personality disorders by dr. raja roy choudhury. what is personality? “you have a strong need for...
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Personality Disorders
BYDR. RAJA ROY CHOUDHURY
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What is Personality?
“You have a strong need for other people to like & admire you. You have a tendency to be critical of yourself. You have a great deal of unused capacity, which you have not turned to your advantage… disciplined & controlled on the outside, you tend to be worrisome & insecure inside…at times, you’re extraverted, affable, & sociable; at other times, you’re introverted, wary, & reserved”
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Personality
• Unique, relatively consistent pattern of thinking, feeling and behaving.
• It is how you handle situations, yoursense of humor, or your expectations of others
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Psychoanalytic approach
• Sigmund Freud (1856 – 1939)– Josef Breuer’s “talking cure”.
– Individuals are ruled by unconscious forces, they resist painful insights, and that transfer feelings for one object to another.
– Iceberg Metaphor.
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Freud’s Structure of Personality
Conscious—Acuteawareness
Preconscious—Justunder awareness;easily known
Unconscious—Wellbelow awareness;Difficult to know but very influential
Sup
ere
go
Consciousness
Ego
Id
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Psychoanalytic Approach
• Personality is result of the battle for control between id, ego & superego
• Defense mechanisms (or defense mechanisms) are unconscious psychological strategies brought into play by various entities to cope with reality and to maintain self-image.
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Freud’s Psychosexual Stages of Development
• Oral (Birth to 1½ years)
• Anal (1½ to 3 years)
• Phallic (3 to 6 years)
• Latency (6 years to puberty)
• Genital (puberty – adulthood)
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Allport’s Trait Theory
• Trait– Relatively enduring, consistent personality characteristics -
inferred from behavior
• 3 types of traits– Cardinal traits
– Central traits
– Secondary traits
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Type theories
• 5-factor model of personality– 5 different dimensions determines personality type
– Dimensions• Openness to experience
• Conscientiousness
• Extraversion
• Agreeableness
• Neuroticsm
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Behaviorist perspective
• Albert Bandura– Self Efficacy: The more influence a person thinks they have
on a behavior, the more likely they are to engage in it, especially to the degree that it has positive outcomes.
• Mischel– Situational specificity– Interactionism: both traits and situations interact to
produce behavior, thoughts
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Humanist Perspective
• Focuses on the positive aspects of being human (e.g., goodness, creativity, free will)
• Rogers: Person-centered therapy
• Congruence vs. incongruence
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Personality in the contemporary era
• The challenges faced in the current era is different.
• They exert a pressure on the shaping of personality.
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Factors influencing the development of personality
• Parenting styles and parental values.
• New and advanced technology.
• Need for achievement.
• Cut-throat competition.
• Societal pressures.
• Value system.
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Personality Disorder
Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning.
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DSM IV Criteria for Personality Disorder
• An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. Manifested in two or more of the following:
Cognition Affectivity Interpersonal functioning Impulse control
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DSM IV General Criteria for Personality Disorder
• Pattern is inflexible and pervasive across a broad range of personal and social situations
• Pattern leads to clinically significant impairment or distress
• Pattern is stable and of long duration and onset can be traced to adolescence or early childhood
• Maladaptive behavior leads to poor life functioning
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DSM IV General Criteria for Personality Disorder
• Pattern not better accounted for as a manifestation of another disorder
• Not due to substance or Medical Condition (e.g., head trauma)
• Ego syntonic (feels like a normal part of oneself, and that others are the root of all problems)
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Disorder Vs. Trait
• Conscientiousness and scrupulosity in small doses is advantageous (trait).
• In the extreme, leads to paralyzing over attention to detail with interferes with finishing tasks (disorder).
• Some traits are maladaptive at either extreme:– Too little trust: paranoid– Too much trust: gullibility leading to being taken advantage of
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The history of personality disorders
• The Greek and Roman Gods and Goddess were the personality disorder types of the ancient world.
• Most of the disorders describe their traits.
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Paranoid personality disorder.
• Hera-Juno, Wife of Zeus- Queen of the gods• Archetype of the suspicious Paranoid.
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Paranoid personality disorder
Pervasive distrust and suspiciousness, sees motives of
others as malevolent.
• Suspects, without sufficient basis, that others are
exploiting, harming, or deceiving him or her
• Preoccupied with unjustified doubts about the
loyalty or trustworthiness of friends or associates
• Reluctant to confide in others due to lack of trust
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Paranoid personality disorder
• Persistently bears grudges, i.e., is unforgiving of insults,
injuries, or slights.
• Reads hidden demeaning or threatening meanings into benign
remarks/events.
• Perceives attacks on character that are not apparent to others
and responds with counterattacks.
• Has recurrent suspicions, without justification, regarding
fidelity of spouse or sexual partner.
