Personality disorders are characterized by enduring patterns of thinking and behavior that impair social functioning. They are categorized into three clusters: A) odd/eccentric, B) dramatic/erratic, and C) anxious/fearful. Specific disorders are defined by sets of symptoms related to needs for affiliation, power, self-image, and relationships. Treatment focuses on improving coping skills and relationships through therapies like dialectical behavior therapy.

1. Personality Disorders
Symptoms
Diagnosis
Frequency

2.  Personality: enduring patterns of thinking and behavior
that define the person and distinguish him or her from
other people.
 Personality disorder - emphasizes the duration of the
pattern and the social impairment associated with the
traits in question.
 Disorders characterized by extreme and rigid
personality traits that cause impairment
 Axis II disorders
 Ego syntonic

3. Social Motivation
 Motives describe the way that the person would
like things to be, and they help to explain why
people behave in a particular fashion.
 Two of the most important motives in
understanding human personality are
affiliation—the desire for close relationships
with other people.
power—the desire for impact, prestige, or
dominance.

4. Social Motivation
 Many of the symptoms of personality
disorders can be described in terms of
maladaptive variations with regard to
needs for affiliation and power.

5. Cognitive Perspectives Regarding Self
and Others
One central issue involves our image of
ourselves.
Is the self-image stable?
Is self-esteem maintained by external
validation?

6. Cluster A are
people who are
perceived as odd or
eccentric
Includes paranoid,
schizoid, and
schizotypal
personality
disorders

7. Cluster B are people
whose behavior is overly
dramatic, emotional, or
erratic
 Includes antisocial,
borderline, histrionic and
narcissistic personality
disorders

8. Cluster C are people who
often appear anxious or
fearful
Includes avoidant,
dependent, and obsessive-
compulsive personality
disorders

9. Paranoid Personality Disorder
Personality traits involving
extreme distrust and
suspiciousness.

10. Paranoid Personality Disorder
 Includes four or more of the following:
 Suspiciousness of others
 Unjustified doubts about disloyalty
 Reluctance to confide in others
 Reading threatening meanings into benign events
 Persistent tendency to bear grudges
 Tendency to feel attacked and counterattack
 Unjustified suspiciousness about infidelity of partner

11. Schizoid Personality
Disorder
Personality traits
involving detachment
from social relationships
and a restricted range of
emotional expression

12. Schizoid Personality Disorder
 Include four or more of the following:
 Neither desires nor enjoys close relationships
 Almost always chooses solitude
 Little if any interest in sexual relationships
 Takes pleasure in few activities
 Lacks close friends
 Indifferent to praise or criticism
 Emotional coldness, detachment or flatness

13. Schizotypal Personality Disorder
Personality traits
involving
eccentricities of
behavior, cognitive
or perceptual
distortions, and
acute discomfort in
close relationships

14. Schizotypal Personality Disorder
Five or more of the following:
Ideas of reference
Odd beliefs or magical thinking
Unusual perceptual experiences
Odd thinking and speech
Suspiciousness or paranoid ideas
Inappropriate or constricted affect
Odd, eccentric or peculiar behavior or
appearance
Lack of close friends
Excessive social anxiety

15. Antisocial Personality
Disorder
 Personality traits
involving profound
disregard for, and
violation of, the rights
of others

16. Antisocial Personality Disorder
Includes three or more of the following:
 Failure to conform to lawful behavior
 Deceitfulness
 Impulsivity
 Irritability or aggressiveness
 Reckless disregard for safety of self and
others
 Consistent irresponsibility
 Lack of remorse

17. Borderline Personality Disorder
Personality traits involving
instability in interpersonal
relationships, self-image,
and emotions, impulsivity,
and self-destructive
behavior

18. Borderline Personality Disorder
Five or more of the following:
Frantic efforts to avoid
abandonment
Unstable and intense relationships
Unstable self image
Impulsivity (self destructive)
Suicidal behavior
Affective instability
Chronic feelings of emptiness
Inappropriate, intense anger

