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  • Because personality disorders involve the whole fabric of an individual’s being, clinicians typically perceive them as the most challenging disorders to try to treat. A clinician has to consider the person’s life history when evaluating whether he or she has a personality disorder. Diagnosis is difficult because many personality disorders have similar features.
  • Evident in various personal and social situations; causes distress or impairment. Cognition: Ways of perceiving self, other people, and events. Affectivity: Range, intensity, and appropriateness of emotional expression. The pattern is inflexible and pervasive across a range of situations. The pattern is stable and of long duration.
  • Considerable controversy exists over whether personality disorders should be conceptualized in terms of dimensions. At present, though, the categorical system is being used.
  • Antisocial personality disorder and borderline personality disorder are the most extensively researched. For each of these disorders, there is a relatively specific set of theoretical perspectives and treatment approaches.
  • Associated with serial killers and other career criminals, but not all those with APD are criminal, nor vice versa.
  • Pinel recognized this disorder as a form of madness in which the individual exhibited impulsive and destructive behaviors while maintaining rational thought. Decades later, this disorder was labeled moral insanity . Cleckley developed a set of criteria for the condition, calling it psychopathy. Based upon large scale studies of forensic populations, Hare developed the PCL-R , which has two factors: (1) core psychopathic personality traits and (2) antisocial lifestyle.
  • An individual can be a criminal and can engage in adult antisocial behavior without qualifying for antisocial personality disorder. Nevertheless, many individuals who are sent to prison meet the psychological criteria for antisocial personality disorder. Estimates within prison populations range from 40% to 75%.
  • Defects have been found in the prefrontal areas of the cerebral cortex, in areas involved in planning future activities, and considering moral implications of one’s actions. These abnormalities may have genetic causes: It has been observed for decades that criminal behavior runs in families. Adoption findings: Adoptees whose biological parents had antisocial personality disorder were more likely to develop it too, particularly if raised in an adverse adoptive environment. Children without biological predisposition did not develop the symptoms even if raised in similarly harsh settings.
  • Neurological deficits: High psychopathy checklist scores were found to be strongly related to brain volume for the hippocampus , a brain area involved in learning. Originally the fearlessness hypothesis , the response modulation hypothesis holds that psychopaths are able to learn to avoid punishment when this is their main goal. However, if their attention is focused elsewhere, they do not pay attention to information that would let them avoid aversive consequences. Lack of emotional reactivity Unable to process information not relevant to their primary goals Low self-esteem leads to need to prove competence by aggression.
  • Family: Lee Robins (1966) - Divorce, conflict, inconsistent discipline, parental conflicts in parenting style, parents with antisocial traits raise likelihood. Abuse and neglect: Individuals with antisocial personality have more history of having been abused or neglected during childhood. Neglect has been found to precede 50% more arrests for violent crimes compared to matched comparison subjects. Physical abuse during childhood led to a rate double that of the comparison group.
  • Individuals with antisocial personality disorder rarely seek treatment except in legal context. Goal of treatment: Help the client feel better about himself; boost client’s self esteem. Techniques are confrontational: Refute the client’s fabrications, point out selfish and self-defeating behaviors. Group therapy may be helpful because peers are not easily accepted by client.
  • The female character Alex in the movie Fatal Attraction is a good example of what a person with borderline personality is like. In addition to having disturbed relationships, people with borderline personality disorder are often confused about their own identity , their concept of who they are. Chronic feelings of boredom lead them to seek stimulation.
  • Splitting: Perceiving other people as being all good or all bad. Parasuicide: A suicidal gesture to get attention from loved ones, family, or professionals.
  • Childhood sexual abuse may alter sympathetic nervous system that leads to hypersensitivity and impulsivity in adulthood. One study found that the hippocampus was 16% smaller in borderline women than in healthy control subjects, and the amygdala was 8% smaller.
  • Physical or sexual abuse, especially in women, leads to expectation of harm from others, therefore producing ambivalence in one’s relationship with others.
  • Psychodynamic theorists suggest the individual has failed to develop a consistent, independent, “real” self ( ego ). Caused by mother who is both overinvolved with child and inconsistent in emotional relatedness. Child develops distorted perceptions of others known as “splitting” (others are either all good or all bad). Child’s “false” self is fused with distorted perception of others.
  • Cognitive theorists also note the dichotomized thinking about self and others (“splitting”). Thoughts about self and others are either all negative or all positive. Perceived failure to achieve a goal leads to low sense of self-efficacy. Low self-efficacy leads to lack of confidence, low motivation, inability to seek long-term goals. Unstable family patterns: Living with child abuse, depression, substance abuse, antisocial parents.
