Cluster A Personality Disorders

Paranoid personality Schizoid personality
Shizotpal personality

Cluster B Personality Disorders

Antisocial personality Borderline personality
Histrionic personality Narcissistic personality

Cluster C Personality Disorders

Avoidant personality Dependent personality
Obsessive-compulsive personality

Paranoid Personality Disorder

Pervasive, persistent and inappropriate mistrust of other -
suspicious of others motives and assume others want to exploit, harm
and deceive them. Preoccupied with unjustified doubts about
loyalty/trustworthiness of friends Reluctant to confide in
others because of unwarranted fear that information will be used
against them. Persistently bears grudges

Paranoid Personality Disorder
Predisposing Factors

Possible hereditary link - higher in relatives of
schizophrenia Subjected to parental antagonism and harassment
-were scapegoats - and learned to perceive the world as harsh and
unkind. Anticipate humiliation and betrayal by others.

Schizoid Personality Disorders

Profound defect to form personal relationships Failure
to respond to others in a meaningful way More frequent in
men than women Aloof & indifferent to others,
emotionally cold, no close friends - solitary, Appears shy,
anxious, or uneasy presence of others Takes no pleasure in
few or any activities, inappropriately serious

Schizoid Personality Disorders
Predisposing factors

Possible hereditary factor Childhood is said to be:
bleak, cold, uempathic, lack of nurturing Child displays a
shy, anxious, introverted temperament

Schizotypal Personality Disorder

Graver form of the less severe schizoid disorder
Individuals appear aloof and isolated Behave in a bland
and apathetic manner Suffer from magical thinking,unusual
perceptual experiences, bodily illusions Odd thinking and
speech; suspiciousness or paranoid ideation Lack of close
friends or confidants other than relatives

Schizotypal Personality Disorder
Predisposing Factors

Physiological influence include - deficits in brain or
neurochemical dysfunctions Early family dynamics -
indifference, impassivity, or formality, affective deficits made
individual unattractive and unrewarding social companions

Antisocial Disorders

A pattern behavior is socially irresponsibly, exploitative,
without remorse, disregard for the rights of others. Fails
to maintain consistent occupation, conform to the law, exploits and
manipulates others, Fails to develop stable
relationship Prevelance of 2-4 % of men

Borderline Personality Disorder - borderline of neuroses or psychoses

Pattern of intense and chaotic relationships, fluctuating and
extreme attitudes regarding other people, impulsive.
Emotionally unstable, directly and indirectly
self-destructive Lack of clear sense of identity
Affects 1-2 percent mostly in women

Histrionic Personality Disorder

Behavior includes: excitable, emotional, colorful, dramatic,
extroverted 2-3 percent and mostly in women S/S:
Self-dramatization, attention-seeking, overly gregarious, seductive,
Manipulative, exhibitionist, highly distractibility, difficulty
paying attention to detail, easily influenced, strongly dependent,
somatic complaints are common.

Histrionic Personality Disorder
Predisposing Factors

Link to the nor adrenergic and serotonergic systems
Bio genetically temperament, learned behavior patterns - child
may have received positive reinforcement was contingent to perform
approved and admired behaviors.

Narcisstic Personality Disorder

Exaggerated sense of self-worth (achievements, talents, expects
to recognized as superior), lack of empathy, belief to receive
special consideration Prevalence of 6%; Most often in men
than women Preoccupied with success, power, brilliance,
beauty, or ideal love - overly self-centered Mood is
grounded in grandiosity - have a fragile self-esteem and mood can
change if expectations are not met. Criticism may cause
responses of rage, humiliation and shame.

Narcisstic Personality Disorder
Predisposing Factors

During childhood - fears, failures, or dependency needs were
responded to criticism,disdain, or neglect. Parents often
narcisstic and may have overindulged child and failed to set limits
on behaviors.

