CH-19-20 Disorders of Personality – Personality Psychology: Domains of Knowledge About Human Nature : Chapter Notes

This Document Contains Chapters 19 to 20 Chapter 19 Disorders of Personality Chapter Outline The Building Blocks of Personality Disorders Symptoms of personality disorders can be viewed as maladaptive variations within the domains of traits, emotions, cognitions, motives, and self-concept Personality disorders as maladaptive variations or combinations of normal personality traits Several personality disorders involve maladaptive variations on common motives, especially power and intimacy Cognitive processes can become distorted in personal disorders Several personal disorders include extreme variations in experienced emotion Most personality disorders include distortion of self-concept Social relationships, especially interpersonal and sexual behavior, frequently disturbed or involve maladaptive patterns in personality disorders Biology forms a building block of several personality disorders Disorders of personality can provide insight into the normal workings of personality The Concept of Disorder Psychological disorder Pattern of behavior or experience that is distressing and painful to the person Leads to disability or impairment in important life domains Associated with the increased risk for further suffering, loss of function, death, or confinement Abnormal psychology: Study of mental disorders, including thought disorders, emotional disorders, and personality disorders
What Is Abnormal? Statistical definition: Whatever is rare, not frequent, and not statistically normal Social definition: Whatever society does not tolerate Statistical and social definitions are tied to changing social or cultural norms Psychologists thus look within persons, inquiring about subject feelings and thoughts Psychopathology: Study of mental disorders The Diagnostic and Statistical Manual of Mental Disorders Widely accepted system for diagnosing and describing mental disorders Because society standards change over time, and because new research accumulates, the DSM undergoes revision from time to time What is a Personality Disorder? Enduring pattern of experience and behavior that differs greatly from expectations of a person’s culture Disorder is usually manifested in more than one of following areas: Thoughts, feelings, how a person gets along with others, and the ability to control own behavior Pattern of behavior is rigid and displayed across a variety of situations, leading to distress in key areas of life such as work and relationships Pattern of behavior typically has a long history in a person’s life, often back to adolescence or childhood Pattern must not be attributable to drug abuse, medication, or other medical condition Culture, age, and gender: The effect of context Must take into account person’s culture, age, gender before defining behavior as revealing personality disorder Specific Personality Disorders The Erratic Cluster: Ways of Being Unpredictable, Violent, or Emotional Antisocial personality disorder Little concern for others Impulse Easily irritated and assaultive Reckless and irresponsible Glib or superficial charm Callous social attitudes Lack of guilt feelings or remorse Indifferent to suffering of others Borderline personality disorder Marked by instability: relationships, behavior, emotions, even images of themselves Shifting views of themselves Strong emotions huge vacillations in both mood and feelings about the self and others Histrionic personality disorder Excessive attention seeking and emotionality Inappropriately seductive or provocative Physical appearance is often very important Express their opinions frequently and dramatically, however their opinions are shallow Display strong emotions in public Difficult to get along with, due to their excessive need for attention They crave excitement and novelty Narcissistic personality disorder Need to be admired Strong sense of self importance Lack of insight into other peoples’ feelings or needs Sense of entitlement Feelings of superiority Self-esteem appears strong, but is fragile Envious of others
The Eccentric Cluster: Ways of Being Different Schizoid personality disorder Detached from normal social relationships Obtains little pleasure out of life Appears inept or socially clumsy Passive in the face of unpleasant events Schizotypal personality disorder Anxious in social relations and avoids people Appears “different” and does not conform Suspicious of others Odd or eccentric beliefs, such as in ESP or magic Thoughts and speech sometimes disorganized Paranoid personality disorder Distrustful of others Misinterprets social events as threatening Harbors resentment toward others Prone to pathological jealousy Argumentative and hostile The Anxious Cluster: Ways of Being Nervous, Fearful, or Distressed Avoidant personality disorder Feelings of inadequacy Sensitive to criticism Restricts activities to avoid embarrassments Low self-esteem Dependent personality disorder Excessive need to be taken care of Submissive Seeks reassurance from others Rarely takes initiative, rarely disagrees with others Does not work well independently May tolerate abuse from others to obtain support