Chapter 13 Personality Disorders PDF

10/12/2024 Copyright Notice Do not remove this notice. 1 CHAPTER 13 PERSONALITY DISORDERS Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd...

10/12/2024 Copyright Notice Do not remove this notice. 1 CHAPTER 13 PERSONALITY DISORDERS Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-2 2 1  10/12/2024 LEARNING OBJECTIVES 13.1 Outline the factors differentiating normal from dysfunctional personality functioning 13.2 Describe the two classification systems for diagnosing personality disorders, including their similarities and differences 13.3 Summarise and critically evaluate research on the prevalence of personality disorders in general 13.4 Describe prominent models regarding the aetiology and treatment of personality disorders in general 13.5 Describe prominent models regarding the aetiology and treatment of specific personality disorders Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-3 3 Personality Disorders are: [were] previously coded on Axis II of the DSM Sometimes more subtle and less incapacitating than many “Axis I” disorders Less often treated “Disorders of reputation” Often ego syntonic (as opposed to ego dystonic) Assumed by many to occur on a continuum (but this is questionable) Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-4 4 2  10/12/2024 The Definition of Personality A persistent pattern of thinking and feeling and behaving that is pervasive across situations and enduring over time Five factor model comprises five essential traits: – Neuroticism – Extroversion – Openness to experience – Conscientiousness – Agreeableness Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-5 5 Traits versus Disorders Traits are present in the general (non-clinical) population. Some traits in small doses (e.g., conscientiousness) are advantageous Some traits are maladaptive at either extreme: – Too little trust: paranoid – Too much trust: gullibility leading to being taken advantage of Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-6 6 3  10/12/2024 The Definition of Personality Disorder Millon (1981) identified three core features that differentiate disordered personality from normal-range problematic behaviours: – Functional inflexibility – Self-defeating behaviour patterns – Tenuous stability under stress and marked instability in mood, thinking and behaviour during difficult life events Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-7 7 The Definition of Personality Disorder DSM-5-TR Definition: – “A Personality Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (American Psychiatric Association, 2022). Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-8 8 4  10/12/2024 DSM-5-TR General Diagnostic Criteria for PDs A. An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas: 1) cognition (i.e., ways of perceiving and interpreting self, other people, and events) 2) affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response) 3) interpersonal functioning 4) impulse control B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. C. The enduring pattern leads to clinically significant distress of impairment in social, occupational, or other important areas of functioning. D. The pattern is stable and of long duration, and its onset can be traced back to at least to adolescence or early adulthood. E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder. F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma). Copyright © 2022 American Psychiatric Association Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-9 9 Criteria for Borderline Personality Disorder A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 3. Identity disturbance: markedly and persistently unstable self-image or sense of self. 4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms. Copyright © 2022 American Psychiatric Association Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-10 – 10 5  10/12/2024 The Diagnosis of Personality Disorder DSM-5-TR includes 10 distinct personality disorders categorised into one of three clusters: – Cluster A—odd or eccentric traits and behaviours – Cluster B—dramatic, emotional, erratic traits – Cluster C—anxious and fearful traits Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-11 11 PD Clusters (DSM-5-TR) Cluster A – Odd or Eccentric Mad – Paranoid, Schizoid, Schizotypal Cluster B – Dramatic, Emotional or Erratic Bad – Antisocial, Borderline, Histrionic, Narcissistic Cluster C – Anxious or Fearful Sad – Avoidant, Dependent, Obsessive-Compulsive Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-12 12 6  10/12/2024 DSM Versus ICD Personality Disorders Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-13 13 The DSM-5-TR Personality Disorders Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-14 14 7  10/12/2024 Cluster A: Paranoid PD Clinical Description – Mistrust and suspicion  Pervasive  Unjustified – Few meaningful relationships – Volatile – Tense – Sensitive to criticism Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-15 15 Cluster A: Schizoid PD Clinical Description – Appear to neither enjoy nor desire relationships – Limited range of emotions  Appear