  • Dialectical behavioral therapy integrates confrontive and supportive methods. DBT clients show considerable improvement in symptoms of depression, dissociation, anxiety, and anxiety. Although medication will not alter a person’s ingrained personality, it can help regulate some symptoms, reducing impulsivity and emotional volatility.
  • What differentiates people with this disorder from those who show appropriate emotionality is their low emotional stability, shown in the fleeting nature of their emotional states and their use of excessive emotions to manipulate others rather than express their true feelings.
  • Histrionic people are determined to be the center of attention and will behave in whatever way necessary to ensure that this happens. They seek attention and approval from others and become furious if they don’t get it.
  • They want immediate gratification of their wishes and overreact to even minor provocations, usually in an exaggerated way, such as by weeping or fainting. Although their relationships are superficial, they assume them to be intimate and refer to acquaintances as “dear” friends.
  • Cognitive-behavioral theorists propose that these people suffer from mistaken assumptions underlying their approach to life such as believing that eliciting admiration and support from others will make up for their perceived deficits.
  • Grandiosity: An exaggerated view of oneself as possessing special and extremely favorable personal qualities and abilities. Unrealistic, inflated sense of self-importance stemming from grave self-doubt. Common feature of other personality disorders, especially Histrionic and Borderline personality disorders
  • The elitist narcissists feel privileged and empowered, and tend to flaunt their status and achievements. The amorous narcissist tends to be sexually seductive, yet avoids real intimacy. The unprincipled narcissists are much like antisocial individuals in that they tend to be unscrupulous, arrogant, and exploitative. The compensatory narcissists tend to be negativistic, seeking to counteract their deep feelings of inferiority. They try to create illusions of being superior and exceptional.
  • Freud felt the narcissist was fixated in the phallic stage of psychosexual development. Later psychodynamic theorists attributed narcissism to an adult expression of childhood insecurity and need for attention due to failed parent-child relationship.
  • Some researchers refer to these three as schizophrenic spectrum disorders , implying that all three are on a continuum of psychological disturbance and may be related. Two (schizoid and schizotypal) share some aspects of symptoms found in schizophrenia.
  • Cognitive-behavioral therapy seems to be most effective. Out of all people with personality disorders, those with paranoid personality are least likely to seek treatment.
  • Treatment: Most promising is an approach geared toward helping them work on their styles of communication.
  • Schizotypal personality disorder: A personality disorder that primarily involves peculiarities and eccentricities of thought, behavior, appearance, and interpersonal style. People with this disorder may have peculiar ideas, such as magical thinking and beliefs in psychic phenomena.
  • This may be latent schizophrenia. People with schizoid and schizotypal personality are more likely to have biological relatives with schizophrenia.
  • Whereas the schizoid reduces interactions with others out of a lack of interest in people, the avoidant individual desperately wants social interactions yet also avoids them out of fear of social failure and humiliation. They have restrained and guarded social interactions. They feel the pain of emotional isolation.
  • The psychodynamic perspective focuses on fear of attachment. The cognitive-behavioral approach appears to work better in explaining and treating avoidant individuals.
  • These interventions are most successfully accomplished after the client comes to trust the therapist. Those who are most distrustful and angry seem to benefit from graduated exposure. Those who are easily coerced respond particularly well to social skills training.
  • Without others near them, people with dependent personality feel despondent and abandoned.
  • Convinced of their own inadequacies, they cannot make even the most trivial decisions on their own.
  • While helping this client, the therapist must avoid becoming an authority figure to the client because it would be counterproductive for the individual to become dependent on the therapist.
  • The words obsessive and compulsive in this context have a different meaning from their use in association with anxiety disorders. The individual with obsessive-compulsive personality does not have the strong obsessions and compulsions associated with the anxiety disorder known as obsessive-compulsive disorder.
  • In striving for perfection, they become caught up in a worried style of thinking, and their behavior is inflexible. They have poor ability to express emotion and have few intimate relationships. It is one of the more common personality disorders and is present in more men than women.
  • Failure to achieve their unrealistic standard of perfection makes them feel worthless.
  • It is quite likely that the diagnostic criteria for these disorders, and even their names, will undergo continued revision in future editions of DSM .
