Personality disorders
Lecture 1 PD diagnosis and assessment 3
Cluster A 3
Paranoid 3
Schizoid 3
Schizotypal 3
Cluster B 4
Antisocial 4
Borderline 4
Histrionic 4
Narcissistic 5
Cluster C 5
Avoidant 5
Dependent 5
Obsessive compulsive 6
Problems with the present PD diagnosis system 6
Propositions for alternative model 6
General PD criteria in alternative model 7
Alternative model 7
Assessment of PD in clinical practice 7
Lecture 2 PD course and risk factors 8
Course of PDs 8
Comorbidity 9
Co-occurence of PD explained 9
Risk factors 9
Biosocial theory of pd 10
Neurobiology 10
Environmental factors 11
Lecture 3 Cluster C assessment 12
Cluster C 12
Biopsychosocial model - cognitive schemas 12
Dependent 12
Avoidant 13
Obsessive Compulsive 13
Assesment of PD 13
Lecture 4 Antisocial pd and psychopathology 15
Antisocial 15
Psychopathology, DSM and definition 15
Pathways to antisocial behavior 16
Treatments for ASPD 16
Lecture 5 Borderline personality disorder 17
Borderline 17
, Alternative model bpd 17
Etiology 18
Gene-environment interaction 18
Diathesis stress models (treatment) 18
Lecture 6 Narcissistic and Histrionic 19
Narcissistic 19
Alternative model NPD 19
Narcissism 19
Theories on narcissistic pd 19
Histrionic 20
Association with other pds 20
Alternative model: personality disorder - trait specified 21
Lecture 7 Schematherapy 22
Schema operations 22
Modes 23
Assessment and change 23
Lecture 8 Cluster A 24
Paranoid 24
Schizoid 24
Schizotypal 25
Schizotypy 26
Schizotypy and schizophrenia: common basis 26
Schizophrenia spectrum disorder 26
Lecture 9 Mentalization-Based Treatment (MBT) 27
Mirroring 27
Consequences of bad mentalizing 28
Borderline personality disorder 28
MBT in practice 28
MBT treatment 29
, Lecture 1 PD diagnosis and assessment
Personality: the enduring characteristics and behavior that compromise a person’s unique
adjustment to life, including major traits, interests, drives, values, self-concept, abilities and
emotional patterns. Personality disorders are pervasive, persistent and pathological.
PD criteria DSM-5:
1. An enduring pattern of inner experience and behavior that deviates markedly from
the expectations of the individual’s culture. Manifested in cognition, affectivity,
interpersonal functioning or impulse control.
2. The pattern is inflexible and pervasive across different personal and social situations.
3. The pattern leads to clinically significant distress or impairment in social and
occupational areas of functioning.
4. The pattern is stable and of long duration, and onset can be traced to adolescence.
5. The pattern is not better accounted for as a manifestation or consequence of another
mental disorder.
6. The pattern is not due to the direct physiological effects of a substance.
Cluster A
Paranoid, schizoid, schizotypal. Characteristics are odd, eccentric and weird.
Paranoid
1. Pervasive distrust and suspiciousness of others such that their motives are
interpreted as malevolent, beginning in early adulthood and present in a variety of
contexts. 4 or more of:
- Suspects that others are harming or deceiving
- Preoccupied with unjustified doubts about loyalty and trust of friends
- Reluctant to confide in others because of fear that the info will be used
against him
- Reads hidden demeaning or threatening meanings into remarks or events
- Bears grudges and is unforgiving of insults, injuries or slights
- Perceives attacks on his or her character that are not apparent to others and
react angrily
- Has recurrent suspicions without justification regarding fidelity of spouse
2. Doesn’t occur exclusively during the course of another personality disorder
Schizoid
1. Pervasive pattern of detachment from social relationships and a restricted range of
expressions of emotions in interpersonal settings, beginning in early adulthood. 4 or
more of:
- Neither desires nor enjoys close relationships
- Almost always chooses solitary activities
- Has little interest in having sexual experiences with another person
- Takes pleasure in few activities
- Lacks close friends or confidants other than first-degree relatives
- Appears indifferent to the praise of criticism of others
- Shows emotional coldness, detachment or flattened affectivity
2. Doesn’t occur exclusively during the course of another personality disorder
Schizotypal
1. Pervasive pattern of social and interpersonal deficits marked by acute discomfort with
close relationships and cognitive distortions and eccentricities of behavior, beginning
in early adulthood. 5 or more of:
- Odd beliefs that influence behavior like superstition or clairvoyance
- Unusual perceptual experiences, including bodily illusions
- Odd thinking and speech