cold, detached – Appear unaffected by praise, criticism  Unable or unwilling to express emotion – No thought disorder Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-16 16 8  10/12/2024 Cluster A: Schizoid PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-17 17 Cluster A: Schizotypal PD Clinical Description – Psychotic-like symptoms  Magical thinking  Ideas of reference  Illusions – Odd and/or unusual  Behavior  Appearance – Socially isolated – Highly suspicious Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-18 18 9  10/12/2024 Cluster B: Antisocial PD Clinical Description – Noncompliance with social norms – “Social Predators”  Violate rights of others  Irresponsible  Impulsive  Deceitful – Lack a conscience, empathy, and remorse Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-19 19 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-20 20 10  10/12/2024 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-21 21 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-22 22 11  10/12/2024 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-23 23 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-24 24 12  10/12/2024 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-25 25 Cluster B: Antisocial PD Nature of psychopathy – Glibness/superficial charm – Grandiose sense of self-worth – Proneness to boredom/need for stimulation – Pathological lying – Conning/manipulative – Lack of remorse Overlap with ASPD, criminality – Intelligence may differentiate Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-26 26 13  10/12/2024 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-27 27 Cluster B: Antisocial PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-28 28 14  10/12/2024 Cluster B: Borderline PD Clinical Description – Patterns of instability  Labile, intense moods  Turbulent relationships – Impulsivity – Fear of abandonment – Very poor self-image – Self-mutilation – Suicidal gestures Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-29 29 Cluster B: Borderline PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-30 30 15  10/12/2024 Cluster B: Borderline PD Comorbid disorders – Depression – 24-74%  Suicide – 6% – Bipolar – 4-20% – Substance abuse – 67% – Eating disorders  25% of people with bulimia nervosa have BPD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-31 31 Cluster B: Histrionic PD Clinical Description – Overly dramatic – Sensational – Sexually provocative – Impulsive – Attention-seeking – Appearance-focused – Impressionistic – Vague, superficial speech – More common diagnosis in women Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-32 32 16  10/12/2024 Cluster B: Narcissistic PD Clinical Description – Exaggerated and unreasonable sense of self-importance – Require attention – Lack sensitivity and compassion – Sensitive to criticism – Envious – Arrogant Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-33 33 Cluster B: Narcissistic PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-34 34 17  10/12/2024 Cluster B: Narcissistic PD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-35 35 Cluster C: Avoidant PD Clinical Description – Extreme sensitivity to opinions – Avoid most relationships – Interpersonally anxious – Fearful of rejection Similar in many ways to social anxiety disorder Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-36 36 18  10/12/2024 Cluster C: Dependent PD Clinical Description – Rely on others for major and minor decisions – Unreasonable fear of abandonment – Clingy – Submissive – Timid – Passive – Feelings of inadequacy – Sensitivity to criticism – High need for reassurance Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-37 37 Cluster C: Obsessive-Compulsive PD Clinical Description – Fixation on doing things the “right way” – Rigid – Perfectionistic – Orderly – Preoccupation with details – Poor interpersonal relationships – Obsessions and compulsions are rare Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-38 38 19  10/12/2024 The Role of Culture in Personality Disorders Certain personality styles, and disorders, fit certain cultures or occupations – OCPD the most common in a national epidemiological study in Australia There is a cultural emphasis on the role and value of the individual and the community can influence how often a disorder is diagnosed Culture influences whether behaviours and traits are ‘aberrant’ or not Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-39 39 Epidemiology of Personality Disorders 40 20  10/12/2024 Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-41 41 Problems with Classification of Personality Disorders  Interrater Reliability  Comorbidity  Overlap among disorders Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-42 42 21  10/12/2024 Overlap Among PDs 43 Overlap Among PDs From: Morey, L. C. (1988). Personality disorders in DSM–III and DSM–III–R: Convergence, coverage, and internal consistency. The American Journal of Psychiatry, 145, 573–577. 44 22  10/12/2024 Overlap Among PDs Lenzenweger, M., Lane, M., Loranger, A. W., & Kessler, R. (2007). DSM-IV Personality Disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 62(6): 553–564. 