Personality Disorders By:Dr. Akmal Mostafa KamalAssistant Professor of Psychiatry, Faculty of Medicine, Cairo .University
?What Is a Personality• Personality is a relatively stable and enduring set of characteristic cognitive, behavioral and emotional traits.• Over time, a person will interact with others in a reasonably predictable way.• Personality changes with experience, maturity, and external demands in a way that promotes adaptation to the environment.• It is affected by genetic and psychosocial factors.
•The trait approach to personality isone of the major theoretical areas inthe study of personality.•The trait theory suggests thatindividual personalities are composedbroad dispositions.•Consider how you would describethe personality of a close friend.
•Chances are that you would list anumber of traits, such as outgoing,kind and even-tempered.•A trait can be thought of as arelatively stable characteristic thatcauses individuals to behave incertain ways.
•Unlike many other theories of personality,such as psychoanalytic or humanistictheories, the trait approach to personality isfocused on differences between individuals.•The combination and interaction of varioustraits combine to form a personality that isunique to each individual.•Trait theory is focused on identifying andmeasuring these individual personalitycharacteristics.
Gordon Allport‘s Trait Theory•In 1936, psychologist GordonAllport found that one English-language dictionary alonecontained more than 4,000 wordsdescribing different personalitytraits.• He categorized these traits intothree levels:
Cardinal Traits:•Traits that dominate an individual‘swhole life, often to the point that theperson becomes known specifically forthese traits.• People with such personalities oftenbecome so known for these traits thattheir names are often synonymous withthese qualities.
Cardinal Traits:•Traits that dominate an individual‘swhole life, often to the point that theperson becomes known specificallyfor these traits.• People with such personalities oftenbecome so known for these traits thattheir names are often synonymouswith these qualities.
•Consider the origin and meaning ofthe following descriptive terms:Freudian, Machiavellian, narcissism,Don Juan, etc.•Allport suggested that cardinal traitsare rare and tend to develop later inlife.
• Central Traits:• The general characteristics thatform the basic foundations ofpersonality.•These central traits, while not asdominating as cardinal traits, are themajor characteristics you might useto describe another person.•Terms such as intelligent, honest,shy and anxious are consideredcentral traits.
• Secondary Traits:• Traits that are sometimes relatedto attitudes or preferences and oftenappear only in certain situations orunder specific circumstances.•Some examples would be gettinganxious when speaking to a groupor impatient while waiting in line.
Raymond Cattell•Trait theorist Raymond Cattell reducedthe number of main personality traitsfrom Allport‘s initial list of over 4,000down to 171.• Mostly by eliminating uncommon traitsand combining common characteristics.•Next, Cattell rated a large sample ofindividuals for these 171 different traits.
•Then, using a statistical technique knownas factor analysis, he identified closelyrelated terms and eventually reduced hislist to just 16 key personality traits.•According to Cattell, these 16 traits arethe source of all human personality.•He also developed one of the most widelyused personality assessments known asthe Sixteen Personality FactorQuestionnaire (16PF).
Eysenck•Eysenck’s Three Dimensions of Personality.•British psychologist Hans Eysenck developed amodel of personality based upon just threeuniversal traits:•• Introversion/Extraversion:•Introversion involves directing attention on innerexperiences, while extraversion relates to focusingattention outward on other people and theenvironment.•So, a person high in introversion might be quietand reserved, while an individual high inextraversion might be sociable and outgoing.
• Neuroticism/Emotional Stability:•This dimension of Eysenck‘s traittheory is related to moodiness versuseven-temperedness.•Neuroticism refers to an individual‘stendency to become upset oremotional, while stability refers to thetendency to remain emotionallyconstant.
Psychoticism:•Later, after studying individualssuffering from mental illness,Eysenck added a personalitydimension he called psychoticism tohis trait theory.•Individuals who are high on thistrait tend to have difficulty dealingwith reality and may be antisocial,hostile, non-empathetic andmanipulative.
The Five-Factor Theory The Five-Factor Theory of Personality•Both Cattell‘s and Eysenck‘s theory havebeen the subject of considerableresearch, which has led some theorists tobelieve that Cattell focused on too manytraits, while Eysenck focused on too few.•As a result, a new trait theory oftenreferred to as the "Big Five" theoryemerged.
•McCrae and Costa (1999) describefive trait characteristics ofpersonality, which consist of apersons level of agreeableness,conscientiousness, extraversion,neuroticism, and openness.•This five factor model of personalityrepresents five core traits thatinteract to form human personality.
