PERSONALITY PERSONALITY DISORDERSDISORDERSAlberto L. Choy MD FRCPCPsychology 344Fall 2003Forensic Psychology
University of Toronto, Erindale
IntroductionIntroduction
Overview of the DSM-IV (credits to) Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition Descriptions of personality disorders and
application to forensic settings
THE MULTIAXIAL ASSESSMENTTHE MULTIAXIAL ASSESSMENT
Axis I: clinical disorders - “mental illnesses” and mental disorders
Axis II: personality disorders and mental retardation
psychologists can diagnose with the multiaxial assessment
DIMENSIONAL MODELSDIMENSIONAL MODELS other models to describe personality maladaptive variants of personality traits -
eg: “five factor model” neuroticism, introversion vs. extroversion,
closedness vs. openess (to experience), antagonism vs. agreeableness, conscientiousness
PERSONALITY TESTINGPERSONALITY TESTING
Millon Clinical Multiaxial Inventory (MCMI) no “norms” between patients and normals biased towards “finding” problems
Minnesota Multiphasic Personality Inventory (MMPI-2) most widely used in forensic assessments measures that address test taking attitudes
PERSONALITY TRAITSPERSONALITY TRAITS
an enduring pattern of perceiving, relating to, and thinking about the world and oneself, exhibited in a wide range of social and personal contexts
examples: impulsivity, social anxiety, affective stability
PERSONALITY DISORDER PERSONALITY DISORDER (1/3)(1/3)
personality traits are maladaptive and inflexible
and
significant functional impairment or subjective distress
“extremes of personality characteristics”
PERSONALITY DISORDER PERSONALITY DISORDER (2/3)(2/3)
inner experience and behaviour deviates from cultural expectation
impairment in 2 of: cognition affectivity interpersonal functioning impulse control
PERSONALITY DISORDER PERSONALITY DISORDER (3/3)(3/3)
inflexible and pervasive, broadly significant distress and/or function(s)
disturbance stable and life-long
NOT due to another mental disorder, substances, medical condition
“traits” vs. personality disorder
Paranoid Personality DisorderParanoid Personality Disorder
pervasive distrust and suspiciousness sees other’s motives as malevolent criteria may include:
suspicions that they are being exploited unjustified doubts about loyalty of others closed; fear of information used against reacts angrily to perceived attack suspcious / jealous of spouse not psychotic
Schizoid Personality DisorderSchizoid Personality Disorder
detatchment from social relationships restricted range of expressed emotions prefer being alone criteria may include:
no interest in close relationships, including family little interest in sex with others no close confidants emotional flatness
Schizotypal Personality DisorderSchizotypal Personality Disorder
discomfort with relationships odd, eccentric thoughts / behaviour criteria may include:
ideas of reference (not delusions) magical beliefs (not cultural) suspiciousness or odd / constricted affect lack of close friends social anxiety: more paranoid
Antisocial Personality DisorderAntisocial Personality Disorder disregard for, and violation of, the rights of others terms: psychopathy, sociopathy, dyssocial criteria may include:
impulsive behaviours (drugs, crime) lacking in remorse deceitful / conning / manipulative irritable / aggressive evidence of Conduct Disorder (before 15)
Borderline Personality DisorderBorderline Personality Disorder
pervasive instability: self image, relationships, affect - impulsivity
criteria may include: frantic avoidance of abandonment unstable, intense interpersonal relationships impulsive behaviour marked reactivity of mood / rage / emptiness recurrent self-harm/suicide
Histrionic Personality DisorderHistrionic Personality Disorder
excessive emotionality and attention seeking behaviour
criteria include: flamboyant appearance / behaviour superficial, rapidly shifting emotions suggestible believes relationships are deeper than they really are seductive or provocative, socially
Narcissistic Personality DisorderNarcissistic Personality Disorder grandiosity, need for admiration, lacking in
empathy criteria may include:
solely self-involved: “no.1”, entitled derogatory to others, for himself grandiose, self important, may exaggerate believes he is “special” / high status associates lacks empathy interpersonally exploitive
Avoidant Personality DisorderAvoidant Personality Disorder
social inhibition / anxiety and feelings of inadequacy
criteria may include: marked social anxiety / avoids contact strong wish for relationships restraint in relationships: fear of shame sees self as inept, unappealing, inferior avoids risk, especially of embarrassment
Dependent Personality DisorderDependent Personality Disorder excessive need to be taken care of submissive, clingy criteria may include:
fear of separation / abandonment will do unpleasant things to obtain nurturance unable to decide without excessive advice / reassurance will not express disagreement urgent relationship seeker: to be taken care of
Obsessive-Compulsive Personality DisorderObsessive-Compulsive Personality Disorder
preoccupation with detail, order, control at the expense of openness, efficiency criteria may include:
excessive: rules, details, lists, organization perfectionism, but too slow / stubborness “workaholic” without friends / leisure inflexible, scrupulous: morals, ethics may not throw things out will not delegate tasks
Personality Disorder Not Otherwise SpecifiedPersonality Disorder Not Otherwise Specified
mixed traits dysfunction
APPLICATIONAPPLICATION CRIME CIVIL / DISABILITY ADAPTIVE ASPECTS
CRIMECRIME
murder serial murder / group murder
cults sex
mutilation assaults fraud / robbery domestic violence harrassment
CIVILCIVIL
disability malingering in disability
ComorbidityComorbidity
Major mental illness
substance use / abuse
psychopathy
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