42. Contd….
Has a style of speech that is excessively
impressionistic and lacking in detail.
Shows self-dramatization, theatricality, and
exaggerated expression of emotion.
Is suggestible (i.e., easily influenced by others
or circumstances).
Considers relationships to be more intimate
than they actually are
46. criteria for Narcissistic Personality
DisordeR
A pervasive pattern of grandiosity (in fantasy or
behavior), need for admiration, and lack of empathy,
beginning by early adulthood and present in a variety
of contexts, as indicated by five (or more) of the
following:
1. Has a grandiose sense of self-importance (e.g.,
exaggerates achievements and talents, expects to
be recognized as superior without commensurate
achievements).
2. Is preoccupied with fantasies of unlimited
success, power, brilliance, beauty, or ideal love.
47. Delusions of Grandeur
Grandiose delusions are one of the most common types of delusions in bipolar
disorder. Examples of grandiosity include:
• Exaggerating your own achievements
• Criticizing and dismissing other's achievements or talents
• Constantly boasting and talking about yourself
For example, you may believe that you:
• Are a multimillionaire
• Found a cure for cancer
• Are related to a Hollywood celebrity
48. Contd….
Has a sense of entitlement (i.e., unreasonable
expectations of especially favourable treatment or
automatic compliance with his or her expectations).
Is interpersonally exploitative (i.e., takes advantage of
others to achieve his or her own ends).
Lacks empathy: is unwilling to recognize or identify
with the feelings and needs of others.
Is often envious of others or believes that others are
envious of him or her.
Shows arrogant, haughty behaviors or attitudes
52. Conduct disorder
Conduct disorder is a
type of behavior disorder.
It's when a child has
antisocial behaviuor. He
or she may disregard
basic social standards
and rules. He or she may
also: Be irresponsible.
53. Clinical Features of Conduct Disorder
Four types of symptoms of conduct disorder are
recognized:
(1) Aggression or serious threats of harm to people or
animals;
(2) Deliberate property damage or destruction (e.g.,
fire setting, vandalism);
(3) Repeated violation of household or school rules,
laws, or both; and
(4) Persistent lying to avoid consequences or to obtain
tangible goods or privileges.
54. Criteria for Anti-social behaviour
1. A pervasive pattern of disregard for and violation of the rights of others, since age 15
years, as indicated by three (or more) of the following:
1. Failure to conform to social norms concerning lawful behaviors, such as performing acts that
are grounds for arrest.
2. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
3. Impulsivity or failure to plan.
4. Irritability and aggressiveness, often with physical fights or assaults.
5. Reckless disregard for the safety of self or others.
6. Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary
obligations.
7. Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from
another person.
55. Contd…
1. The individual is at least age 18 years.
2. Evidence of conduct disorder typically with onset before age 15 years.
3. The occurrence of antisocial behaviour is not exclusively during schizophrenia or
bipolar disorder."
58. criteria for Borderline Personality
Disorder
A pervasive pattern of instability of interpersonal relationships,
self-image, and affects, and marked impulsivity, beginning by
early adulthood and present in a variety of contexts, as indicated
by five (or more) of the following:
1. Frantic efforts to avoid real or imagined abandonment. (Note:
Do not include suicidal or self-mutilating behaviour covered in
Criterion 5.)
2. A pattern of unstable and intense interpersonal relationships
characterized by alternating between extremes of idealization and
devaluation.
3. Identity disturbance: markedly and persistently unstable self
image or sense of self
59. Cont…..
4. Impulsivity in at least two areas that are potentially self
damaging (e.g., spending, sex, substance abuse, reckless
driving, binge eating). (Note: Do not include suicidal or self
mutilating behavior covered in Criterion 5.)
5. Recurrent suicidal behavior, gestures, or threats, or self
mutilating behavior.
6. Affective instability due to a marked reactivity of mood
(e.g., intense episodic dysphoria, irritability, or anxiety usually
lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger
(e.g., frequent displays of temper, constant anger, recurrent
61. People with Cluster C personality disorders often show anxiety and
fearfulness. These are characteristics that we do not see in the other two
clusters. I
65. criteria for Avoidant Personality
DisordeR
A pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation,
beginning by early adulthood and present in a variety of
contexts, as indicated by four (or more) of the following:
1. Avoids occupational activities that involve significant
interpersonal contact because of fears of criticism,
disapproval, or rejection.
2. Is unwilling to get involved with people unless certain
of being liked.
