Personality Disorders

Introduction

Personality disorders are innate disorders that can be diagnosed in an individual and have the capacity to subsist in a human being for quite some time. Many people who suffer from these disorders are always unaware of the symptoms and treatment; therefore they assume the importance of proper diagnosis to these disorders. The major question that this paper is grappling with is what are personality disorders? This paper will define and classify personality disorders; giving their symptoms and treatment procedures involved and present the findings to the Abnormal psychology class for further discussions.

Main Body

Definition

DSM-IV-TR has defined personality disorder as a mold located in the interior experience and behavior that digress from the normal expectations of the individual’s culture which originates from adolescent years and is perceived to cause misery or damages to an individual and the society. In addition, when these molds of perception, relations and thought about oneself and the surroundings are not consistent with the expectations of the society or the culture, it qualifies them to be called personality disorders. Frances & Ross (2001) further add that these inconsistencies must have a wide deviation from the norms and expectations of the society. Since behavior has been observed to be a continuum, the difficulty that exists to tell where abnormality begins or ends, it becomes a challenge to know where deviation begins and ends.

Classification of personality disorders

It can be observed that there are ten personality disorders that are further divided into three clusters namely, Odd or eccentric personality disorders, Dramatic or Emotional disorders, and Anxious or Fearful disorders. The first cluster has three disorders namely, Paranoid personality disorder, Schizotypal personality disorder, and Schizoid personality disorder. The second cluster has four disorders namely, antisocial personality disorder, borderline personality disorder, Histrionic personality disorder and Narcissistic personality disorder. The last cluster has three disorders namely, avoidant personality disorder, dependent personality disorder, and obsessive-compulsory personality disorder. In an attempt to accomplish the purpose of this paper, heavy borrowing has been made from Diagnostic and Statistical Manual of Mental Disorders and therefore all the definitions in this paper are picked from it. In addition, the paper will follow the chronology of clusters given above in discussing the features, causes and treatment for the ten disorders.

Cluster one: Odd or eccentric personality disorders

The first disorder in this category is known as Paranoid Personality disorder and is defined as “a pattern of distrust and suspiciousness such that others’ are interpreted as malevolent.” In other words, a person diagnosed with paranoid disorder will most of the time think that other people are always thinking ill of him and therefore, prepares to act or counterattack according to emotions. They will always do their investigations in order to support their suspicion and will feel insecure to have many friends. The main features of paranoid disorder include suspicion that others may harm, exploit or deceive a person. Another feature of this disorder is the doubts about the loyalty of friends and close acquaintances. In other words, such a person will never confide with any person due to this suspicion. Moreover, there is a tendency to hold grudges over an individual who has caused injuries and insults. These are some of the features that are verifiable in an individual perceived to have this personality disorder.

Paranoid personality disorder has several causes that have been observed and the first cause is attributed to the upbringing. Durand & Barlow (2003) have argued that parent’s input in upbringing of a child may be one of the speculative causes of this disorder. The other factor that can cause this disorder is cultural dictations of a particular group of people. In general, it has been summed up that cognition and cultural inclinations could be the causes of paranoid personality disorder. In treating this disorder, it is salient that the therapist endeavor to build trust with the individual. This will pave way for the application of cognitive therapy concepts in the procedure.

Secondly, Schizoid personality disorder is defined as “a pattern of detachment from social relationships and a restricted range of emotional expressions.” In other words, persons with schizoid disorder lack enthusiasm to relate with people and usually enjoy being alone. The detachment cuts across all types of relationships that include consummation related relationships like marriage. Most of them are insensitive to others’ opinions and thus are not interested to share their emotions with them. The main features of schizoid disorder include lack of craving for secure association, will always opt for solitude and will have little or no slum for sex with the spouse. In addition, they are involved in very few or none activities and seems to enjoy a handful of friends who happen to be their close relatives. Finally, they will appear cold and detached in terms of their emotions thus very hard for them to socialize.

It has been argued that genes, neurobiology and psychosocial factors may contribute to the development of schizoid personality disorder. This may result in the inability to express their emotions to events which may excites or provoke their emotions. Therefore, submission can be made that it is very rare for an individual with schizoid personality disorder to seek treatment. However, when they do, a therapist can make a choice of showing the treasure that exist in people and thus point out to the importance of relationships. Good interests in social skills must be the driving force behind the therapy sessions.