Obsessive-compulsive personality disorder Preoccupied with order Strives for perfection Devoted to work, seeks little leisure time or friendship Frequently miserly or stingy Rigid and inflexible and stubborn Prevalence of Personality Disorders Prevalence refers to total number of cases present in given population during a particular period of time Obsessive Compulsive personality disorder most common, with just over 4% prevalence rate Next most common are Schizotypal, Histrionic, and Dependent personality disorders, about 2% prevalence rate each Narcissistic personality disorder least common, with 0.2% prevalence rate Total prevalence rate for having at least one personality disorder is 13% Gender Differences in Personality Disorders The overall prevalence rate for personality disorders is fairly equal in men and women Exceptions: antisocial personality disorder occurs in men with a prevalence rate of about 4.5 percent and in women at only about a 0.8 percent prevalence rate Dimensional Model of Personality Disorders Distinctions between normal personality traits and disorders are in terms of extremity, rigidity, maladaptiveness Parallel with chemistry: A little of this trait, some of that trait, and amplifying to extremely high (or low) levels, resulting in specific disorder Dominant model currently is categorical model (DSM-IV and DSM-5) Causes of Personality Disorders Abnormal psychology and psychopathology are highly descriptive disciplines Some theoretical work on causes of personality disorders Most work emphasizes either “biological” causes or “social” causes of personality disorders SUMMARY AND EVALUATION Hallmark of psychological definition of abnormal is anything that prevents a person from having satisfying relationships or from carrying on productive work Sigmund Freud taught that the sign of a mature adult personality is the ability to love and to work All of the personality disorders refer to symptoms that cause problems with relationships, work, or both Personality disorders refer to enduring patterns of experience and behavior that differ greatly from the norms and expectations of a person’s culture Disorder shows up in how a person thinks, feels, gets along with others, and the ability to control own actions Pattern is displayed across situations, leading to the distress in self or others in key areas of life such as love and work Disorder typically has a long history in a person’s life KEY TERMS Disorder Abnormal Psychology Schizoid Personality Disorder Abnormal Schizotypal Personality Disorder Psychopathology Paranoid Personality Disorder Personality Disorder Categorical View Neurotic Paradox Dimensional View Avoidant Personality Disorder Antisocial Personality Disorder Dependent Personality Disorder Borderline Personality Disorder Obsessive-Compulsive Personality Disorder Eye-blink Startle Method Prevalence Histrionic Personality Disorder Differential Diagnosis Narcissistic Personality Disorder Chapter Overview This chapter introduces students to disorders of personality. The authors begin with an overview of the concept of disorder, noting that a psychological disorder is a pattern of behavior or experience that is distressing and painful to the person, leads to some disability or impairment in important life domains, and is associated with increased risk for further suffering, loss of function, death, or confinement. The authors then review the concepts of “abnormal” and “psychopathology.” Next the authors discuss the concept of personality disorder, providing a definition and description based on current thinking in Western psychiatry. The authors then differentiate categorical and dimensional approaches to psychopathology, in general, and personality disorders, in particular. Next the authors discuss the importance of context, especially culture, age, and gender, in defining what is and what is not abnormal or a disorder. The authors then review the 10 specific personality disorders recognized by Western psychiatry. The erratic cluster of personality disorders includes antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. These four disorders are defined by “ways of being” that are unpredictable, violent, or emotional. The next cluster of personality disorders, the eccentric cluster, includes disorders that are defined by ways of being that are odd, different, or peculiar. The eccentric cluster includes schizoid personality disorder, schizotypal personality disorder, and paranoid personality disorder. Finally, the anxious cluster of personality disorders includes disorders that are defined by ways of being that are nervous, fearful, or distressed. The anxious cluster includes avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. The authors close with a brief review of some of the proposed causes of personality disorders. Learning Objectives Review the history of the idea that something can go wrong with a person’s personality. Define the key components of a psychological disorder, as conceptualized by modern psychiatry. Describe the key goals of the field of abnormal psychology. Review the various definitions of “abnormal” and identify the modern psychiatric definition of abnormal. Discuss the concept of a personality