3. Shows restraint within intimate relationships because
of the fear of being shamed or ridiculed.
66. Cont…..
4. Is preoccupied with being criticized or rejected
in social situations.
5. Is inhibited in new interpersonal situations
because of feelings of inadequacy.
6. Views self as socially inept, personally
unappealing, or inferior to others.
7. Is unusually reluctant to take personal risks or to
engage in any new activities because they may
prove embarrassing
69. criteria for Dependent Personality
Disorder
A pervasive and excessive need to be taken care of that
leads to submissive and clinging behavior and fears of
separation, beginning by early adulthood and present in a
variety of contexts, as indicated by five (or more) of the
following:
1. Has difficulty making everyday decisions without an
excessive amount of advice and reassurance from others.
2. Needs others to assume responsibility for most major
areas of his or her life.
3. Has difficulty expressing disagreement with others
because of fear of loss of support or approval. (Note: Do not
include realistic fears of retribution.)
70. Contd….
4. Has difficulty initiating projects or doing things on his or her
own (because of a lack of self-confidence in judgment or abilities
rather than a lack of motivation or energy).
5. Goes to excessive lengths to obtain nurturance and support
from others, to the point of volunteering to do things that are
unpleasant.
6. Feels uncomfortable or helpless when alone because of
exaggerated fears of being unable to care for himself or herself.
7. Urgently seeks another relationship as a source of care and
support when a close relationship ends.
8. Is unrealistically preoccupied with fears of being left to take
care of himself or herself
73. criteria for Obsessive-Compulsive
Personality DisordeR
A pervasive pattern of preoccupation with orderliness, perfectionism,
and mental and interpersonal control, at the expense of flexibility,
openness, and efficiency, beginning by early adulthood and present in
a variety of contexts, as indicated by four (or more) of the following:
1. Is preoccupied with details, rules, lists, order, organization, or
schedules to the extent that the major point of the activity is lost.
2. Shows perfectionism that interferes with task completion (e.g.,
is unable to complete a project because his or her own overly
strict standards are not met)
3. Is excessively devoted to work and productivity to the
exclusion of leisure activities and friendships (not accounted for
by obvious economic necessity)
74. Contd…..
4. Is overconscientious, scrupulous, and inflexible about
matters of morality, ethics, or values (not accounted for by
cultural or religious identification).
5. Is unable to discard worn-out or worthless objects even
when they have no sentimental value.
6. Is reluctant to delegate tasks or to work with others
unless they submit to exactly his or her way of doing things.
7. Adopts a miserly spending style toward both self and
others; money is viewed as something to be hoarded for
future catastrophes.
8. Shows rigidity and stubbornness
75. General Sociocultural Causal Factors
for Personality Disorders
Personality is the combination of thoughts, emotions and behaviors that makes
you unique. It's the way you view, understand and relate to the outside world,
as well as how you see yourself. Personality forms during childhood, shaped
through an interaction of:
• Your genes. Certain personality traits may be passed on to you by your
parents through inherited genes. These traits are sometimes called your
temperament.
• Your environment. This involves the surroundings you grew up in, events that
occurred, and relationships with family members and others.
76. Individualistic Vs collectivistic culture
There is some evidence that narcissistic
personality disorder is more common in
Western cultures, where personal ambition and
success are encouraged and reinforced (e.g.,
Widiger & Bornstein, 2001).
There is also some evidence that histrionic
personality might be expected to be (and is)
less common in Asian cultures.
77. Treatments and Outcomes
for Personality Disorders
Personality disorders are generally very difficult to treat, in
part because they are, by definition, relatively enduring,
pervasive, and inflexible patterns of behavior and inner
experience.
Goals might include reducing subjective distress, changing
specific dysfunctional behaviors, and changing whole
patterns of behavior or the entire structure of the
personality.
In many cases, people with personality disorders enter
treatment only at someone else’s insistence, and they often
do not believe that they need to change.
78. Adapting Therapeutic Techniques to
Specific Personality Disorders
For people with severe personality disorders,
therapy may be more effective in situations
where acting-out behavior can be constrained.
80. Of all personality disorders, most clinical and
research attention has been paid to the treatment of
BPD.
This is due to the severity of this disorder and the
high risk of suicide that is associated with it.
Treatment often involves both psychological and
biological treatment approaches, with medications
being used as an adjunct to psychological treatment,
which is considered essential
81. Biological Treatments
The use of medications is controversial with this disorder
because it is so frequently associated with suicidal behavior.
