Personality Disorders Overview

Personality Disorders

• Cluster A (Odd/Eccentric): Characterized by social detachment and unusual thinking patterns.
  • Schizoid Personality Disorder: Detachment from social relationships, limited emotional expression, preferring solitary activities, and appearing cold or aloof.
  • Schizotypal Personality Disorder: Significant discomfort in close relationships, cognitive or perceptual distortions (e.g., magical thinking, odd beliefs), eccentric behavior/appearance, and social anxiety stemming from paranoia.
  • Paranoid Personality Disorder: Persistent distrust and suspicion of others' motives, reluctance to confide in others, misinterpretation of benign remarks/events, often grudging, unforgiving, or hypersensitive to criticism.

Cluster B (Dramatic/Emotional)

• Antisocial Personality Disorder: Disregard for and violation of others' rights, deceitful, manipulative, impulsive behavior (often criminal), lack of remorse or empathy, irresponsibility in work and relationships. Diagnosed after age 18, with early signs often being Conduct Disorder. Common characteristics include lying, skipping school, violence, drug abuse, and lack of remorse.
  • Psychopathy: Personality traits like superficial charm, lack of empathy; sometimes considered a subset of ASPD.
  • Sociopathy: Emphasizes environmental factors (e.g., upbringing; common among gangs, criminals; more impulsive, with more emotional outbursts)
• Histrionic Personality Disorder: Excessive emotionality and attention-seeking, dramatic/theatrical behavior to gain approval, easily influenced, and perceptions of relationships as more intimate than they are.
• Borderline Personality Disorder: Instability in relationships, self-image, and emotions, impulsivity (e.g., reckless spending, substance abuse), intense fear of abandonment, episodes of anger, depression, and feelings of emptiness.
• Narcissistic Personality Disorder: Grandiosity, need for admiration, lack of empathy, sense of entitlement and belief in being "special," exploitative in relationships, and fragile self-esteem.

Cluster C (Anxious/Fearful)

• Avoidant Personality Disorder: Extreme sensitivity to criticism or rejection, avoidance of social interactions despite desire for connection, feelings of inadequacy and low self-esteem, and reluctance to engage in new activities due to fear of embarrassment.
• Obsessive-Compulsive Personality Disorder (OCPD): Preoccupation with order, perfection, and control, inflexibility in morals/ethics/values, excessive devotion to work at the expense of leisure and relationships, reluctance to delegate tasks or compromise standards. OCD is distinct; it involves specific obsessions and compulsions causing distress. OCPD is a pattern.
• Passive-Aggressive Personality Disorder: Indirect resistance to authority or demands, procrastination, forgetfulness, intentional inefficiency, subtle hostility (e.g., sarcasm, stubbornness), chronic feelings of resentment and dissatisfaction.

Treatment and Etiology

• Symptomatic Treatment: Medication (e.g., mood stabilizers, antidepressants, anxiolytics, antipsychotics) for specific symptoms. (Effectiveness can vary).
• Treatment Approaches: Long-term therapy is essential, encompassing individual or group sessions.
• Borderline Personality Disorder (BPD): Dialectical Behavior Therapy (DBT) is the supported, evidence-based treatment, often involving structured psychodynamic therapy and weekly group and individual sessions, combined with diary cards, for monitoring behaviors and developing coping skills.
• Risk Factors (BPD): Early physical or sexual abuse, failure to master separation/individuation from the mother, faulty family boundaries, invalidating environment.
• Self-mutilation/Dissociation: Coping mechanisms for intense emotional pain, providing temporary control/relief; dissociation is a response to overwhelming stress, leading to detachment.
• Transient Psychotic Episodes: Brief episodes of paranoia, depersonalization, or derealization due to stress, temporarily impairing reality testing.
• Splitting: Defensive mechanism where people are viewed as "all good" or "all bad," without a balanced perspective.
  • Antisocial Personality Disorder Etiology:
  • Genetic Factors: Family history of antisocial behaviors, personality disorders;
  • Brain Abnormalities: Reduced prefrontal cortex/amygdala activity/structure;
  • Environmental Factors: Early trauma/abuse, inconsistent parenting, neglect;
  • Neurochemical Imbalances: Abnormalities in serotonin and dopamine systems.
• Psychopathy and Physiology: Hypotheses include low, slow, or variable arousal, with relative sensitivity to reward/punishment; evidence supports these.
• Treatment for Antisocial PD and psychopaths: Incarceration is the only evidence-based treatment, although successful psychopaths can be present in various professions.

Temporal Lobe Epilepsy and Personality:

• Temporal Lobe Epilepsy (TLE): Can lead to complex personality changes, including hypermorality, an obsession with detail and trivia, talkativeness, writing excessively, interpersonal difficulties, hyperreligiousity, expanded sense of destiny, fetishism, reduced humor, and sexual disinterest.
• Kluver-Bucy Syndrome: Damaging the amydala can result in strange behaviors.
• Simple Partial Seizures: Brief, sensory experiences, typically within the amygdala
• Complex Partial Seizures: Blank-outs/unresponsiveness, disorientation, and bizarre behaviors after seemingly minor triggers, followed by a variety of symptoms; more widespread in the temporal lobe
• Defensive Aggression: Individuals with TLE might react aggressively to perceived threats in ways disproportionate to the provocation.

This quiz explores the different clusters of personality disorders, focusing on Cluster A and Cluster B characteristics. Learn about disorders such as Schizoid, Schizotypal, Paranoid, and Antisocial Personality Disorders. Test your understanding of their distinctive features and symptoms.