  • Transcript

    • 1. Richard P. Halgin Susan Krauss Whitbourne University of Massachusetts at Amherst slides by Travis Langley Henderson State University Abnormal Psychology Clinical Perspectives on Psychological Disorders 5e Clinical Perspectives on Psychological Disorders 6e Richard P. Halgin Susan Krauss Whitbourne slides by Travis Langley Henderson State University Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 2. Personality Disorders Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 10
    • 3.
      • Personality trait
      • An enduring pattern of perceiving, relating to, and thinking about the environment and others.
      • Personality disorders
      • Ingrained patterns of relating to other people, situations, and events with a rigid and maladaptive pattern of inner experience and behavior, dating back to adolescence or early adulthood.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 4. ANTISOCIAL PERSONALITY DISORDER Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 5. The Nature of Personality Disorders
      • A longstanding maladaptive pattern of inner experience and behavior dating back to adolescence or adulthood that is manifest in at least two of the following areas:
        • Cognition
        • Affectivity
        • Interpersonal functioning
        • Impulse control
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 6. The Nature of Personality Disorders
      • At present, each personality disorder is categorized distinctly in that a person’s symptoms either fit it or they don’t.
      • Researchers who argue for a dimensional approach point out that the most commonly assigned Axis II diagnosis is personality disorder not otherwise specified .
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 7. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 8. DSM-IV Personality Disorder Clusters
      • CLUSTER A – The Eccentric Ones
      • CLUSTER B – The Dramatic Ones
      • CLUSTER C – The Anxious Ones
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. The DSM-IV includes a set of separate diagnoses grouped into three clusters based on shared characteristics:
    • 9. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. The Dramatic Ones
      • Antisocial Personality Disorder
      • Borderline Personality Disorder
      • Histrionic Personality Disorder
      • Narcissistic Personality Disorder
      Because Cluster B disorders have been the most extensively researched, we’ll start with them.
    • 10. ANTISOCIAL PERSONALITY DISORDER
      • A personality disorder characterized by a lack of regard for society's moral or legal standards.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Antisocial                                                
    • 11. ANTISOCIAL PERSONALITY DISORDER Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 12.
      • History
        • Philippe Pinel (1801) - Defect of moral character
        • Hervey Cleckley (1941) - Psychopathy
        • Robert Hare (1997) - Psychopathy Check List
        • DSM Goes beyond psychopathy traits
      ANTISOCIAL Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 13. ANTISOCIAL
      • Associated Behaviors
        • Deceitfulness
        • Impulsivity
        • Unlawfulness
        • Recklessness
        • Aggressiveness
        • Manipulativeness
        • Lack of remorse
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 14. Important Distinctions
      • Adult Antisocial Behavior
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
      • Criminal
      Illegal or immoral behavior such as stealing, lying, or cheating A legal term, not a psychological concept.
    • 15.
      • BIOLOGICAL
        • Various brain abnormalities
        • Diminished autonomic response to social stressors
        • Possible genetic causes
      Perspectives on Antisocial Personality Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 16. Perspectives on Antisocial Personality Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
      • PSYCHOLOGICAL
      • Neurological deficits related to psychopathic symptoms
      • Response modulation hypothesis
      • Unable to process information not relevant to their primary goals
      • Low self-esteem
    • 17.
      • SOCIOCULTURAL
      • Family variables
      • Childhood abuse
      • Childhood neglect
      Perspectives on Antisocial Personality Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.                                                
    • 18. TREATMENT OF ANTISOCIAL PERSONALITY DISORDER
      • Address low self- esteem
      • Confrontational techniques
      • Group therapy
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 19. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 20. BORDERLINE PERSONALITY DISORDER
      • Instability is evident in mood, interpersonal relationships, and self-image.
      • Often sufferers are confused about their own identity or concept of who they are.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. A personality disorder characterized by pervasive instability with a pattern of poor impulse control. Borderline
    • 21. BORDERLINE
      • Observed characteristics:
        • Intense interpersonal relationships
        • Splitting
        • Feelings of emptiness
        • Anger, rage
        • Identity confusion
        • Shifting goals, plans, partners
        • Poor boundaries with others
        • Risk taking, self injurious behaviors
        • Parasuicidal
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Borderline
    • 22. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 23. PERSPECTIVES ON BORDERLINE PERSONALITY
      • BIOPSYCHOSOCIAL
        • Vulnerable temperament
        • Traumatic early childhood experiences
        • Triggering events in adulthood
      • BIOLOGICAL
        • Hippocampus smaller
        • Amygdala smaller
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 24.
      • Physical or sexual abuse
      • Childhood caregiver interaction
        • Emotionally unavailable
        • Inconsistent treatment
        • Failed to validate their thoughts and feelings
        • Failed to protect from abuse
        • Anxious attachment style with mother
      PERSPECTIVES ON BORDERLINE PERSONALITY Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PSYCHOLOGICAL
    • 25.
