MODULE 5

Personality Disorders

A growing proportion of all behavior disorders fall into the loose and ill- defined category of personality disorder. Within this group are many different kinds of problems, ranging from minor distortions of personality to delinquency and criminal behavior. What personality disorders have in common is not similarity of problems or behaviors, but the relative lack of problems, as perceived by the affected person. The distorted personality traits are seen as an integral part of the personality, rather than painful and unwanted symptoms. Thus, there is little motivation to get help or to change.

This category covers a great range of disorders. Little is known about the causes of personality disorders; less is known about effective treatment methods. The problems afflict a great number of people, and the number is increasing. They deserve attention.

As you read the text, try to answer the following questions.

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We have put off the study of personality or personality disorders until the last module for good reason. Under the heading of personality disorder lies much theoretical confusion. The problems in this category have little in common. Personality disorder s are s said to be disturbances of trait and pattern, as opposed to the more well-defined reactions we know as phobias, compulsions, and psychosomatic symptoms. Another feature of character disorders is the lack of anxiety. Because the individual with a character disorder integrates his problem into his personality, it seems what he is rather than something he has. He feels little or no anxiety about himself and therefore has no reason to seek help or to change. Personality disorders may involve a lifelong pattern of socially deviant behavior rather than mental or emotional symptoms

The personality disorders are divided as follows:

1. General personality disorders
2. Sociopathic personality disorders
a. "Acting-out" type
b. "Acting-in" type
3. Sexual deviations

GENERAL PERSONALITY DISORDERS

Personality or personality disorders differ from neuroses or psychoses in that the problem extends throughout the afflicted person's entire character structure. We can distinguish several types of general personality disorders.

The paranoid personality is suspicious, unable to trust other people fully, and he is acutely sensitive to the slightest hint of scorn, hostility or accusation. He is usually unaware of the extent to which he provokes other people with his own aggressive and hostile reactions, and he is typically unable to discriminate between imagined mistreatment by others and actual mistreatment.

The schizoid personality is a loner. Detached, solitary and secretive, this person avoids intimate contact with others, especially the opposite sex. He may be an emotionally impoverished person, or he may have a rich and secret fantasy life. He is typically unable to show hostility (unlike the paranoid personality), and he avoids competition and intimacy.

The compulsive personality is orderly, inhibited and inflexible. He is driven to excesses of frugality, overwork, and cleanliness and he is extremely upset if circumstances prevent living up to his rigid requirements. Although a certain amount of conformity and hard work is important for each of us in order to win social approval, the compulsive is crippled by an excess of conscientiousness, obstinacy and inflexibility.

The cyclothymic personality (or manic-depressive personality) has unaccountable mood fluctuations, or he maintains a constant elated or depressed state without apparent cause. In none of the personality disorders mentioned above are the patterns acute or painful enough to cause the individual to seek help. Should a crisis arise, however, there is a possibility that the personality disorder may develop into a neurosis, or even psychosis.

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SOCIOPATHIC PERSONALITY DISORDERS

Sociopathic personality disorders are characterized by a lack of conscience and an inability to control impulses. The sociopathic individual ignores society except to exploit it. He disregards the rules of society and the responsibilities he has toward his family and friends in his constant drive to satisfy his own needs. He may be a con man, an addict, an alcoholic or a chronic "ne'er- dowell." Sociopathic personality disorders are classified as "acting-out" and "acting-in" types. Those people who exhibit sociopathic personality disorders may frequently come in contact with the law

The acting-in personality obtains pleasure by consuming drugs, drink, or food. Regardless of the consequences to others, this individual cannot resist the contentment he obtains in this way.

The acting-out personality serves himself, with no sense of right or wrong. He is usually a chronic law offender, perhaps a petty thief or swindler, who seems unable to profit from experience, regardless of how many times he is caught. This type of sociopathic personality often seems charming and intelligent and wins the confidence of others, only to victimize them. He has no loyalty except to himself, no need or desire to be close to and understand others. In fact, the emotions, needs and wishes of others are essentially meaningless to him and the rules of society present a challenge rather than a controlling influence.

Both types of sociopathic personality disorder are resistant to treatment, but the acting-out personality is particularly difficult to work with. He may see the therapeutic situation as just another challenge to his ability to manipulate other people. Insight developed in therapy has little effect on his behavior. He may show genuine remorse over his actions, but is unable to resist the impulse to engage in further asocial behavior.