45 Problems with Classification of Personality Disorders  Interrater Reliability  Comorbidity  Overlap among disorders  Overlap with “Axis I” disorders Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-46 46 23  10/12/2024 PDs Versus Other Disorders Personality Disorders and “Axis I” counterpart i) Avoidant PD and Social Anxiety Disorder ii) Borderline PD and PTSD iii) Schizotypal, Schizoid and Paranoid PDs and the psychotic disorders iv) Antisocial and Conduct disorder Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-47 47 Outpatient Co-Occurrence with Other Disorders MDD GAD Panic Social Ph PTSD Alc D Paranoid 4.7% 6.1% 5.6% 7.1% 8.7% 1.2% Schizoid 2.6% 1.7% 2.1% 3.3% 3.3% 0.0% Schizotypal 1.0% 0.0% 2.1% 1.7% 1.1% 1.2% Antisocial 2.9% 3.3% 4.9% 5.0% 9.8% 10.6% Borderline 12.2% 11.1% 16.9% 18.4% 26.1% 17.6% Histrionic 1.3% 0.6% 0.7% 1.7% 3.3% 5.9% Narcissistic 1.8% 2.2% 2.8% 1.7% 3.3% 5.9% Avoidant 20.3% 26.1% 21.8% 45.2% 26.1% 10.6% Dependent 2.9% 3.3% 2.8% 1.7% 2.2% 3.5% Obsessive-compulsive 8.6% 16.1% 13.4% 13.4% 10.9% 5.9% NOS 15.1% 20.6% 14.8% 14.6% 13.0% 14.1% Any PD 51.3% 63.9% 55.6% 76.2% 64.1% 51.8% Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-48 48 24  10/12/2024 Problems with Classification of Personality Disorders  Interrater Reliability  Comorbidity  Overlap among disorders  Overlap with Axis I disorders  Large Numbers of Unclassified Cases  Phenotypic Heterogeneity  Longitudinal Instability  Diagnostic Bias Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-49 49 Diagnostic Bias Differences in diagnostic rates – Borderline (e.g., 75% female) (may not be bias) Assessment bias – Measures Criterion bias – Histrionic = extreme “stereotypical female” – No “macho” disorder Clinician bias Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-50 50 25  10/12/2024 Personality Disorders: Gender Bias Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-51 51 Problems with Classification of Personality Disorders  Interrater Reliability  Comorbidity  Overlap among disorders  Overlap with Axis I disorders  Large Numbers of Unclassified Cases  Phenotypic Heterogeneity  Longitudinal Instability  Diagnostic Bias  Categorical model Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-52 52 26  10/12/2024 Categorical vs. Dimensional Views – “Kind” vs. “Degree” – DSM is categorical  Reifies concepts  Less flexible  Loss of individual information  Sometimes arbitrary Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-53 53 Dimensional Approach to Personality Dysfunction This approach maintains that the various personality characteristics exist on a continuum from low to high. Those with a ‘disorder’ occupy the extreme end of the continuum Although much work was put into creating a dimensional system for the DSM-5, the categorical model was retained The dimensional-categorical hybrid model in the DSM-5’s section on ‘Emerging Measures and Models’ Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-54 54 27  10/12/2024 Alternative DSM-5 PD System Organised into five domains – Negative affectivity – Detachment – Antagonism – Disinhibition – Psychoticism Within the five domains are 25 specific trait facets Each PD has it’s own set of typical pathological personality traits Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-55 55 Alternative DSM-5 PD System Six specific PDs (reduced from 10): – Antisocial – Avoidant – Borderline – Narcissistic – Obsessive-compulsive – Schizotypal Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-56 56 28  10/12/2024 General Models of Aetiology and Treatment Factor approaches emphasise that personality is the degree to which an individual manifests certain traits and combinations of traits Beck’s cognitive model emphasises dysfunctional core beliefs that influence a person’s understanding of themselves, others and the world Young’s schema therapy model emphasises the presence of early maladaptive schemas which may be rigid and resistant to change. Therapy educates the person about their schemas and uses cognitive and behavioural techniques to modify them Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-57 57 Schema Therapy for PDs Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-58 58 29  10/12/2024 Early Maladaptive Schemas Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-59 59 General Models of Aetiology and Treatment: Linehan & DBT Developed for borderline personality disorder but has been applied to antisocial behaviours, substance abuse and eating disorders Disturbances in borderline personality disorder are due to poor emotional regulation, which is due to interaction between biologically based vulnerability and ‘invalidating’ environments Dialectical behaviour therapy (DBT), both individual and group, has been shown to be clinically useful Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-60 60 30  10/12/2024 General Models of Aetiology and Treatment: Cognitive Analytic Therapy Links aspects of cognitive psychology with object relations approach Reciprocal role procedures refers to complimentary patterns the individual enacts in regards to relationships (e.g., abusive parent and abused