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Schizoid personality disorder
• Athena-Minerva - Virgin goddess of wisdom. • She had a Schizoid aspect to her personality.
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Schizoid personality disorder
Pervasive detachment from social relationships and a
restricted range of emotional expression interpersonally.
• Neither desires nor enjoys close relationships,
including being part of a family
• Almost always chooses solitary activities
• Exhibits little interest in having sexual experiences
with another person.
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Schizoid personality disorder
• Takes pleasure in few, if any, activities.
• Lacks close friends or confidants.
• Appears indifferent to the praise or criticism of
others.
• Emotionally cold, detached.
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Schizotypal personality disorder
• Artemis- twin sister of Apollo.
• She is a goddess of transitions, a hunter, a virgin, and
one of the goddesses who assists at childbirth
• Most often off by her self in her Schizotypal world of
wild things and strange thoughts.
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Schizotypal personality disorder
Exhibit little capacity for close relationships accompanied by
cognitive or perceptual disturbances and eccentricities of
behavior
• Ideas of reference
• Odd beliefs or magical thinking, inconsistent with cultural
norms
• Unusual perceptual experiences, including bodily illusions
• Excessive social anxiety related to paranoid fears.
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Schizotypal personality disorder
• Odd thinking and speech (e.g. vague,
circumstantial,metaphorical,over elaborate)
• Suspiciousness or paranoid ideation
• Inappropriate or constricted affect
• Behavior or appearance that is odd, eccentric, or
peculiar
• Lack of close friends or confidants
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Antisocial personality disorder
• Ares - war god and god of violence • He was not well-liked or trusted by the ancient
Greeks• He does not care who suffers from his violent
behavior.
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Antisocial personality disorder
Pervasive pattern of disregard for and violation of
rights of others since age 15.
• Repeatedly breaking the law
• Deceitfulness - repeated lying, use of aliases,
conning others for personal profit or pleasure
• Impulsivity or failure to plan ahead
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Antisocial personality disorder
• Irritability and aggressiveness, as indicated by repeated
physical fights or assaults
• Reckless disregard for safety of self or others
• Consistent irresponsibility - inconsistent work behavior,
doesn’t pay bills/debts
• Lack of remorse, as indicated by being indifferent to or
rationalizing having hurt, mistreated, or stolen from
another
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Antisocial personality disorder
• The individual is at least age 18 years.• ASPD vs. criminality– “criminal” is a legal term denoting conviction for
breaking a law:• Not all people with ASPD are criminals (or in jails)• Not all people with ASPD are psychopaths
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Antisocial personality disorder
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Borderline personality disorder
• Aphrodite- Goddess of beauty, love, and sexuality
• Has love affairs with gods and mortals.• Archetype of a love addicted Borderline.
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Borderline personality disorder
Pervasive instability of interpersonal relationships, self-
image and affect with marked impulsivity by early
adulthood.
• Frantic efforts to avoid real or imagined abandonment
• Pattern of intense and unstable interpersonal
relationships, alternating between extremes of
idealization and devaluation
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Borderline personality disorder
• Identity disturbance: markedly and persistently
unstable self-image or sense of self
• Impulsivity in at least two potentially self-
damaging areas (sex, spending, substance abuse,
reckless driving, binge eating)
• Recurrent suicidal behavior, gestures, or threats,
or self-mutilating behavior
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Borderline personality disorder
• Chronic feelings of emptiness
• Inappropriate and intense anger
• Transient, stress-related paranoid ideation or
severe dissociative symptoms.
• Affective instability with marked reactivity of
mood, lasting few hours to few days
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Histrionic personality disorder
• Hermes- the messenger god.• Tricking the other gods and sometimes making
a public show of himself.
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Histrionic personality disorder
Pervasive excessive emotionality and attention seeking.
• 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
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Histrionic personality disorder
• Displays rapidly shifting and shallow expression of
emotions
• Consistently uses physical appearance to draw attention
to self
• Has a style of speech that is excessively impressionistic
and lacking in detail
• Shows self-dramatization, theatricality, and exaggerated
expression of emotion
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Histrionic personality disorder
• Suggestible, i.e., easily influenced by others.
• Considers relationships to be more intimate than they
actually are.
• Inability to maintain deep, long-lasting attachments
• Exaggeration of thoughts and feelings - everything is
catastrophic or of extreme importance.
• Endless need for reassurance
• Superficial relationships, vain, self-absorbed
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Narcissistic Personality Disorder
• Narcissus- A handsome and Proud Hunter.• He became so enamored with his own image
in the water. He remained at the water's edge until he eventually wasted to death.
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Narcissistic Personality Disorder
Pervasive grandiosity, need for admiration, lack
of empathy.