disorder, including a modern psychiatric definition. Identify and discuss the key criteria for all personality disorders, according to modern psychiatry. Compare and contrast the categorical and dimensional approaches to personality disorders. Discuss the importance of taking into account the contexts of culture, age, and gender, when identifying the presence of a personality disorder. Discuss the key features of antisocial personality disorder. Discuss the key features of borderline personality disorder. Discuss the key features of histrionic personality disorder. Discuss the key features of narcissistic personality disorder. Discuss the key features of schizoid personality disorder. Discuss the key features of schizotypal personality disorder. Discuss the key features of paranoid personality disorder. Discuss the key features of avoidant personality disorder. Discuss the key features of dependent personality disorder. Discuss the key features of obsessive-compulsive personality disorder. Review the key features of a dimensional model of personality disorders. Discuss key causes that have been proposed for personality disorders. Lecture Topics and Lecture Suggestions Personality Disorders in the General Population: DSM-IV and ICD-10 Defined Prevalence as Related to Sociodemographic Profile (Ekselius, Tillfors, Furmark, et al., 2001). This lecture presents students with one attempt at an estimation of prevalence rates of different personality disorders in a community sample. The sample is drawn from a community in Sweden. Students will appreciate the straightforward objectives and design of this research. Use this lecture as a springboard for discussing the prevalence of personality disorders in the general population. Challenge students to think about which personality disorders might be least common in a college population, and which disorders might be most common in a college population. Prevalence and sociodemographic characteristics of Mental Disorders-IV (DSM-IV) and International Classification of Diseases (ICD)-10 defined personality disorders were examined in a community sample Data were obtained by means of the DSM-IV and ICD-10 personality questionnaire postal survey completed by 557 individuals (aged 18–70 years) Results found that the prevalence of any ICD-10 defined personality disorder was 11.0 percent and 11.1 percent when using DSM-IV criteria Comorbidity between personality disorders was common Prevalence similarities between DSM and ICD definitions were obtained for the following personality disorders Paranoid Schizotypal Borderline Histrionic Avoidant Dependent Obsessive-Compulsive Prevalence similarities between DSM and ICD definitions were NOT obtained for schizoid and antisocial personality disorders Personality disorders were significantly more often diagnosed in younger subjects Students and unemployed homemakers had the highest rates Individuals with personality disorders more often received psychiatric treatment, lacked social support, and reported significantly more psychosocial and environmental problems in the past year Thus, it is concluded that personality disorders are relatively common in the community, and Affected individuals are more impaired than subjects without personality disorders Reference: Ekselius, L., Tillfors, M., Furmark, T., et al. (2001). Personality disorders in the general population: DSM-IV and ICD-10 defined prevalence as related to sociodemographic profile. Personality and Individual Differences, 30, 311–320. Personality Disorders as Extreme Variants of Common Personality Dimensions: Can the Five-Factor Model Adequately Represent Psychopathy? (Miller, Lynam, Widiger, et al., 2001). This lecture is designed to present to students recent research on the utility of the five-factor model of personality (Surgency, Agreeableness, Conscientiousness, Emotional Stability, Openness/Intellect) for describing personality disorders. In particular, this lecture highlights research designed to test whether personality disorders might be usefully thought of as extreme variants of the five factors of personality. The specific focus of this research is on psychopathy, a personality dimension or collection of traits that is of great interest to students. Use this lecture as a springboard for discussing the utility of the five-factor model for describing personality disorders, in general, and psychopathy, in particular. The present study examined Widiger and Lynam’s (1998) hypothesis that psychopathy can be represented using the Five-Factor Model (FFM) of personality Participants in the study consisted of 481 21- and 22-year-old men and women who are part of an ongoing longitudinal study Psychopathy was assessed by the degree of similarity between an individual’s NEO-PI-R and an expert-generated FFM psychopathy prototype The expert-based prototype supported the account of Widiger and Lynam, as did the correlations between the NEO-PI-R Psychopathy Resemblance Index (PRI) and the individual personality dimensions The PRI was also related in predicted ways to measures of antisocial behavior, drug use, and psychopathology The results support the contention that psychopathy can be understood as an extreme variant of