19.  One of the most perplexing, most disabling,
and most frequently treated forms of PD.
 Otto Kernberg (1967, 1975)
 BPD refers to a set of personality
features or deficiencies that can be
found in individuals with various
disorders.
 Common features/abnormal behaviors of BPD
 Splitting- alternately seeing people as
entirely good or entirely bad.
 Impulse control problems
 See Figure 9-1

20. Treatment
 Most difficult to treat.
 Between 1/2 to 2/3 of all patients with BPD
discontinue treatment prematurely.
 Marsha Linehan – Dialectical Behavioral Therapy
(DBT)
 Emphasis: Learning to be more comfortable
with strong emotions.
 Emphasis: Therapist’s acceptance of the
patient and their negative behaviors.

21.  Women treated with DBT tend to drop
out of treatment at a lower rate; tend
to experience more improvement than
women in control groups.
 Medication is frequently used
adjunctively.
 Antipsychotics
 Antidepressants
 Lithium
 Anticonvulsants.

22. Histrionic Personality Disorder
Personality traits
involving excessive,
superficial emotionality
and attention seeking

23. Histrionic Personality Disorder
Five or more of the following:
 Uncomfortable if not the center of attention
 Inappropriately seductive or provocative
 Rapidly shifting and shallow emotions
 Use of appearance to draw attention
 Speech is impressionistic and lacking in detail
 Self-dramatization, theatricality
 Suggestibility
 Considers relationships more intimate than they
are

24. Narcissistic Personality Disorder
Personality traits
involving extreme
grandiosity, need
for admiration, and
lack of empathy

25. Narcissistic Personality Disorder
 Five or more of the following:
 Grandiose sense of self-importance
 Preoccupied with fantasies of unlimited success, power,
brilliance, etc.
 Belief that he or she is “special”
 Requires excessive admiration
 Sense of entitlement
 Interpersonally exploitative
 Lacks empathy
 Often envious
 Arrogant or haughty

26. Personality traits involving social
inhibition, feelings of inadequacy,
and hypersensitivity to negative
evaluation
• Avoidant Personality Disorder

27. Avoidant Personality Disorder
Four or more of the following:
Avoids activities due to fear of criticism,
disapproval or rejection
Unwilling to get involved with people unless certain
of being liked
Restrained in relationships due to fear of being
shamed or ridiculed
Preoccupied with criticism or rejection in social
situations
Inhibited in new situations due to feelings of
inadequacy
Views self as inept, unappealing, inferior
Reluctant to take personal risks

28. Dependent Personality Disorder
Personality traits
involving submissive and
clinging behavior related
to an excessive need to
be cared for by others

29. Dependent Personality Disorder
Five or more of the following:
Excessive need for advice and reassurance to make
decisions
Needs others to assume responsibility for most areas
of life
Difficulty expressing disagreement
Difficulty initiating or doing things on own
Goes to excessive lengths for nurturance or support
Feels helpless when alone, due to exaggerated fears
of being unable to care for self
Urgently seeks new relationship if close relationship
ends
Preoccupied with fears of being left to care for self

30. CAUSES TREATMENT
 Little research on the etiol
ogy of DPD.
 Overprotective, authoritar
ian parents are likely to fo
ster development of depe
ndency.
 Insecurely or anxiously att
ached children are likely t
o become dependent.
 Virtually no literature on
the outcome of treatme
nt for DPD.
 Enter therapy for other r
easons, such as depressi
on, anxiety or substance
use disorder.
 Cognitive therapy
 Psychopharmacology is t
ypically not used.

31. Obsessive-Compulsive Personality Disorder
Personality traits
involving
preoccupation with
orderliness,
perfectionism, and
control at the
expense of
spontaneity,
flexibility, and

32. Obsessive-Compulsive Personality Disorder
Four or more of the following:
Preoccupation with rules, lists, order, schedules, etc.
Perfectionism
Excessive devotion to work and productivity
Over-conscientious, scrupulous, inflexible about morality
Inability to discard worn-out or worthless objects
Reluctance to delegate tasks or work with
others unless they submit to exactly his or
her way of doing things
Miserly spending style
Rigidity and stubbornness