Today, antidepressant medications (most often from the
SSRI – Selective serotonin reuptake inhibitors) category) are
considered most safe and useful for treating rapid mood
shifts, anger, and anxiety
. In addition, low doses of antipsychotic medication have
modest effects that are broad based; that is, patients show
some improvement in depression, anxiety, suicidality,
impulsive aggression, rejection sensitivity, and especially
transient psychotic symptoms and cognitive and perceptual
distortions
82. Contd…
However, the consensus to date is that drugs are only
mildly beneficial for BPD
83. Psychosocial Treatments
Clinical trials suggest that several types of
psychotherapy may be effective for BPD.
However, these treatments share two common
weaknesses.
These are their relative complexity and
long duration, both of which makes them
difficult to disseminate to the broader
population
85. Dialectical behavior therapy
Developed by Marsha Linehan, is a unique kind of cognitive
and behavioral therapy specifically adapted for BPD
He believes that patients’ inability to tolerate strong states
of negative affect is central to this disorder. One of the
primary goals of treatment is to encourage patients to
accept this negative affect without engaging in self-
destructive or other maladaptive behaviors.
Accordingly, Linehan has developed a problem-focused
treatment based on a clear hierarchy of goals, which
prioritizes decreasing suicidal and self-harming behavior
and increasing coping skills.
86. Dialectical Behavior Therapy Techniques
Settings in which DBT are often used include:
• Group therapy where patients are taught behavioral skills
in a group setting.
• Individual therapy with a trained professional where a
patient's learned behavioral skills are adapted to their
personal life challenges.
• Phone coaching in which patients can call the
therapist between sessions to receive guidance on coping
with a difficult situation they are currently in.
87. Other Techniques
Core Mindfulness
Mindfulness helps you focus on the present
or "live in the moment." This helps you pay
attention to what is happening inside you
(your thoughts, feelings, sensations, and
impulses) as well as using your senses to
tune in to what's happening around you
(what you see, hear, smell, and touch) in
nonjudgmental ways.
The strategy can also help you stay calm
and avoid engaging in automatic negative
thought patterns and impulsive behavior.
88. Distress Tolerance
Distress tolerance skills help you accept yourself and your
current situation. DBT teaches several techniques for
handling a crisis, including:
• Distraction
• Improving the moment
• Self-soothing
• Thinking of the pros and cons of not tolerating distress
Distress tolerance techniques help prepare you for intense
emotions and empower you to cope with them with a more
positive long-term outlook.
89. Interpersonal Effectiveness
Interpersonal effectiveness helps you to become more
assertive in a relationship (for example, expressing your
needs and be able to say "no") while still keeping a
relationship positive and healthy. You will learn to listen
and communicate more effectively, deal with challenging
people, and respect yourself and others.
90. Emotion Regulation
Emotion regulation lets you navigate powerful feelings in a
more effective way. The skills you learn will help you to
identify, name, and change your emotions.6
When you are able to recognize and cope with intense
negative emotions (for example, anger), it reduces your
emotional vulnerability and helps you have more positive
emotional experiences.
91. Effectiveness of Dialectical Behavior
Therapy
For BPD: Studies have found that DBT is effective in the
treatment of borderline personality disorder (BPD) and
reducing suicide risk in individuals with BPD. One study
found that after a year of treatment, more than 75% of
people with BPD no longer met the diagnostic criteria for
the condition.
92. Treating Other Personality Disorders
Cluster A – psychoactive drugs likes SSRI, antipsychotic
drugs, Antidepressants for schizotypal personality disorder
Other than uncontrolled studies or single cases, no
systematic, controlled studies of treating people with either
medication or psychotherapy yet exist for paranoid,
schizoid, narcissistic, or histrionic disorder .
One reason for this is that these people (because of the
nature of their personality pathology) rarely seek treatment
Cluster C disorders using a form of short-term psychotherapy
that is active and confrontational like CBT
96. Psychopathic traits include antisocial behaviors, lack of
empathy, disregard for others, and narcissism. While such
traits might indicate that someone is high in psychopathy,
this does not necessarily mean that they are a psychopath.
97. Is There a Psychopath Test?
While there may be plenty of free "psychopath tests"
floating around on the internet, two tests that are most
often used are the Psychopathy Checklist-Revised (PCL-R)
and the Psychopathic Personality Inventory (PPL).
98. Signs of a Psychopath
Psychopathic traits may emerge during childhood and grow
worse over time.5 The following are some of the most common
signs of a psychopath.