The sociopathic personality disorder may be formed when parents (or other authority figures) are inconsistent, neglectful, unloving or antisocial themselves. Sometimes, one child among many in a family may learn to attract attention by getting into trouble. If the parents punish, a pattern of "acting-out" may develop.

SEXUAL and GENDER IDENTITY DISORDERS

Without judging a sexual practice to be "normal" or "abnormal," the DSM diagnostic system classifIies any sex behavior that is unusual as a sexual deviation. Exhibitionism, in which an individual, usually a man, exposes his genitals in public is another form of sexual deviation. This problem is often associated with extreme anxiety and therefore is an exception to other personality disorders. Other sexual deviations include voyeurism (watching sexual behavior of others), transvestism (wearing clothes of the opposite sex), fetishism (sexual desire directed toward a bodily part or a piece of clothing), and sadomasochism (sexual gratification in inflicting or enduring pain). Promiscuity (indiscriminate and frequent sexual relations), has many causes, including a need to prove sexual ability or attractiveness.


MODULE 5|
PROGRESS CHECK I

Now test yourself without looking back.

1. Like the neurotic, and unlike the psychotic, the person with personality disorder:

a. is likely to benefit from treatment.
b. can function relatively well in the real world.
c. feels guilty and miserable.

2. Match.

1 ) Paranoid personality_______

2) Schizoid personality___________

3) Compulsive personality_________

4) Cyclothymic personality_____________

a. Suspicious, mistrustful, touchy, aggressive
b. Usually elated or depressed without causeÄmood fluctuations
c. Orderly, inhibited, inflexible, conformist
d. Solitary, secretive, avoids intimacy, especially with the opposite sex

3. What personality disorder is characterized by a lack of guilt or shame, the appearance of friendliness and sincerity, chronic Iying, cheating and stealing?

4. From what has been determined so far, which of the following types of upbringing might be the more likely to result in a sociopathic personality disturbance?

a. Genetic factors more than learning
b. Too strict disciplining and training in moral behavior
c. Inconsistent discipline and neglect
d. Lack of affection

5. A man has a collection of over 100 pairs of women's shoes and derives a great deal of pleasure and excitement from looking at them. This is an example of:

a. sexual deviation. b. psychosis.
c. phobia.
d. mania.

ANSWER KEY PAGE 50

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4 OR MORE CORRECT UNIT TEST
FEWER THAN 4 CORRECT PAGE 45


MODULE 5
EXERCISES

Which factors distinguish personality disorders from anxiety disorder and psychoses?

a. Unlike the neurotic, the individual with a character disorder feels little or no anxiety or misery.

b. Unlike the psychotic, the individual with a character disorder can function reasonably well in the real world.

c. Unlike the neurotic, the whole personality of the individual suffering from personality disorder is affected.

d. Unlike the neurotic, the individual with a character disorder can benefit quickly from therapy.

_______________________________________3.

Match

1) Compulsive personality ______

2) Obsessive-compulsive neurotic _______

3) Paranoid personality______

4) Paranoid schizophrenic_______

a. Mr. L is frugal and hardworking. He is extremely meticulous about everything he does and seemwell-adapted to his job as quality controller in an electronics factory. When work back-logs prevent him from taking his usual extreme care with his work, he works harder. He scarcely has time for anything but his job because he has such high standards of perfection. Yet he reports that he has no problems

b) Mr. M. believes that at- . tempts are repeatedly being made to kill him because he is the promised Messiah destined to overcome the forces of evil.

c. Miss N feels that her only friend is betraying her and speaking ill of her behind her back. Although her friend is extremely patient with her, Miss N often misinterprets what she says and flies into a temper when her friend remonstrates that she feels unjustly accused.

d. Mrs. O feels that she must follow a very elaborate and strict daily routine. This involves washing and dressing in a certain order. This elaborate ritual which is carried on throughout the day is extremely time consuming, but any attempts to change it produce anxiety.

_________________________________ 4

Eighteen-year-old Jim has no real friends and doesn't stick to any job long. Whenever a job starts to exert any pressure on him, especially because of competition from work mates, he quits. Fellow employees consider him unapproachable. He repeatedly rebuffs all friendly overtures, even prefers to eat by himself. He rents a single room and his landlady affirms that he is a model tenant. He is quiet, and he never brings girls home. She never gets more than a "good morning" from him in return for all her efforts to make conversation.

Jim's entire personality structure is disordered. His behavior seems to indicate that he is a:

a. paranoid personality.
b. compulsive personality.
c. cyclothymic personality.
d. schizoid personality.