The third disorder in this cluster is called schizotypal personality disorder. It is defined as “a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.” In other words, individuals diagnosed with schizotypal personality disorder assembles those with schizoid personality disorder in that they are both isolated. Their way of relating and dealing with other people and how they conduct themselves leaves more questions than answers. The distinctive feature of schizotypal personality disorder is the wrong elucidations of events happening around them. They usually have paranormal thoughts and anomalous beliefs that contribute a lot to the way they act or behave. Furthermore, their speech has qualities of exaggeration, blurred and stereotyping. Finally, there is social anxiety that goes hand in hand with paranoid worries about the self.

Schizotypal disorder causes can be traced back to the family of origin. It has also been discovered that there is a close relationship between schizophrenia and schizotypal personality disorder and this means that schizophrenia can become a causal agent to schizotypal disorder. Finally, the environment is also a factor that can contribute to the development of this kind of disorder. Durand & Barlow (2001) submits an example of a woman who recently suffered from influenza as a candidate to get schizotypal disorder. In treating this disorder, integration between medical interventions and psychology is the top most priority for the client. Medical treatment will require the doctor to treat it like schizophrenia while a therapist will be required to help the client adapt to the kind of life that is comfortable with them.

Cluster two: Dramatic/Emotional disorders

The first disorder in this category is known as antisocial personality disorder. It is defined as “a pattern of disregard for, and violation of, the rights of others.” These are people are less concerned with the needs of others and they care little about them. They will always have the ease of doing things that are undoable to normal human being. For instance, defilement of a minor is an action that a normal person may not have the confidence to do it. The first major feature of antisocial personality disorder is the deliberate effort to non-conformation to the social norms. Such a person will always be found on the other side of the law and seemingly not interested to be guided by rules and regulations. Secondly, such people may do anything like cheating and conmen’s language so that they can benefit themselves at the expense of other people.

For instance, a driver suffering from antisocial disorder may drive without taking good care of the lives of other road users for selfish gains. In addition, if something happens to others, the person will be less concerned with the events that have led to the disaster and may end up showing his levels of irresponsibility between 15 and 18 years. Hare (1991) later observed an interconnection between antisocial personality disorder and psychopathy that focuses on less of overt behavior. This was later developed to include criminality in order to introduce the law aspect in the study. This disorder has a complicated sort of treatment in that the doctor or the therapist must consider the age, chronic history of the client and any other association with other disorders. However, the good thing is that antisocial disorder can be prevented through integration of good teaching in institutions of learning and parenting.

The other disorder in this cluster is referred to as borderline personality disorder and is defined as “a pattern of instability in interpersonal relationships, self image, and affects, and, marked impulsivity.” In other words, they are very unstable in terms of their moods and emotions. This means that other life aspects that correlate with moods and emotions like relationships are not firm or unhinged. It has been known as one of the most common personality disorder and such patients will make deliberate moves to avoid situations that can lead to being abandoned. They will easily opt into drug abuse and will do body mutilation perhaps to show how angry they may be. In addition, their real self appears to be very unstable and this tampers with their self image. Such patients may compromise major decisions while driving, having sex and may lack the audacity to control their anger. Finally, most of them will have advance dissociative symptoms.

Research has shown that borderline disorder can be identified with family of origin issues and may association with other disorders like mood disorders. Brisk cultural changes on the other hand have a share in providing a highway for borderline personality disorder. This is because environmental changes will attract several human related phobias, like fear of unknown, and anxiety over the future. Not much from medics has been achieved in terms of medical treatment for these cases, but psychology has provided a treatment procedure that enables the clients to deal with distress mainly by providing support and care they need in the therapy process. This is referred to as dialectical behavior therapy (Durand & Barlow, 2003).

Histrionic Personality Disorder has been defined as “a pattern of excessive emotionality and attention keeping.” In other words, persons who suffer from this disorder can also be called attention seekers. All they want is to be noticed. For instance, they may dress uniquely so that others can notice them. It may be the way they walk or else, they intentionally walk past the dais in a meeting so that other people may take note of them. One of the distinctive features of histrionic personality disorder is the distress an individual gets when in a situation that has denied him or her attention. This makes them feel uncomfortable about the situation. Their behavior may be provocative and will always tend to use material appearance to distract others. This can be achieved through speaking, mode of dressing, style of walking, just to mention a few. Causes of this disorder are not clear but its psychological treatment has been identified. A therapist’s approach to this problem can be focused on relationship between one individual and another. The therapist, needless to say, must point out the short-lived pleasure that a client may gain from such events of drawing attention to themselves.