common dimensions of personality, and The results underscore the utility of a dimensional model of personality disorders Reference: Miller, J. D., Lynam, D. R., Widiger, T. A., et al. (2001). Personality disorders as extreme variants of common personality dimensions: Can the Five-Factor Model adequately represent psychopathy? Journal of Personality, 69, 253–276. Classroom Activities and Demonstrations Larsen and Buss review several definitions of “abnormal.” This activity is designed to get students to think critically about their own definitions of what is and what is not abnormal behavior. This activity should be completed before the instructor lectures on the topic. The idea is to give students an opportunity to express their own conceptions of what is and what is not abnormal. Distribute Activity Handout 19–1 (“What is Abnormal?”). Give students about five minutes to complete the handout. Ask several students to volunteer their definitions of abnormal. Encourage alternative conceptions. Use this activity as a springboard for discussing the various ways that abnormal can be defined, and the special way in which modern psychology and psychiatry defines abnormal. Larsen and Buss provide a definition of “personality disorder.” This activity is designed to get students to express their own ideas about the defining features of a personality disorder. This activity should be completed before the instructor lectures on the topic. The idea is to give students an opportunity to express their own conceptions of what defines the key components of a personality disorder. Distribute Activity Handout 19–2 (“What is a Personality Disorder?”). Give students about five minutes to complete the handout. Ask several students to volunteer their nominations for the key components of a personality disorder. Use this activity as a springboard for discussing the special way in which modern psychology and psychiatry defines a personality disorder. Larsen and Buss review the defining features and characteristics of 10 specific personality disorders. This activity is designed to encourage students to actively apply this material to someone they know, or have read or heard about who might have a personality disorder. Distribute Activity Handout 19–3 (“An Example of Someone with a Personality Disorder”). Give students about 10 minutes to complete the handout. Ask students to volunteer their nominations for someone with a personality disorder and ask them to provide evidence of the presence of the defining characteristic of that particular personality disorder. Use this activity as a springboard for discussing more formally the defining feature of one or more of the personality disorders. Chapter 20 Summary and Future Directions Chapter Outline Introduction Personality psychologists seek to understand the whole of personality However, understanding the whole may be impossible Instead, the difficult task of understanding the whole person is best approached by breaking personality into its parts or domains Current Status of the Field Personality psychologists doing research today focus on specific components or domains of knowledge about personality Starting about 50 years ago, personality psychologists began turning away from grand theories of personality (e.g., Freud’s psychoanalysis) Whole of personality is the sun of its parts, and the understanding of the parts will provide an understanding of the whole Domains of Knowledge: Where We’ve Been, Where We’re Going Dispositional Domain Concerns aspects of personality that are stable and make people different from each other Trait psychologists will continue to focus on interaction of persons and situations Trait psychologists will continue to lead the way in developing new methods for measuring personality characteristics and new statistics for evaluating personality research Search will continue for traits not yet identified by lexical and statistical strategies of identifying individual differences Biological Domain Core assumption of biological domain is that humans are biological systems Concerns factors within the body that influence or are related to personality Biological domain refers to the physical elements and biological systems in the body that influence or are influenced by our behaviors, thoughts, and feelings Area likely to be active in the future is psychology of approach and avoidance More emphasis on genetic influences on personality, as well as work by genetic researchers identifying environmental influences on personality Personality research will continue on genetic influences at the molecular level Evolutionary perspectives will continue to gain in importance, adding a new layer of questions and insight to personality
Intrapsychic Domain Concerns factors within the mind that influence behavior, thoughts, and feelings—many of these influences are argued to operate at the unconscious level Psychologists will continue to be interested in the idea that people can have thoughts outside of conscious awareness Topic of repressed memories also is likely to receive attention by researchers and clinicians