Agreeableness:• Refers to how you interact with other people, and it involves the level of intimacy you maintain in your personal relationships and how helpful and sympathetic you are.• Characteristics of an agreeable personality include trust, straightforwardness, altruism, compliance, modesty, and tender- mindedness.
Conscientiousness:• Refers to your work style.• It involves your generaldedication to activities; how hardyou work and how efficient andfocused you are.•Conscientious people aretypically competent, orderly,dutiful, achievement striving, self-disciplined, and deliberate.
•Extraversion:• Refers to how you expressyourself.•This trait considers your sociability,positive emotionality, assertiveness,and activity or energy level.•If you are extraverted, youreprobably warm, gregarious,assertive, active, seek excitement,and tend toward positive emotions.
•Neuroticism:•Refers to your emotional style.•It involves the extent to which youexperience negative emotions suchas worry, self-doubt, stress andtension.•Most neurotic personalities displayanxiety, angry hostility, depression,self-consciousness, impulsiveness,or vulnerability (or some combinationof these characteristics).
•Openness:•Describes your intellectual style -the extent to which you are open tonew ideas and innovativeapproaches, and have an activeimagination.•Some characteristics of opennessinclude fantasy, appreciation of art,the tendency to have a variety ofemotions, action (not reaction), andindividual ideas and values.
•While most agree that people canbe described based upon theirpersonality traits, theorists continueto debate the number of basic traitsthat make up human personality.•While trait theory has objectivity thatsome personality theories lack (suchas Freud‘s psychoanalytic theory), italso has weaknesses.
•Some of the most common criticisms oftrait theory center on the fact that traitsare often poor predictors of behavior.••While an individual may score high onassessments of a specific trait, he or shemay not always behave that way in everysituation.•Another problem is that trait theories donot address how or why individualdifferences in personality develop oremerge.
What is a Personality ?Disorder•A personality disorder is an extreme set ofcharacteristics that goes beyond the rangefound in most people.•It could be defined as:•An enduring pattern of inner experiencesand behavior that deviates markedly from theexpectations of the individuals culture.•It is pervasive and inflexible.•It has an onset in adolescence or earlyadulthood.•It is stable over time.
•A personality disorder is an extreme setof characteristics that goes beyond therange found in most people.•It could be defined as:•An enduring pattern of inner experiencesand behavior that deviates markedly fromthe expectations of the individuals culture.•It is pervasive and inflexible.•It has an onset in adolescence or earlyadulthood.•It is stable over time.
Why Recognize Personality ?Disorders•- In the psychiatric setting:•They are considered axis II disorders and canpresent concurrently with any other psychiatricdisorders.•Their presence affects markedly the prognosis,compliance to treatment and choice of therapy.•They are egosyntonic in the majority of eases, i.e..the patient does not think of them as maladaptiveor bad.•They are either discovered during treatment, orthe family complains of them.
Personality DisordersDSM groups personality disorders intothree clusters:– Cluster A (Exhibits odd or eccentricbehavior).– Cluster B (Exhibits dramatic, emotional,or erratic behavior).– Cluster C (Exhibits anxious or fearfulbehavior).
Cluster A (Exhibits odd or eccentric behavior)– Paranoid Personality Disorder Pervasive distrust and suspiciousness of others suchthat their motives are interpreted as malevolent.– Schizoid Personality Disorder Pervasive pattern of detachment from socialrelationships and a restricted range of expression ofemotions in interpersonal settings.– Schizotypal Personality Disorder Pervasive pattern of social and interpersonal deficitsmarked by acute discomfort with, and reduced capacityfor, close relationships as well as by cognitive orperceptual distortions and eccentricities of behavior.
Cluster B (Exhibits dramatic, emotional, or erratic behavior)– Antisocial Personality Disorder Pervasive pattern of disregard for and violation of therights of others occurring since age 15 years.– Borderline Personality Disorder Pervasive pattern of instability of interpersonalrelationships, self-image, and affects, and markedimpulsivity beginning by early adulthood and present in avariety of contexts– Histrionic Personality Disorder Pervasive pattern of excessive emotionality andattention seeking– Narcissistic Personality Disorder Pervasive pattern of grandiosity (in fantasy orbehavior), need for admiration, and lack of empathy
Cluster C (Exhibits anxious or fearful behavior)– Avoidant Personality Disorder Pervasive pattern of social inhibition, feelings ofinadequacy, & hypersensitivity to negative evaluation.– Dependent Personality Disorder Pervasive & excessive need to be taken care of thatleads to submissive & clinging behavior & fears ofseparation.– Obsessive Compulsive Personality Disorder Pervasive pattern of preoccupation with orderliness,perfectionism, and mental and interpersonal control, atthe expense of flexibility, openness, and efficiency.