Avoidant Personality Disorder

Extreme sensitivity to rejection and social withdrawal
Prevalence is about 1% and equally in women and men
Awkward and uncomfortable in social situations, desire close
relationships but avoids them for fear of rejection
Perceived as timid, withdrawn, or cold and strange, often lonely
and feel unwanted. View others as critical and betraying.

Avoidant Personality Disorder
Predisposing Factors

No clear cause known May be a combination biological,
genetic and psycho-social - parental rejection and censure

Dependent Personality Disorder

Relying on others for emotional support Common within
the population, common among women than men and younger
children Lack of self of confidence apparent in posture,
voice, mannerisms, Typically passive, overly generous and
thoughtful - while underplaying key characteristics Low
self-worth, easily hurt by criticism and disapproval Avoid
positions of responsibility and become anxious when forced to do
so.

Dependent Personality Disorder
Predisposing Factors

Possible hereditary Stimulation and nurturance are
experienced exclusively, singular attachment is made by infant to
exclusion of all others

Obsessive Compulsive Personality Disorder

Inflexibility about the way in which things are done
Devotion to production at the exclusion of personal
pleasure Relatively common; Occurs in most men and women and
in oldest children. Concerned with matters of organization
and efficiency, tend to be rigid and unbending, socially polite and
formal, rank-conscious Appear calm on the outside but
experience ambivalence, conflict and hostility inside

Obsessive Compulsive Personality Disorder
Predisposing Factors

Over control by parents Notable parental lack of
positive reinforcement for acceptable behavior Frequent
punishment for undesirable behavior

Borderline Assessment

Instability relationship Marked Impulsive
Chronic depression, inability to be alone, clingning and
distancing behaviors, splitting and manipulation

Borderline Personality Disorder
Predisposing Factors

Psycho-social influences - childhood trauma and abuse
Fixed in the stage of rapprochement phase of development ( ages
16-24 months) - fails to achieve task of autonomy

Borderline Personality Disorder
Outcomes

The client has not harmed self, seeks out staff when desire for
self-mutilation is strong Able to identify true source of
anger and express anger appropriately Relates to more than
one staff member

Antisocial Personality Disorder

Most frequently encountered jail, prisons, and rehabs
Sometimes admitted by court Common Behaviors -
exploitation and manipulation for others personal gain, belligerent
and argumentative, lacks of remorse, unable to delay
gratification Failure to conform to societal norms, impulsive
and reckless,

Antisocial Personality Disorder
Predisposing Factors

Possible genetic influence; Disruptive childhood behavior
(ADHD, Conduct disorder); history of physical abuse, absent or
inconsistent parental discipline. Extreme poverty, removal
from the home, Always being rescued when in trouble.

Antisocial Personality Disorder
Outcomes

Client discusses angry feelings with staff and in group
sessions Has not harmed self or others Follows rules
and regulations of the therapy environment

Treatment Modalities
Interpersonal psychotherapy, Psychoanalytical psychotherapy,
Milieu/Group Therapy

Interpersonal - brief/time-limited understand and modify the
maladjusted behaviors, cognition and affects of clients. Core
element empathic therapist-client relationship.
Psychoanalytical - Treatment of choice for histrionic
personality disorder, focuses on unconscious motivation for seeking
total satisfaction from others Milieu - good for antisocial
personality disorder - who respond to support and feedback from
peers

Treatment Modalities
Cognitive Behavioral Therapy, Dialectical Behavior Therapy,

Cognitive/Behavioral Therapy - Offer reinforcement for positive
change includes social skills training and assertiveness training -
useful for obsessive-compulsive, antisocial, avoidant
personality. Dialectical Behavior Therapy - includes group
skills training, individual psychotherapy, telephone contact, and
therapist consultation. Useful for self-destructive behaviors

Treatment Modalities
Psychopharmacology

SSRI' & MAOI's useful in decreasing in impulsive and
self-destructive SSRI and Antipsychotic combo useful in
treating dysphoria, mood instability, impulsivity. Lithium
carbonate and propranolol may be useful for violent episodes of
antisocial behavior.