The last disorder in this category is referred to as narcissistic personality disorder. It is defined as “a pattern of grandiosity, need for admiration and lack of empathy.” These are the people who live in the shadow of their true self. Alloy, et al (2005) describes them as people who are preoccupied with themselves and all they do is driven by self gains. Some of the features of narcissistic disorder are flamboyant sense of importance for self and the love of fantasies like power and beauty. In addition, they always believe that they are important and unique therefore others may come second. Such individuals end up using others using arrogant means to accomplish their goals. It is also observed that they are never comfortable with situations in which the people present are not admiring them. It is important to note that these features are not realistic and therefore the patients of this nature end up being very depressed.

The major cause for this disorder can find its origin from parenting. Failure by parents to teach their children empathy for others and how important it is to share fortunes with others is enough to raise the alarm. Therefore, therapy with such a client will concentrate on the lavishness and the lack of empathy for others. This must be approached through a bipolar approach and this will pave way for the client to make the right decision.

Cluster three: Anxious or fearful personality disorders

The first disorder in this cluster is referred to as avoidant personality disorder and is defined as “a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.” This hypersensitivity is directed to what others are saying about them and this result to individual with avoidant disorder to hide or avoid other people. Major feature include total avoidance to interpersonal activities that may expose the person to critiques and challenges. Moreover, such individual will always fear to be criticized, and this forms the base in which his mind will be preoccupied with such demeaning thoughts. Another feature is the unwillingness to interact with people and always being afraid of ridicule and shame. They are very pessimistic about themselves and performance, especially where there is competition.

The biggest proposal to the cause of this disorder is the combined effort of biological and psychosocial influences. The pessimistic temperament in them may be spotted in the early childhood development and this may trigger the caregivers to reject the child at that tender age. This rejection can cause withdrawal and finally pull the child’s esteem, which thereafter causes avoidant personality disorder. Therefore, treatment to this disorder is purely behavioral which include reinforcement schedules as well as experiential therapy concepts.

The other personality disorder in this category is dependent personality disorder and has been defined as “a pattern of submissiveness and clinging behavior related to an excessive need to be taken care of.” These are individuals who ride on the backs of others in the name of being helped. They would love to be helped to make decisions that concern their future. They are always willing to take the back seat in order to be helped to reach a certain destination. They always feel some sense of inadequacy and therefore rely heavily on others. The distinctive feature to this disorder is their dependency on others to make decisions on their behalf. They will always minimize chances of disagreement lest they lose support from others. In addition, in case they lose a relationship, they are in hurry to look for another one for support and guidance.

It has been argued that all human beings are born with a certain level of dependency. The absence of people that provide for our daily needs may be the cause of this disorder. One of the goals of therapy in treatment procedure is cut out dependency syndrome and creating a strong will in the client to believe in self.

The last disorder in this category is obsessive-compulsive personality disorder defined as “a pattern of preoccupation with orderliness, perfectionism, and control.” Their driving force is for things to be done and done the right way. This explains why there is a tendency to gain and maintain control. The main features include the dominance in terms of control, giving of orders and rules, and this tends to cover the main goal of the task. Secondly, they always insist on things to be done with ultimate care which tampers with important deadlines. Such people are reluctant to delegate duties as well as their devotion to job description and duties. Causes have been attributed to feeble genetic factors. Treatment for this disorder is not clear but on a person opinion, the therapist can emphasis on the merit and demerits of extending deadlines for projects all in the name of perfectionism.

Conclusion

Much effort has been dedicated to diagnosis and classification of personality disorders but extremely fair effort in terms of causes and treatment. A clarion call can be made towards the end of this paper that more and elaborate treatment procedures for personality disorders are needed so that they can be treated sufficiently.

References

Alloy, L. B. et al (2005). Abnormal Psychology: Current perspectives. Boston: McGraw Hill.

American Psychological Association. (2000). Diagnostic & Statistical Manual of Mental Disorders. Arlington: Author.

Bohus, M. et al. (2000). Evaluation of inpatient dialectical-behavioural therapy for borderline personality disorder – A prospective study. Behaviour Research and Therapy , Vol.38, 9, 875-887.

Durand, V. M. (2003). Essentials of Arbnormal Psychology. Toronto: Thomson Learning.

Frances, A. & Ross, R. (2001). DSM-IV-TR case studies: A Clinical Guide to Differential Diagnosis. Boulevard: American Psychological Association.

Hare, R. D. (1991). Manual for the Revised psychopathy checklist. Toronto: Multihealth systems.