A. Defining Personality
i. is it constant across situations?
ii. is it multifaceted?
iii. is it permanent, unchanging?
iv. where does it come from?
v. stable set of characteristics & tendencies that determine an individuals response to a varity of circumstances
B. Defining Abnormal Personality
i. inflexible, maladaptive traits that interfere with a person's ability to perform adequately in various soical roles:
CLUSTER A - Odd, eccentric, mistrust, constricted emotion
a. Paranoid - tense, guarded, suspicious b. Schizoid - socially isolated with restricted emotional expression
c. Schizotypal - peculiarities of thought, appearance, behavior, emotionally detached
CLUSTER B- Dramatic, emotional, erratic a. Antisocial - manipulative, exploitive, dishonest, disloyal, lacks guilt, breaks social rules, childhood history of troubled behavior b. Borderline - cannot tolerate being alone, intense, unstable moods and personal relationships, chronic anger, drug/alcohol abuse
c. Histrionic - Seductive, needs immediate gratification and constant reassurance, rapidly changing moods, shallow emotions d. Narcissistic - self-absorbed, expects special treatment and adulation, envious of attention to tothers
CLUSTER C - Anxious, fearful, avoidance tendencies
a. Avoidant - easily hurt and embarrassed, few close friends, sticks to routines to avoid new and possibly stressful experiences
b. Dependent - wants others to make decisions, needs constant advice and reassurance, fears being abandoned c. Obsessive-Compulsive - perfectionistic, overerconscientious, indecisive, preoccupied with details, stiff, unable to express affection.
d. Passive-Aggressive - resents demands and suggestions, procrastinates, sulks, "forgets" obligations or is deliberately inefficient
Comparison to Axis I
a. earlier onset
b. perhaps less florid
c. less responsive to treatment
d. more continuously/consistently present
e. systems are ego syntonic
Challenges of Assessment
a. best format?
i. interview - response bias
ii. behavioral observation
b. best source?
i. reliability - different clinicians find different personality disorders; diagnostic criteria are subjective (e.g. suspiciousness)
ii. validity - overlap in diagnostic criteria and phenomenology raise questions about whether they are distinct entities.
(1) 85% of patients with one personality disorder quality for another. (2) some suggest a dimensional approach might be more valid than a categorical approach.