Dx relies on inferred traits or consistent patterns of beh rather than more objective means
There are self-report inventories and semi-structured interviews, but no good assessment device
Diagnostic reliability and validity is still low
Categories are not mutually exclusive
Difficulties in studying causes
Comorbidity
Little prospective research --almost all is retrospective among people already dx’d
Temperamental characteristics are possible biological factors
Possible psych factors include maladaptive habits and cognitive styles that may originate in disturbed attachment, ineffective parenting, early emo, phys or sexual abuse
Sociocultural factors—social stressors, societal changes, cultural values
Cluster A—odd—paranoid, schizoid, schizotypal—odd or eccentric behaviors that are similar to, but not as extensive as those seen in schizophrenia. Often leave person isolated.
Cluster A—odd—paranoid, schizoid, schizotypal—odd or eccentric behaviors that are similar to, but not as extensive as those seen in schizophrenia. Often leave person isolated.
Cluster B—dramatic—antisocial, borderline, histrionic, narcissistic—dramatic, emotional, erratic. Almost impossible to have a satisfying, giving relationship. More commonly dx’d than others.
Cluster C—anxious—avoidant, dependent, obsessive compulsive pd—anxious and fearful behavior, similar sx to anxiety disorders, but no direct link between these and Axis I
Suspicious of people, frequently angry, hostile, expects to be mistreated and abused.
Suspicious of people, frequently angry, hostile, expects to be mistreated and abused.
Thus—secretive, looking for signs of trickery, reluctant to confide; blaming, bear grudges, way jealous, doubts about loyalty and trustworthiness, may read hidden messages \
Prevalence maybe .5-2.5%, males>females
Causal factors—little is known, inconsistent findings on genetic transmission
High concordance between MZ twins
Psychosocial factors are suspected
Treatment of Paranoid PD:
Do not typically see selves as needing help; few come willingly
View role of pt as inferior and distrust/rebel against therapists
Therapy has limited effect and moves slowly
Central symptoms
Central symptoms
Inability to form social relationships and an indifference toward developing them.
Demonstrate little emotion
Focus mainly on themselves
Little affected by praise or criticism
Not interested in sex
<1%, males > females
Causal factors
Causal factors
Used to think that this was a precursor to schizophrenia
No evidence of hereditary link
Parents may have been abusive or unaccepting of children
Cognitively—thoughts seem to be vague and empty, unable to pick up emotional cues
Treatment—social withdrawal keeps them from entering therapy
Generally remain emotionally distant from therapist, seem not to care about treatment, and make limited progress at best.
Cognitive therapists—help them focus on pleasurable experiences or think about emotions
Behavioral therapists—teach social skills—role playing, exposure therapy, homework assignments
Extreme introversion
Extreme introversion
Sensitivity
Eccentricity
Oddities of thought, perception and speech that are similar to schizophrenia (ideas of reference, bodily illusions –such as having extrasensory abilities or being able to sense external forces
3% prevalence
Males>females
Perhaps similar causes to schizophrenia.
Perhaps similar causes to schizophrenia.
High activity of dopamine
Higher rates of this among relatives of those with schizophrenia and those with depression
Therapy is difficult—need to reconnect with the world and recognize limits of thinking and powers. Try to set clear limits. Increase positive social contacts. Ease loneliness.
Cognitive—try to help them see inaccuracy of thoughts
Behavioral methods—speech lessons, social skills training, tips on appropriate dress and manners
Low doses of antipsychotics may have some success
Overly dramatic and attention seeking
Overly dramatic and attention seeking
Explain emotion extravagantly
Very shallow, self-centered
Overly concerned with physical attractiveness
Uncomfortable when not the center of attention
Believe relationships are more intimate than they are
Inappropriately provocative
Easily influenced by others
Speech vague, lacks details
2-3% prevalence
Males=females or females slightly greater
Psychodynamic
Psychodynamic
Cold and controlling parents left them feeling unloved and afraid of abandonment; to defend against fear of loss, act provocatively so that they have to be rescued