      • Poor ego development
      • Caregiver overinvolved yet inconsistent
      • Distorted perception of others
      PERSPECTIVES ON BORDERLINE PERSONALITY Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PSYCHODYNAMIC
    • 26.
      • Splitting
      • Low sense of self-efficacy
      • Lack of confidence
      • Low motivation
      • Inability to seek long-term goals
      PERSPECTIVES ON BORDERLINE PERSONALITY Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE-BEHAVIORAL
      • Modern pressures on family
      • Diminished social cohesion and mental cohesion
      • Unstable family patterns
    • 27.
      • CHALLENGING AND COMPLEX
        • Unlikely to remain in treatment long
        • Unstable relationships with therapist
      • TECHNIQUES
        • Confrontive or
        • Supportive
        • Dialectical Behavioral Therapy
        • May need medication
      TREATMENT OF BORDERLINE PERSONALITY Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 28. HISTRIONIC PERSONALITY DISORDER
      • A personality disorder characterized by exaggerated emotional reactions, approaching theatricality, in everyday behavior. Melodramatic.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Histrionic
    • 29. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. The term histrionic is derived from a Latin word meaning “actor.”
    • 30. HISTRIONIC
      • Dramatic, attention-getting behavior
      • Fleeting, shifting emotional states
      • More commonly diagnosed in women
      • Flirtatious and seductive
      • Need for immediate gratification
      • Easily influenced by others
      • Lack analytical ability
      • Superficial relationships
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 31.
        • Feelings of inadequacy and need for others
        • Global nature of thinking underlies diffuse, exaggerated and changing emotional states
      • TREATMENT GOALS
        • Learn how to think more objectively and precisely
        • Learn self-monitoring strategies
        • Learn impulse control
        • Acquire assertiveness skills
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. VIEWS AND TREATMENT OF HISTRIONIC PERSONALITY
      • COGNITIVE-BEHAVIORAL
    • 32. NARCISSISTIC PERSONALITY DISORDER
      • Named for Greek legend of Narcissus .
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Personality disorder characterized by an unrealistic, inflated sense of self-importance and lack of sensitivity to other people ’s needs:
      • egotistical
      • arrogant
      • exploitative of others
      Narcissistic
    • 33. NARCISSISTIC SUBTYPES Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Noting the many types of behaviors involved, Millon and colleagues proposed subtypes :
      • elitist
      • amorous
      • unprincipled
      • compensatory
    • 34. THEORIES OF NARCISSISTIC PERSONALITY
      • Freudian
        • Stuck in early psychosexual stages
      • Cognitive-Behavioral
        • Lack insight into or concern for feelings of others
        • Grandiose sense of self clashes with real world failures
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 35. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
      • PSYCHODYNAMIC and COGNITIVE-BEHAVIORAL therapies overlap in their goals for the client:
        • Reduce grandiose thinking.
        • Develop more realistic view of self.
        • Develop more realistic view of others.
        • Enhance ability to relate to others
        • Avoid demands for special attention
      TREATMENT OF NARCISSISTIC PERSONALITY
    • 36. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. The Eccentric Ones
      • Paranoid Personality
      • Schizoid Personality
      • Schizotypal Personality
    • 37. PARANOID PERSONALITY DISORDER
      • SUSPICIOUSNESS
      • GUARDEDNESS
      • PROJECTION OF NEGATIVITY AND DAMAGING MOTIVES ONTO OTHERS
      • ATTRIBUTION OF THEIR PROBLEMS TO OTHERS
      • LOW SELF-EFFICACY
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Paranoid
    • 38.
      • COGNITIVE BEHAVIORAL
        • COUNTER ERRONEOUS THINKING
        • ESTABLISH TRUSTING RELATIONSHIP
        • INCREASE FEELINGS OF SELF-EFFICACY
        • REDUCE VIGILANT AND DEFENSIVE STANCE
        • INSIGHT INTO OTHERS’ PERSPECTIVES
        • APPROACH CONFLICT ASSERTIVELY
        • IMPROVE INTERPERSONAL SKILLS
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT OF PARANOID PERSONALITY
    • 39. SCHIZOID PERSONALITY DISORDER
      • Main characteristic: I ndifference to social relationships, as well as a very limited range of emotional experience and expression.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Schizoid
    • 40. SCHIZOID
      • INDIFFERENCE TO SOCIAL AND SEXUAL RELATIONSHIPS
      • SECLUSIVE; PREFER TO BE ALONE
      • NO DESIRE TO LOVE OR BE LOVED
      • COLD, RESERVED, WITHDRAWN
      • INSENSITIVE TO FEELINGS OF OTHERS
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT: Unlikely to seek or respond to therapy. Schizoid
    • 41. SCHIZOTYPAL PERSONALITY DISORDER
      • Main characteristic: Peculiarities and eccentricities of thought, behavior, appearance, and interpersonal style.