Lecture 1 PD diagnosis and assessment 3
Cluster A 3
Paranoid 3
Schizoid 3
Schizotypal 3
Cluster B 4
Antisocial 4
Borderline 4
Histrionic 4
Narcissistic 5
Cluster C 5
Avoidant 5
Dependent 5
Obsessive compulsive 6
Problems with the present PD diagnosis system 6
Propositions for alternative model 6
General PD criteria in alternative model 7
Alternative model 7
Assessment of PD in clinical practice 7
Lecture 2 PD course and risk factors 8
Course of PDs 8
Comorbidity 9
Co-occurence of PD explained 9
Risk factors 9
Biosocial theory of pd 10
Neurobiology 10
Environmental factors 11
Lecture 3 Cluster C assessment 12
Cluster C 12
Biopsychosocial model - cognitive schemas 12
Dependent 12
Avoidant 13
Obsessive Compulsive 13
Assesment of PD 13
Lecture 4 Antisocial pd and psychopathology 15
Antisocial 15
Psychopathology, DSM and definition 15
Pathways to antisocial behavior 16
Treatments for ASPD 16
Lecture 5 Borderline personality disorder 17
Borderline 17
, Alternative model bpd 17
Etiology 18
Gene-environment interaction 18
Diathesis stress models (treatment) 18
Lecture 6 Narcissistic and Histrionic 19
Narcissistic 19
Alternative model NPD 19
Narcissism 19
Theories on narcissistic pd 19
Histrionic 20
Association with other pds 20
Alternative model: personality disorder - trait specified 21
Lecture 7 Schematherapy 22
Schema operations 22
Modes 23
Assessment and change 23
Lecture 8 Cluster A 24
Paranoid 24
Schizoid 24
Schizotypal 25
Schizotypy 26
Schizotypy and schizophrenia: common basis 26
Schizophrenia spectrum disorder 26
Lecture 9 Mentalization-Based Treatment (MBT) 27
Mirroring 27
Consequences of bad mentalizing 28
Borderline personality disorder 28
MBT in practice 28
MBT treatment 29
, Lecture 1 PD diagnosis and assessment
Personality: the enduring characteristics and behavior that compromise a person’s unique
adjustment to life, including major traits, interests, drives, values, self-concept, abilities and
emotional patterns. Personality disorders are pervasive, persistent and pathological.
PD criteria DSM-5:
1. An enduring pattern of inner experience and behavior that deviates markedly from
the expectations of the individual’s culture. Manifested in cognition, affectivity,
interpersonal functioning or impulse control.
2. The pattern is inflexible and pervasive across different personal and social situations.
3. The pattern leads to clinically significant distress or impairment in social and
occupational areas of functioning.
4. The pattern is stable and of long duration, and onset can be traced to adolescence.
5. The pattern is not better accounted for as a manifestation or consequence of another
mental disorder.
6. The pattern is not due to the direct physiological effects of a substance.
Cluster A
Paranoid, schizoid, schizotypal. Characteristics are odd, eccentric and weird.
Paranoid
1. Pervasive distrust and suspiciousness of others such that their motives are
interpreted as malevolent, beginning in early adulthood and present in a variety of
contexts. 4 or more of:
- Suspects that others are harming or deceiving
- Preoccupied with unjustified doubts about loyalty and trust of friends
- Reluctant to confide in others because of fear that the info will be used
against him
- Reads hidden demeaning or threatening meanings into remarks or events
- Bears grudges and is unforgiving of insults, injuries or slights
- Perceives attacks on his or her character that are not apparent to others and
react angrily
- Has recurrent suspicions without justification regarding fidelity of spouse
2. Doesn’t occur exclusively during the course of another personality disorder
Schizoid
1. Pervasive pattern of detachment from social relationships and a restricted range of
expressions of emotions in interpersonal settings, beginning in early adulthood. 4 or
more of:
- Neither desires nor enjoys close relationships
- Almost always chooses solitary activities
- Has little interest in having sexual experiences with another person
- Takes pleasure in few activities
- Lacks close friends or confidants other than first-degree relatives
- Appears indifferent to the praise of criticism of others
- Shows emotional coldness, detachment or flattened affectivity
2. Doesn’t occur exclusively during the course of another personality disorder
Schizotypal
1. Pervasive pattern of social and interpersonal deficits marked by acute discomfort with
close relationships and cognitive distortions and eccentricities of behavior, beginning
in early adulthood. 5 or more of:
- Odd beliefs that influence behavior like superstition or clairvoyance
- Unusual perceptual experiences, including bodily illusions
- Odd thinking and speech