• Grandiose sense of self-importance, expects
to be recognized as superior
• Preoccupied with fantasies of unlimited
success, power, brilliance, beauty, or ideal love
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Narcissistic Personality Disorder
• Believes he/she is “special,” unique and can only be
understood by or should associate with other
special people
• Requires excessive admiration
• Sense of entitlement
• Interpersonally exploitative, i.e., takes advantage of
others to achieve his or her own ends
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Narcissistic Personality Disorder
• 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.
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Narcissistic Personality Disorder
• Become enraged at criticism
• Fragile self-esteem, prone to depression
• Their behavior produces interpersonal
difficulties, rejection, loss, occupational
problems, which they can’t handle
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Avoidant personality disorder
• Poseidon- The sea God.• Avoidant tendencies in his desire to hide away
in the deep parts of the sea.
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Avoidant personality disorder
Pervasive social inhibition, feelings of inadequacy,
hypersensitivity to negative evaluation.
• Avoids occupational activities that involve
significant interpersonal contact because of fears
of criticism, disapproval or rejection
• Unwilling to get involved with people unless
certain of being liked
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Avoidant personality disorder
• Shows restraint within intimate relationships because of
the fear of being shamed or ridiculed
• Preoccupied with being criticized or rejected in social
situations
• Inhibited in new interpersonal situations because of
feelings of inadequacy
• Extreme sensitivity to rejection leads to socially
withdrawn life
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Avoidant personality disorder
• Views self as socially inept, personally
unappealing, or inferior to others
• Unusually reluctant to take personal risks or to
engage in new activities for fear of embarrassment
• Withdraw and feel hurt if a request is refused or if
they feel rejected or ridiculed
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Dependent personality disorder
• Vesta- goddess of the hearth, home, and family.
• The Dependent personality type, who does her job and keeps out of the way of the others.
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Dependent personality disorder
Pervasive and excessive need to be taken care of, leads to
submissive and clinging behavior and fears of separation.
• Has difficulty making everyday decisions without an
excessive amount of advice and reassurance from others
• Needs others to assume responsibility for most major
areas of his or her life
• Has difficulty expressing disagreement
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Dependent personality disorder
• Has difficulty initiating or doing things on own
• Goes to excessive lengths to obtain nurturance and
support from others
• Feels uncomfortable or helpless when alone because of
exaggerated fears of being unable to care for himself or
herself
• Urgently seeks another relationship as a source of care
and support when a close relationship ends
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Dependent personality disorder
• Unrealistically preoccupied with fears of being
left to take care of himself or herself
• May stay with an abusive, unfaithful or
alcoholic partner rather than face being alone
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Obsessive-Compulsive personality disorder
• Hephaestus- The God of Fire.• Compulsive tendencies that kept him at work
making things for the Olympians.
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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.
• Preoccupied with details, rules, lists, order,
organization, schedules to the extent that the major
point of the activity is lost
• Shows perfectionism that interferes with task
completion
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Obsessive-Compulsive personality disorder
• Excessively devoted to work and productivity to the
exclusion of leisure activities and friendships (not
accounted for by obvious economic necessity)
• Overly-conscientious, scrupulous, and inflexible about
matters of morality, ethics, or values (not accounted for
by cultural or religious identification)
• Unable to discard worn-out or worthless objects even
when they have no sentimental value
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Obsessive-Compulsive personality disorder
• Reluctant to delegate tasks or to work with others
unless they submit to exactly his or her way of doing
things
• Adopts a miserly spending style toward both self and
others; money is viewed as something to be hoarded
for future catastrophes
• Shows rigidity and stubbornness
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Obsessive-Compulsive personality disorder
• Do well with routines and poorly with changes
• Unable to compromise in interpersonal
relationships
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Personality Disorder clusters
• Cluster A:
– Main feature is odd or eccentric in nature
• Paranoid PD – distrust and suspiciousness
• Schizoid PD – detachment from social relationships
(does not want them)
• Schizotypal PD – social deficits and perceptual
distortions or eccentricities
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Personality Disorder clusters
• Cluster B
– Main feature is dramatic, emotional, or erratic
• Antisocial PD – disregard for social norms and rights of others
• Borderline PD – instability in relationships, self-image, and
mood; impulsivity
• Histrionic PD – excessive emotionality and attention seeking
• Narcissistic PD – grandiosity, need for admiration, self-centered
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Personality Disorder clusters
• Cluster C
– Main feature involves anxiety or fearfulness
• Dependent PD – submissive, need to be taken care of
• Avoidant PD – social inhibition and inadequacy
• Obsessive-compulsive PD – orderliness, perfectionism,
need to control things
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Uncertainty
For all of its uncertainty, we cannot flee the future. Barbara Jordan
• Does personality change?