      Schizotypal
    • 42. SCHIZOTYPAL PERSONALITY DISORDER Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Schizotypal
      • CONSTRICTED, INAPPROPRIATE AFFECT
      • IDEAS OF REFERENCE, MAGICAL THINKING
      • SOCIAL ISOLATION
      • PECULIAR COMMUNICATION
      TREATMENT: Parallels interventions commonly used in treating schizophrenia.
    • 43. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. The Anxious Ones
      • Avoidant Personality
      • Dependent Personality
      • Obsessive-Compulsive
    • 44. AVOIDANT PERSONALITY DISORDER
      • Most prominent feature:
      • The individual desires, but is fearful of, any involvement with other people and is terrified at the prospect of being publicly embarrassed.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Avoidant
    • 45. AVOIDANT - THEORIES Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
      • COGNITIVE-BEHAVIORAL
        • Hypersensitive due to parental criticism
        • Feel unworthy of others’ regard
        • Expect not to be liked
        • Avoid getting close to avoid expected rejection
        • Distorted perceptions of experiences with others
    • 46.
      • COGNITIVE-BEHAVIORAL
        • BREAK NEGATIVE CYCLE OF AVOIDANCE
        • CONFRONT AND CORRECT DYSFUNCTIONAL ATTITUDES AND THOUGHTS
        • GRADUATED EXPOSURE TO SOCIAL SITUATIONS
        • LEARN SKILLS TO IMPROVE CHANCE OF INTIMACY
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT OF AVOIDANT PERSONALITY
    • 47. DEPENDENT PERSONALITY DISORDER
      • Main characteristic: This individual is extremely passive and tends to cling to other people to the point of being unable to make any decisions or to take independent action.
      • Others may characterize them as “clingy.”
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. dependent
    • 48. DEPENDENT
      • Fear of abandonment
      • Despondent without others
      • Unable to initiate activities
      • Insecure about making decisions without others
      • Go to extreme to get approval from others
      • Devastated when relationships end
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. dependent
    • 49. DEPENDENT - THEORIES
      • Theories
      • PSYCHODYNAMIC
        • Fixated at oral psychosexual stage because of parental overindulgence or neglect
      • OBJECT RELATIONS
        • Insecure attachment to parents led to fear of abandonment
        • Low self-esteem leads them to rely on others
      • COGNITIVE-BEHAVIORAL
        • Thinking they are inadequate and helpless, they find someone to take care of them
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. dependent
    • 50.
      • COGNITIVE-BEHAVIORAL
        • Therapist and client develop structured ways to increase client independence in daily activities
        • Identify skill deficits and improve functioning
        • Therapist must avoid becoming an authority figure or making client dependent on therapist
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT OF DEPENDENT PERSONALITY
    • 51.
      • Main characteristic: Perfectionistic
      • So overwhelmed with their concern for neatness and minor details that they have trouble making decisions or getting things accomplished.
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Obsessive-Compulsive
    • 52. OBSESSIVE-COMPULSIVE
      • RIGID BEHAVIORAL PATTERNS
      • FANATICAL CONCERN WITH SCHEDULES
      • STINGY WITH TIME AND MONEY
      • TENDENCY TO HOARD WORTHLESS OBJECTS
      • LOW LEVEL OF EMOTIONALITY
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Obsessive-Compulsive
    • 53. THEORIES OF OBSESSIVE-COMPULSIVE
      • FREUDIAN
        • Fixation at anal psychosexual stage
      • OBJECT RELATIONS
        • Insecure parent-child attachments
      • COGNITIVE-BEHAVIORAL
        • Distorted world view
        • Unrealistic standard of perfection
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATMENT: Difficult to treat. Therapy may reinforce ruminative tendencies.
    • 54. And in conclusion . . . ?
      • Personality disorders are
      • Chronic and persistent
      • Hard to explain
      • Difficult to treat
      • Subject to much further study
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    • 55.
      • For more information on material covered in this chapter, visit our Web site:
      Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. http:/ www.mhhe.com/halgin6e