___________________________________ 1

Although the lives of individuals with personality disorders usually reflect the characteristic pattern of the disorder, they seem to be sufficiently adjusted as far as they themselves are concerned. However, what may happen, should a crisis arise?_______________________________________2

ANSWERS

1 d

2 may become neurotic or psychotic.

3 a,b,c

4 1) a: 2) d; 3) c: 4) b


Bob is extremely neat, clean, stubborn and stingy. He expects everything in the house to be spotless and in its proper place. Even a book left on the table or a crooked picture annoys him. If a gues uses and ash-tray, he will quickly clean it. He is extremely conscientious about his job and his family responsibilities and feels resentful if time or other circumstances prevent him from dischargin what he considers to be his duties.

Bob's personality would be described as:

a. compulsive
b. psychotic
c. paranoid
d. schizoid

___________________________________________5

Unlike the paranoid personality, the schizoid personality is unable to joining a close relationship show hostility. Because of this he is likely to:

a. be gregarious, though suspicious.
b. avoid competitive situations and intimacy with people.
c. seek an outlet for his aggressions in competitive situa- tions.
d. (none of these)

_______________________________________1

The symptoms above characterize the_______________________________ personality

_____________________________________3

Match

a) Acting-in personality type ______

b) Acting-out personality type ______

a. Sixteen-year-old Tom has beenin and out of corrective institutions for three years. He is a drug addict whose only inte4rest in the real world is centered around obtaining drugs.

b. Eighteen-year-old Dick is a petty thief with a charming manner and an engaging smile. He behaves on impulse with no long-range goals in view and feels no guilt or anxiety about his actions. Although he appears friendly, he is a loner and is incapable of joining a close relationship.

________________________________7

Parents, or other people with whom the child identifies, who are inconsistent, neglectful, unloving, or antisocial themselves are thought to be a causative factor in the development of______________________________________2

Which of the following is likely to be a sociopathic personality?

a. Confidence man
b. Habitual car stealer
c. Alcoholic personality
d. Manic-depressive psychotic
e. Obsessive-compulsive neurotic

______________________________________________ 8

ANSWERS

1 b
2 the sociopathic personality
3 sociopathic
4 compulsive
5 a
6 Manic-depressive psychotic
7 1) a 2) b
8 a, b, c

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The chief characteristics of the sociopathic personality are:

a. lack of moral development or conscience
b. feeling of gilt and anxiety.
c. impulsive behavior -- seeking immediate gratification
d. premedicated compulsive behavior.

__________________________________________-4

John is a convict receiving psychotherapy in prison. His therapist reports that John has received no love from either of his parents and does not fear its loss. Hence he has not identified with his rejecting parents and has not internalized their rules. For him, wrongdoing consists not in breaking rules, but only in getting caught and punished. He experiences little or no anxiety or guilt. John should probably be classified as a__________________________________1

NOW TAKE PROGRESS CHECK 2

1. sociopathic personality

2 b,d

3 impulsive behavior

4 a,c


MODULE 5
PROGRESS CHECK 2

1. Match.

1) Personality disorder______________

2) Neurosis__________________ a. Can function relatively well in real world
b. Feels anxious
c. Feels miserable
d. Whole personality is affected

2. Jane is an attractive girl and an efficient secretary. However she often to her boss that her co-workers talk behind her back and are jealous of her secretarial skills. She is extremely critical of others and at the same time flares up at the slightest suggestion of any criticism of herself.

From what personality disorder is Jane suffering?_____________________________________

3. A behavior disorder characterized by lack of guilt and shame, and by antisocial behavior is called:

a. neurosis.
b. psychosis.
c. sociopathic personality disturbance.

4. A middle-aged man loiters around a grammar school and tries to pick up young girls for sexual purposes. This illustrates a type of personality disorder known as ___________________________________

5. Match.

1 ) Compulsive personality_________

2) Cyclothymic personality___________

3) Schizoid personality_____________

a. Mrs. A is calm some of the time but often becomes unexplainably active and happy. She engages in frenzied activity, especially house cleaning, during these times.

b. Mr. B lives alone, painting canvases that he sometimes is able to sell. He hates to have his paintings shown in the same show as those of any other painter. He has no friends.

c. Miss C is generally depressed. She attributes her depression to the terrible state of the world. Although she feels too blue to have much fun or to enjoy her job, she feels no wish to change.

d. Mr. D is a college student. He takes voluminous notes in each course. He underlines every important word in every text, and reads every reference mentioned by his instructors. He is satisfied with nothing less than perfection in every course. He is proud of his style of life, although it includes very little time for anything but work.

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