Cognitive/Experiential Domain Centers on subjective experiences and other mental process Psychologists are likely to continue to focus attention on self-concept and identity Likely that psychologists will incorporate the idea that identity is like a story, and that the narrative approach will continue to be part of personality psychology Psychologists will continue to investigate the notion that people construct their experiences, how this works, and what it tells us about personality Goal concepts and emotions will continue to be important within personality psychology
Social and Cultural Domain Personality does not reside merely in the heads, nervous systems, and genes of people Rather, personality affects, and is affected by, significant others in our lives At the cultural level, groups differ tremendously from one another Different cultures may evoke different facets of personality Study of culture and cross-cultural difference and similarities will continue to grow in personality psychology Whatever their origins, gender differences will continue to be of compelling interest to personality psychologists
Adjustment Domain Personality plays a key role in how we cope, adapt, and adjust to the ebb and flow of events in life Personality is linked with important health outcomes, health-related behaviors, and even how long we live Shift in personality psychology toward looking at the role of positive emotions Psychologists will continue to apply the trait approach to understanding personality disorders Integration: Personality in the Twenty-First Century Domains of knowledge are complementary, not conflicting The different domains seek answers to different questions Real action in personality research will be at boundaries of domains Progress in personality will depend on researchers’ willingness and ability to reach across domains Chapter Overview This final chapter provides students with a brief summary of theory and research covered in previous chapters, and with a discussion of possible future directions for the field of personality psychology. The authors begin by reviewing the current status of the field, noting that personality psychology is much more domain-based in theory and research than in decades past. Early personality theorists such as Freud presented grand theories of human nature, whereas modern personality psychologists are much more likely to focus their efforts within a particular domain of knowledge. The authors then review theory and research in each of the six domains. In addition, the authors offer several predictions regarding likely future directions for theory and research in each of these domains. The authors close by noting that personality psychology in the future will benefit by the integration of theory and research across the six domains of knowledge. Learning Objectives Discuss the current status of the field of personality psychology. Discuss the contention that comprehensive understanding of the whole of personality requires the study and subsequent integration of different domains of knowledge about personality. Review some of the key findings and theories with each of the six domains of knowledge about personality. Identify several likely future directions for research and theory in each of the six domains of knowledge about personality. Discuss the contention that the six domains of knowledge should be viewed as complementary, not competing or conflicting. Discuss the contention that some of the most interesting work in personality psychology in the future will occur at the boundaries of the six domains of knowledge. Lecture Topics and Lecture Suggestions Comorbidity Between Verbal and Non-Verbal Cognitive Delays in 2-yr-olds: A Bivariate Twin Analysis (Purcell, Eley, Dale, et al., 2001). This lecture is designed to present students with an example of research that clearly cuts several of the six domains of knowledge that were highlighted by Larsen and Buss. Behavioral genetic methods and techniques (biological domain) are used to assess the comorbidity or co-occurrence of two types of cognitive delays (cognitive-experiential domain) in young children. The focus on individual differences in verbal and non-verbal abilities also places this research within the dispositional domain, and the specific focus on delays or problems in development might also place this research in the adjustment domain. Use this lecture as a springboard for discussing other research that might cut across multiple domains of personality psychology. Purcell et al. (2001) assessed verbal (vocabulary, V) and non-verbal (non-verbal, P) performance for more than 3,000 pairs of two-year-old twins born in England and Wales in 1994 V and P delay probands were selected who were in the lowest 5 percent of V and P The comorbidity of delay was assessed both categorically, using twin cross-concordances, and dimensionally, by applying a bivariate extension of J. DeFries and D. W. Fulker’s group analysis Both approaches are bi-directional, in that probands can be selected for either V delay (and analyzed in relation to their co-twins P score) or P delay (analyzed in relation to their co-twin’s V score) From a categorical perspective, twin cross-concordances indicated that comorbidity between V delay and P delay is due to genetic factors whether probands are selected for