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Block 4 Unit 2 Personality Disorder

1. Discuss the nature of personality disorders.

Personality disorders are a diagnostic category of psychiatric disorders characterized by a chronic, inflexible, and maladaptive pattern of relating to the world. This pattern affects how a person thinks, feels, and behaves, negatively impacting their interpersonal relationships. They are not uncommon, with roughly 10% of adults meeting the diagnostic criteria. Unlike some disorders, personality disorders are a variant form of a normal personality and represent a rigid and narrow range of responses to stress.

2. What are the different types of personality that we obtain even in normal persons?

Various personality types that can be seen in "normal" individuals:

• Paranoid Personality: Characterized by suspiciousness and distrust of others.
• Cyclothymic Personality: Described as having mood swings.
• Schizoid Personality: Characterized by social detachment and limited emotional expression.
• Explosive Personality: Characterized by sudden outbursts of rage or aggression.

• Obsessive-Compulsive Personality: Characterized by a concern for perfection and orderliness.
• Hysterical (Histrionic) Personality: Characterized by excessive attention seeking and emotional instability.
• Asthenic Personality: Characterized by low energy and fatigue.
• Antisocial Personality: Characterized by a disregard for the rights of others.
• Passive-Aggressive Personality: Characterized by resistance to demands and negativity.
• Inadequate Personality: Characterized by inability to cope with life's challenges.

3. Discuss paranoid, cyclothymic, schizoid and explosive personality.

• Paranoid Personality: These individuals are suspicious, distrustful, cold, and detached, struggling to form relationships.
• Cyclothymic Personality: As described by the source, cyclothymic personality is characterized by unstable mood.
• Schizoid Personality: These individuals are socially detached, with limited emotional expression and may not seek out relationships with others.
• Explosive Personality: These individuals exhibit sudden outbursts of rage, verbal or physical aggression, and struggle to control their anger despite feeling guilt and regret.

4. Elucidate the obsessive compulsive personality, hysterical personality, and asthenic personality.

• Obsessive-Compulsive Personality: These individuals are characterized by a preoccupation with perfection, orderliness, and adherence to social norms. They are rigid, have difficulty with ambiguity, and strive to control situations.
• Hysterical (Histrionic) Personality: These individuals are attention-seeking, emotionally unstable, and prone to self-dramatization.
• Asthenic Personality: These individuals are characterized by low energy and fatigue.

5. Describe antisocial personality, passive aggressive personality and inadequate personality.

• Antisocial Personality: Individuals with this personality disregard the feelings and rights of others and often display a lack of remorse, and violent behavior.
• Passive-Aggressive Personality: These individuals resist demands and express negativity in a passive way.
• Inadequate Personality: These individuals have difficulty coping with life's challenges and feel incapable.

6. How do you diagnose personality disorders? 

Personality disorders are diagnosed on Axis II of the DSM-IV, and they are considered near permanent disorders. Axis I disorders are symptom disorders that may come and go, whereas Axis II disorders are more pervasive. Individuals with personality disorders often attribute their difficulties to the environment and do not see themselves as needing clinical treatment. Diagnosis relies on observing behavioural manifestations and patterns rather than subjective feelings of distress.

7. Delineate the features of personality disorders. 

The key features of personality disorders include:

• Early Onset: Symptoms are typically evident since late adolescence.
• Stability: Symptoms are consistent over time with no significant periods where the symptoms are not evident.
• Pervasive: The symptoms are evident across various personal, social, and occupational settings.
• Maladaptation: The symptoms cause clinically significant maladjustment resulting in personal distress or impairment in social and occupational functioning.

8. Discuss the biological causative factors of personality disorder. 

Biological factors may predispose individuals to personality disorders, with research suggesting that:

• Infants' constitutional reaction tendencies (such as high or low vitality) may play a role.
• Personality traits are moderately heritable, indicating a genetic component.
• Low levels of the neurotransmitter serotonin may lead to impulsive-aggressive behaviors in borderline personality disorder.

• Disturbances in the regulation of noradrenergic neurotransmitters may play a role.
• Deficits in the dopamine system may be related to transient psychotic symptoms.

9. Elucidate the psychological causes of personality disorder. 

Psychological factors contributing to personality disorders include:

• Early learning experiences, with abuse and neglect in childhood being linked to certain personality disorders.
• Psychodynamic theories which suggest a disruption in the development of healthy self-esteem. For instance, children must have their grandiosity mirrored by their parents so that they can move past the need to be the center of attention. Lack of parental empathy and devaluation can also contribute to these disorders.

10. What are the socio-cultural factors contributing to personality disorders? 

A culture that emphasizes impulse gratification, instant solutions, and pain-free benefits may contribute to the self-centered lifestyles seen in personality disorders.

11. Discuss the cluster A personality disorders. 

Cluster A personality disorders are characterized by odd or eccentric behavior, including:

• Paranoid Personality Disorder: Individuals are suspicious, distrustful, and can be cold and detached, struggling to form relationships.
• Schizoid Personality Disorder: Individuals show social detachment, limited emotional expression, and do not seek relationships.
• Schizotypal Personality Disorder: Individuals have odd beliefs, speech, and behavior with social deficits and discomfort.

