Learning Objectives. Reading Assignment. Key Terms. Written Lecture

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1 UNIT VII STUDY GUIDE Personality Disorders in Adults and Abnormal Behavior in Children Reading Assignment Chapter 13: Personality Disorders and Impulse Control Disorders Chapter 14: Abnormal Behavior in Childhood and Adolescence Key Terms 1. Antisocial personality 2. Asperger s 3. Autism 4. Avoidant personality 5. Borderline personality 6. Childhood disintegrative 7. Conduct 8. Dependent personality 9. Ego dystonic 10. Ego syntonic 11. Encopresis 12. Enuresis 13. Fragile X syndrome 14. Histrionic personality 15. Impulse control s 16. Kleptomania 17. Narcissistic personality 18. Obsessive-compulsive personality 19. Oppositional defiant 20. Paranoid personality 21. Pathological gambling Learning Objectives Upon completion of this unit, students should be able to: 1. Recognize and classify personality s by odd and eccentric behavior; dramatic, emotional, or erratic behavior; and/or anxious or fearful behavior. 2. Discuss the psychodynamic, learning, family, biological, and sociocultural perspectives of personality s. 3. Explain the psychodynamic, cognitive-behavioral, and biological approaches of treating personality s. 4. Discuss how cultural beliefs play a role in mental health issues of children and describe the prevalence and risk of mental health s in children. 5. Explain pervasive developmental s; especially autism. 6. Explain causes and interventions for mental retardation. 7. Describe the types of learning and communication s and their treatment approaches. 8. Recognize the types of attention deficit and disruptive s, and childhood anxiety and depression s, as well as treatments for these s. Written Lecture Personality Disorders Take a look at the reality shows on TV. We have bridezillas lambasting anyone who does not agree with what they want for their wedding, dating shows where a bachelor stays on the show just to make fun of the star bachelorette and dupe the rest of the bachelor participants, and singing contests where it s not always about the talent, but about which contestant gets the most votes. YouTube allows unmonitored self-promotion, and anyone can blog about his or her social and sexual escapades. These sometimes rude and crude media productions invite offers of book deals and movie rights. If you promote yourself well, you can become a millionaire. These reality antics both intrigue and irritate us as viewers. This is the paradox of a narcissist. If narcissists were just complete fools, we would avoid them. However; their entertaining and funny side hides their aggression and manipulation; but only for a while. Our fascination and attraction with this odd combination makes it hard to recognize this personality (Kaufman, 2011). A question to ponder: Are we creating narcissists by promoting and indulging children s self-esteem? Personality s are characterized by patterns of persistent, maladaptive behaviors that affect how a person relates to others. Together these behaviors result in an enduring personality profile. An individual with a personality has very poor insight into the and is generally unaware that their behavior is abnormal. In other words, they are not bothered by their maladaptive pattern of functioning. In contrast, people with clinical s, such as major PSY 2010, Abnormal Psychology 1

2 22. Pervasive developmental s 23. Phenylketonuria 24. Rett s 25. Schizoid personality 26. Schizotypal personality depression, experience distress due to the. This prompts them to seek out treatment. The person with a personality rarely seeks out treatment for maladaptive behavior associated with their personality. Personality s are divided into three clusters in the DSM-IV-TR. They are listed below. 1. Cluster A: Characterized by odd and eccentric behavior Paranoid Personality Disorder extreme suspiciousness of others intentions; believes others are out to hurt them in some way; absence of delusions Schizoid Personality Disorder isolated from others and does not seek out relationships with others; emotionally aloof and detached; seems apathetic Schizotypal Personality also socially isolated; holds bizarre or odd beliefs; no clear evidence of psychosis but seems to be more pervasive in individuals with a family history of Schizophrenia 2. Cluster B: Characterized by dramatic and erratic behavior Antisocial Personality Disorder demonstrates disregard for social norms, including laws; disregards and violates the rights of others; irresponsible, and lacks remorse Borderline Personality Disorder demonstrates difficulty regulating emotion; impulsive with frequent mood changes; has problematic and tumultuous relationships; extreme fear of abandonment leads to behaviors, such as suicide threats and attempts, as well as selfmutilation Narcissistic Personality Disorder demonstrates extreme and grandiose self-admiration; lacks empathy for others Histrionic Personality Disorder excessive display of emotions; craves attention and loves being the center of attention; manipulative 3. Cluster B: Characterized by extreme anxiousness/fearful behavior Avoidant Personality Disorder fears rejection, which causes them to avoid social situations and relationships with others Dependent Personality Disorder displays the need to be taken care of by others; the fear of losing support of others leads to clingy behavior Obsessive-Compulsive Personality Disorder preoccupation with orderliness; perfectionist; inflexible. (Unlike Obsessive Compulsive Disorder, people with this personality are not distressed by their need to be perfect or abide by strict rules and regulations.) Causes and Treatment of Personality Disorders According to the American Psychological Association, there are several factors that have been found to be related to the development of personality s. These include genetic factors, such as malfunctioning genes, childhood trauma (such as sexual abuse), high reactivity to environmental stimuli (such as noise and light), and verbal abuse (American Psychological Association, n.d.). Personality s are notoriously difficult to treat. This, in part, is due to the lack of insight presented by the individual with a personality. They tend to be quite resistant to suggestions that their behavior may be causing issues or problems making therapy difficult, and often terminate treatment prematurely. However, current research shows promise for treating personality s. For instance, research on borderline personality shows Dialectical Behavior Therapy (DBT) and cognitive-behavioral therapy can be effective (Yager, 2010). PSY 2010, Abnormal Psychology 2