child) Therapy focuses on working with the person to develop an understanding of these reciprocal role procedures Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-61 61 A Diagram used in Cognitive Analytic Therapy Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-62 62 31  10/12/2024 General Models of Aetiology and Treatment: Mentalisation-based Treatment Integrates object relations theory and attachment theory First developed for borderline personality disorder Mentalisation is the capacity to think about one’s mental state and the mental states of others This treatment uses the therapeutic relationship to stabilise the person’s sense of self and enhance their capacity to know their own mind and that of others Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-63 63 Aetiology and Treatment of Cluster A Disorders Aetiology: – Genetically based neurological abnormalities combined with certain environmental inputs predispose an individual to developing odd, eccentric or psychotic features Treatment: – There is limited empirical evidence on treatment – Intimacy and trust issues make treatment difficult – Cognitive behaviour therapy and the use of some medications may be of benefit Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-64 64 32  10/12/2024 Aetiology and Treatment of Cluster B Disorders Aetiology of antisocial personality disorder: – Interaction between genetic vulnerability and adverse environmental conditions Treatment of antisocial personality disorder: – The majority of treatment focuses on comorbid disorders, e.g. substance use, and on risk management – Mentalisation-based treatment is being trialled – There is debate about the use of antidepressants – Lithium and antipsychotic medication have been used to manage impulsive and aggressive behaviours Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-65 65 Aetiology and Treatment of Cluster B Disorders Aetiology of borderline personality disorder: – The importance of genetics is unclear – Psychosocial factors, e.g., childhood trauma, are strongly associated with borderline personality disorder – Biological influences are also likely Treatment of borderline personality disorder: – People with BPD often seek help – Psychological intervention is recognised as the first-line treatment – Studies have investigated psychodynamic treatments, CBT, DBT, schema therapy and cognitive analytic therapy Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-66 66 33  10/12/2024 Aetiology and Treatment of Cluster B Disorders Aetiology of narcissistic personality disorder: – Little is known about the origins – Most theories centre on invalidating childhood experiences Treatment of narcissistic personality disorders: – Individuals are unlikely to seek treatment unless experiencing distress related to other difficulties – Limited research base on treatment for NPD Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-67 67 Aetiology and Treatment of Cluster B Disorders Aetiology of histrionic personality disorder: – Models emphasise the role of inconsistent, intense and non-empathic parent-child interactions Treatment of histrionic personality disorder: – There is a lack of empirical findings – Because of dependency issues, individuals with HPD may be more likely to seek help – Cognitive therapy may be helpful to address identifying and challenging assumptions about dependency on others Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-68 68 34  10/12/2024 Aetiology and Treatment of Cluster C Disorders Aetiology of avoidant personality disorder: – Some evidence of a modest genetic contribution – May manifest in the very early developmental period, and be associated with childhood neglect and early rejection experiences Treatment of avoidant personality disorder: – Often seek treatment for comorbid disorders, i.e., depression and anxiety – CBT, social skills training and psychodynamic therapies have been studied – Behavioural techniques aimed at countering social avoidance are effective Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-69 69 Aetiology and Treatment of Cluster C Disorders Aetiology of dependent personality disorder: – Potential genetic predisposition or vulnerability – Early physical abuse may lead to DPD Treatment of dependent personality disorders: – Promising results from trials of schema therapy and DBT – Behavioural strategies for anxiety management are also useful Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-70 70 35  10/12/2024 Aetiology and Treatment of Cluster C Disorders Aetiology of obsessive-compulsive personality disorder: – Moderate genetic contribution to the development of OCPD – Cognitive theories emphasise core beliefs regarding the intolerable nature of perceived faults or flaws Treatment of obsessive-compulsive personality disorder: – Individuals typically seek help for comorbid anxiety or depression – Some support for the efficacy of cognitive behavioural interventions Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-71 71 Any Questions? If so, post them online Copyright © 2017 McGraw-Hill Education (Australia) Pty Ltd Rieger, Abnormal Psychology, 4e 13-72 72 36