12. Elucidate the Cluster B personality disorders. 

Cluster B personality disorders are characterized by dramatic, emotional, or erratic behavior, including:

• Borderline Personality Disorder: Individuals have unstable moods, self-image, and relationships; they may also experience chronic emptiness.
• Antisocial Personality Disorder: Individuals disregard the rights and feelings of others, are often violent, and lack remorse.
• Narcissistic Personality Disorder: Individuals have an exaggerated sense of self-importance, are preoccupied with admiration, and lack empathy.
• Histrionic Personality Disorder: Individuals are excessively attention-seeking and emotionally unstable.

13. Explain the cluster C personality disorders. 

Cluster C personality disorders are characterized by anxious or fearful behavior, including:

• Dependent Personality Disorder: Individuals have an extreme need to be taken care of, fear separation, and show passive, clinging behavior.

• Avoidant Personality Disorder: Individuals are socially inhibited, feel inadequate, and are oversensitive to criticism.
• Obsessive-Compulsive Personality Disorder: Individuals are preoccupied with perfectionism, orderliness, and control.

14. Define personality disorders. Discuss the origin and diagnosis of personality disorders.

Personality disorders are a diagnostic category characterized by chronic, inflexible, and maladaptive patterns of relating to the world, affecting how a person thinks, feels, and behaves. These disorders are a variant form of normal personality and are not uncommon. Diagnosis is based on observing patterns of behavior, and the disorders are considered to be near-permanent..

15. What are the various personalities that we come across? 

There are a variety of personalities, including: paranoid, cyclothymic, schizoid, explosive, obsessive compulsive, hysterical (histrionic), asthenic, antisocial, passive aggressive and inadequate personality.

16. Describe the symptoms of Cluster A personality disorders.

Cluster A disorders display odd or eccentric behavior.

• Paranoid: suspiciousness, distrust
• Schizoid: social detachment, limited emotional expression.
• Schizotypal: odd beliefs, speech, and behavior.

17. What are the symptoms of Cluster B personality disorders?

Cluster B disorders have dramatic, emotional, or erratic behavior.

• Borderline: unstable moods, self-image, and relationships with chronic emptiness.
• Antisocial: disregard the rights of others, violent, lack remorse.
• Narcissistic: exaggerated self-importance, preoccupation with admiration, lack of empathy.
• Histrionic: attention-seeking, emotional instability.

18. Discuss the symptoms of Cluster C personality disorders. 

Cluster C disorders present as anxious or fearful behavior.

• Dependent: extreme need to be taken care of, fear of separation, clinging behavior.
• Avoidant: socially inhibited, feelings of inadequacy, oversensitivity to criticism.
• Obsessive-Compulsive: preoccupation with perfectionism, orderliness, control.

19. Explain the strategies to treat personality disorders. 

Strategies to treat personality disorders include:

• Psychological and drug therapies.
• Counselling and psychotherapy to explore and understand feelings.
• Cognitive Behavioral Therapy (CBT) to weaken negative thought patterns.
• Dialectical behavior therapy (DBT) which shows promise in treating borderline personality disorder.
• Focusing on coping skills and learning how to relate to others.

20. What is sexual deviation?

Sexual Deviation

The sources define sexual deviation as a condition where individuals repetitively and somewhat compulsively direct their sexual interests towards:

• Objects other than the opposite sex.
• Sexual acts not associated with intercourse.
• Intercourse only when associated with stylised behaviour (e.g., sexual sadism).

This term carries a moral connotation and is somewhat related to cultural norms. It also suggests that this behaviour reflects at least developmental difficulties, if not psychopathology. "Deviant" sexual behaviour is seen as an attempt to achieve some sexual gratification while avoiding fears associated with usual adult sexual practices.

21. Delineate the causes of personality disorders

Causes of Personality Disorders

The causes of personality disorders are complex and not fully understood. The sources indicate that it's likely a combination of factors that contribute to the development of these disorders. These include:

• Biological Factors:
  • Constitutional reaction tendencies: An infant's innate traits, such as high or low vitality, may predispose them to particular personality disorders.
  • Genetic Contributions: There is increasing evidence for a genetic component to personality disorders, as many personality traits are moderately heritable.
  • Neurotransmitter Functioning: There is evidence that some personality disorders such as borderline personality disorder are related to lower levels of serotonin, which can lead to impulsive and aggressive behaviour, or disturbances in noradrenergic neurotransmitter regulation, similar to chronic stress conditions. Deficits in the dopamine system might also be related to transient psychotic symptoms.
• Psychological Factors:
  • Early Learning Experiences: These are considered significant in predisposing a person to develop a personality disorder.
  • Childhood Abuse and Neglect: Studies have indicated that abuse and neglect in childhood are related to the development of certain personality disorders, such as borderline personality disorder.
  • Psychodynamic Theories: These theories suggest that disruptions in early development, such as a failure to move past the need to be the center of attention, a lack of parental empathy or devaluation can lead to personality disorders.
• Socio-Cultural Factors:
  • Changing Culture: Emphasis on instant gratification, and pain-free solutions may contribute to the development of self-centered lifestyles seen in some personality disorders.
  • The sources also note that personality disorders are more common when stress levels are high.

It's important to note that there is a high level of co-morbidity among personality disorders, meaning that individuals often qualify for more than one diagnosis. Many individuals with these disorders are never seen by clinical personnel, making it difficult to study the causes of these disorders. Additionally, many people with personality disorders do not know they have one, and may believe that their difficulties are due to external factors and that they do not require clinical treatment.