DISORDERS INVOLVING PERSONALITY

A. Normal and Abnormal Personality
1. What is personality?
   a. The stability-over-time issue
   b. The consistency-across-situations issue
   c. The “person-within-a-person” issue
2. What is normal?
   a. Quantitative criteria: statistical norms
   b. Qualitative criteria
      (1) Successful adaptation
      (2) Flexible adjustment
      (3) The 4 Ds
   c. Assessment
      (1) Personality inventories: the MMPI
      (2) DSM Axis V and possible new axes: defensive functioning, relational functioning, social and occupational functioning

B. Personality Disorders: General Issues
1. Defining characteristics
   a. Specific criteria
      (1) Long-term, early onset
      (2) Inflexible and pervasive influence on psychosocial functioning
      (3) Impairment and/or distress
      (4) Ego syntonic, lack of insight and poor prognosis
   b. In DSM
      (1) Distinguished from Axis I
      (2) Relationship to Axis I
      (3) Category vs. dimension
      (4) Diagnostic reliability, etiology and treatment issues
      (5) Overlap and comorbidity
2. Epidemiology
   a. Incidence
   b. Gender differences: real or diagnostic bias?
   c. Relationship to culture

C. Personality Disorders in DSM
1. Cluster A
   a. Essential qualities
   b. Relationship to psychotic disorders
   c. Clinical descriptions
      (1) Paranoid
      (2) Schizoid
      (3) Schizotypal
2. Cluster B
   a. Essential qualities
   b. Clinical descriptions
      (1) Borderline
         a) History of the concept and divergent views
         b) Characteristics
         c) Diagnostic confusion and controversy
      (2) Antisocial
         a) History of the concept: psychopath and sociopath
         b) Characteristics
         c) Relationship to psychopathy and criminality
      (3) Histrionic
      (4) Narcissistic
3. Cluster C
   a. Esssential qualities
   b. Clinical descriptions
      (1) Avoidant
      (2) Dependent
      (3) Obsessive-compulsive
   c. Distinguishing Cluster C from Axis I anxiety and mood disorders
4. Other possibilities
   a. Depressive personality disorder
   b. Passive-aggressive (negativistic) personality disorder

D. Etiology
1. Lack of reliably-diagnosed clinical cases and research studies
2. Biomedical perspective
   a. Genetics
      (1) The concept of schizophrenic spectrum and Cluster A
      (2) Inborn temperament and ASPD
   b. Neurophysiological theories
      (1) Autonomic arousal and APSD
      (2) Cortical arousal and APSD
3. Intrapsychic perspective
   a. Individuation and separation in BPD: the missing core
   b. The role of loss and trauma in BPD and ASPD
4. Cognitive-behavioral perspective
   a. Inconsistent discipline and ASPD
   b. Fear of punishment and ASPD
   c. Future time orientation and failure to consider consequences in ASPD
5. Socio-cultural perspective
   a. Western individualism and Cluster B
   b. Gender stereotyping

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages for use in a non-profit, educational setting.  Please include this copyright notice on all pages.