V delay or for P delay Monozygotic and dizygotic cross-concordances were 24 percent and 8 percent, respectively, for probands selected for V delay and 27 percent and 6 percent for probands selected for P delay From a dimensional perspective, selecting for V delay yielded high bivariate group heritability and a genetic correlation of 1.0 In contrast, when selecting on P, DF analysis indicated lower bivariate group heritability and only a modest genetic correlation with V assessed dimensionally. Reference: Purcell, S., Eley, T. C., Dale, P. S., et al. (2001). Comorbidity between verbal and non-verbal cognitive delays in 2-yr-olds: A bivariate twin analysis. Developmental Science, 4, 195–208. Beauty, Dominance, and the Mating Game: Contrast Effects in Self-Assessment Reflect Gender Differences in Mate Selection (Gutierres, Kenrick, & Partch, 1999). This lecture presents a second example of research that cuts across several of the six domains of knowledge presented by Larsen and Buss. The focus on self-assessments places the research within the cognitive domain, and the focus on mate selection clearly places the research within the social and cultural domain. In addition, the focus on the traits of dominance and attractiveness places this research within the dispositional domain. Challenge students to think about how this research might be extended to other domains of knowledge in personality psychology. Gutierres et al. (1999) examined the effects of exposure to physically attractive and dominant same-sex individuals on self-judgments of desirability as a mate in 190 college students Consistent with prior findings on mate selection, it was predicted that women’s self-assessments of their mate’s value would be adversely affected by exposure to highly physically attractive women and would be relatively unaffected by exposure to socially dominant women Conversely, men’s self-assessments of their mate’s value were expected to be more affected by the social dominance than by the physical attractiveness of the men to whom they were exposed Findings for self-assessed judgments of desirability as a marriage partner were in line with hypotheses Results fit with earlier findings suggesting that such effects may be caused by changes in the perceived population of competitors rather than direct changes in self-perceptions of physical appearance or dominance Overall, findings are supportive of models assuming domain-specific rather than domain-general cognitive processes Reference: Gutierres, S. E., Kenrick, D. T., & Partch, J. J. (1999). Beauty, dominance, and the mating game: Contrast effects in self-assessment reflect gender differences in mate selection. Personality and Social Psychology Bulletin, 25, 1126–1134. Classroom Activities and Demonstrations Now that students have completed a course on personality psychology, it can be interesting for students to reflect on the nature of personality, now with a different perspective than the one with which they started the course. This activity is designed to encourage students to think deeply about the key components of personality—incorporating what they have learned by taking this course. Distribute Activity Handout 20–1 (“What is Personality?”). Give students about five minutes to complete the handout. Ask students to volunteer some of the components they identified as key components of personality. Use this activity as a springboard for reviewing the key components of personality, as revealed by work across the six domains of knowledge about human nature that Larsen and Buss presented. This activity is designed to get students thinking about where the future of personality psychology should head. Now that students have completed a course in personality psychology, and have learned about the exciting theory and research in this field, what are the key directions or topics that the students think personality psychologists of the future should address? Distribute Activity Handout 20–2 (“What Should Personality Psychologists of the Future Study?”). Give students about five minutes to complete the handout. Ask students to volunteer some of the topics or questions that they nominated as key directions for the future of personality psychology. Use this activity as a springboard for discussing the future of personality psychology, including future research directions, and future theoretical directions. Now that students have completed a course on personality psychology, it can be useful for them to reflect on some of the most interesting things they learned. This activity gives students a chance to identify what they found most intriguing and most interesting about personality psychology. Distribute Activity Handout 20–3 (“Fascinating Areas of Personality Psychology”). Give students about five minutes to complete the handout. Ask students to volunteer some of the topics or questions that they nominated as the most interesting topic, findings, or areas within personality psychology. Use this activity as a springboard for discussing the past, present, and future of theory and research in personality. Instructor Manual for Personality Psychology: Domains of Knowledge About Human Nature Randy Larsen, David Buss 9780078035357