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Personality disorders

Refer to enduring + stable patterns of thought, feeling and behavior, that deviate from the norms of ones culture and may lead to distress and impairment

  •  emerges in adolescence or early adulthood

=> extreme levels of personality traits, but may tend to fluctuate over the course of time


Schizoid personality disorder

Involves an extreme degree of detachment from social relationships + very limited expression of emotions in interpersonal settings

--> e.g.: emotional detachment + social isolation


Schizotypal personality disorder

Tendency to be highly superstitious with the paranormal + having bizarre perceptual experiences

--> detachment from social relationships also due to discomfort


Paranoid personality disorder

Characterized by a strong suspiciousness of others motives + by a sense of being followed

--> e.g.: think that others try to harm, deceive, exploit you


Antisocial personality disorder

Refers to a tendency to disregard + violate the right of others

--> e.g.: being deceitful by lying to others/conning them


Borderline personality disorder

Involves extreme instability in ones own self image + ones relationships with others

--> e.g.: having unstable "love/hate" relationships with others + working over possible abandonment


Histrionic personality disorder

Refers to an exaggerated display of emotions + excessive attention seeking

--> e.g.: feeling uncomfortable when not the focus of attention


Narcissistic personality disorder

Refers to a tendency to consider oneself as a superior individual who deserves the admiration of others

--> selfish lack of concern for others needs


Avoidant personality disorder

Characterized by social inhibition, shyness, feelings of inadequacy + oversensitivity to possible negative evaluation

--> strong fears of criticism/disapproval/rejection


What are the differences between the avoidant vs schizoid personality disorder when it comes to their need for social contact ?

Avoidant people want social contact but is simply afraid of rejection, whereas schizoid people are completely indifferent to it


Dependent personality disorder

Characterized by an

a) excessive need to be taken care of

b) submissive, clinging behavior

c) fear of separation


--> need a great deal of advice + reassurance


Obsessive-compulsive personality disorder

Involves being preoccupied with orderliness, perfection + control

--> to an extent that the purpose of the entire activity is lost


DSM 4 cluster

Lists 10 personality disorders which are grouped into 3 "clusters":


--> Cluster A,B,C and (NOS)

  • Only categorical 


Cluster A

(odd + eccentric)

Contains the

a) Schizoid

b) Schizotypal

c) Paranoid

personality disorders, suggesting that these peoples behaviors are strange + unusual


Cluster B

(dramatic + erratic)

Contains the


a) Antisocial

b) Borderline

c) Histrionic

d) Narcissistic


personality disorders, suggesting that these peoples behaviors are impulsive + unstable


Cluster C

(anxious + fearful)

Contains the


a) Avoidant

b) Dependent

c) Obsessive-compulsive


Personality disorders, suggesting that these peoples behaviors are nervous + worried


Cluster NOS

(Not otherwise specified)



a) Depression

b) Passive-Aggressiveness


--> most prevalent personality disorders


Limitations to the DSM 4 

1. Some symptoms do not really show much tendency to co-occur

  •  2 persons diagnosed with the same disorder might not have any symptoms in common

2. Two disorders might have overlapping symptoms and may be diagnosed together

  •  people might me diagnosed with 2 or more disorders

3. "Clusters" of disorders do not match factor analysis results

4. A personality disorder should be seen as a continuum, not as a category

  •  because having it is a matter of degree


According to the new, revised version of the DSM 5, there are 2 essential features of a personality disorder.

Which are those ?

1. Impaired personality functioning

2. Presence of pathological personality traits




In which way is the new DSM 5 version different to the DSM 4 ?

Hybrid version

--> categorical + dimensional 


1. dimensional part is shown in section III of the DSM, which is part for future research, thus it is not really used

2. Dimensional part refers to the 5 domains


Negative affectivity domain

Involves intense experience of negative emotions

--> similar to neuroticism


Detachment domain

Involves withdrawal from social interactions + from other people

--> similar to low extraversion


Antagonism domain

Involves acting in ways that create difficulties for other people

--> similar to low honesty-humility


Disinhibition domain

Involves behaving on impulse, without thinking of consequences

--> similar to low conscientiousness


The new, revised system recognizes 25 personalty traits as being pathological, when showing a high level of one of the traits.

These 25 personality facets are clustered into 5 main domains.

Several of these domains are similar to factors of the big 5 or HEXACO.

Name these domains.

1. Negative affectivity domain

2. Detachment domain

3. Antagonism domain

4. Disinhibition domain

(5. Psychoticism)

--> describes Schizotypal PD


Which methods does a clinician use to diagnose a patient ?

1. Conducting a structured interview with patient or person that know the patient


2. Using a specific rating form

a) Impaired personality functioning

  •  from scale 0-4, with 3-4 indicating a PD

b) Pathological personality trait

  • scale 0-3, with 2-3 being indicative


Which criteria must be met if a personality disorder is to be diagnosed ?

1. Does the patient have Impaired personality functioning, by looking at 


a) whether a person has a clear sense of the self

b) Capabilities of self- or emotional regulation

c) Interpersonal functioning; ability to make and maintain relationships


2. The pathalogical traits have to be 


a) relatively stable across time

b) considered abnormal for the persons stage of development

c) not be due to the effects of some substance e.g.: medication, drugs


What are the causes of Personality disorders ?

1. Show high heritability (50 %), where the rest is due to envirnomental factors or an interplay of both

2. Insecure attachment 

--> schemas

3. Neurobiological differences

3. Childhood trauma




What are the 2 reasons for why it can be difficult to treat personality disorders ?

1. Disorders are based on the individuals own personality characteristics, which tend to be rather stable across long periods of time

2. Some disorders are based on characteristics that make an individual less likely to be cooperative during during treatment


Psychodynamic psychotherapy

Involves encouraging the patient to speak freely about what is on his/her mind

--> thereby the patients self understanding improves his/her functioning