3 DBT focuses on helping the individual regulate emotions, while CBT focuses on changing faulty and dysfunctional beliefs. Other treatment methods include psychodynamic therapy, which consists of helping the person find the root of maladaptive behavior. Biological treatment consists of antidepressant and antianxiety medication. Case Example: Martha was recently hospitalized after threatening suicide. During the initial evaluation, Martha reveals she also cuts herself when she is upset. She often becomes hostile and excessively weepy with others in the inpatient hospital unit and fears that her current boyfriend will abandon her while she is hospitalized. She has difficulties with the other patients due to her impulsivity and excessive moodiness. What personality does Martha display? Borderline Personality Disorder Impulse Control Disorders Impulse control s are characterized by difficulties controlling impulses. This classification of s includes pathological gambling, kleptomania (compulsive stealing), intermittent explosive (failure to control aggressive impulses), pyromania (compulsive fire-setting), and trichotillomania (compulsive pulling of one s hair). Treatment of impulse control s includes psychotropic medication and cognitive-behavioral therapy. Case example: Gary has been arrested several times for assaulting others. While in jail, it becomes clear that Gary easily becomes aggressive; this leads to violent behavior. He is constantly getting into physical altercations with others over small things. For instance, he broke another inmates arm and jaw because the inmate did not hear him when Gary asked him to move. What impulse control is Gary displaying? Intermittent Explosive Disorder Childhood and Adolescent Disorders It is important that culture and age be considered before determining what constitutes abnormal behavior in childhood and adolescence. For instance, imaginary friends during early childhood are developmentally normal and considered age appropriate and should not be considered abnormal behavior or evidence of a mental. Risk factors that increase the likelihood of a mental during childhood includes genetics, environmental stressors; such as unstable living conditions, and family factors; such as abuse. Disorders that can be seen during childhood or adolescence and their symptoms are listed below. 1. Pervasive Developmental Disorders impairment in numerous areas of functioning and behavior. Disorders under this category include autistic and asperger s. 2. Mental Retardation broad-array of impairment in cognitive and social functioning. Intelligence quotient, (IQ) scores of 70 or less combined with inability to perform age-appropriate life tasks. Categories of Mental Retardation include: Mild (IQ 50-70), Moderate (IQ 35-49), Severe (20-34), and Profound (IQ 20 or below). PSY 2010, Abnormal Psychology 3

4 3. Learning Disorders exists when there is a deficiency in a specific learning ability. Disorders in this category include mathematics, of written expression, and reading. The most commonly recognized Learning Disorder is the reading known as dyslexia. Dyslexia is characterized by impairment in reading abilities. 4. Communication Disorders characterized by impairment in the use of and comprehension of language. Disorders include expressive language, mixed receptive/expressive language, phonological, and stuttering. 5. Attention-Deficit and Disruptive Behavior Disorders this group of s is characterized by socially disruptive behaviors. Disorders seen under this category include Attention-Deficit Hyperactivity Disorder (ADHD), conduct, and oppositional defiant. 6. Anxiety Disorders in childhood like adults, children can also experience the many different anxiety s, such as obsessive-compulsive and panic. One unique to childhood is separation anxiety, which is characterized by excessive fear of being separated from parent or caretaker. 7. Depression Disorders in childhood children and adolescents can also experience depressive s similar to that of adults. Symptoms tend to be the same, but it is common for children to demonstrate irritability instead of sadness. It is important to note that suicide is a risk in adolescence. In fact, it is the third leading cause of death in adolescence. Risk factors for suicide at this age include being a girl, living in a rural or less populated area, white race or Native American in the U.S., depression, history of suicide attempts, history of sexual abuse, family conflicts, stressful life events (such as going to a new school), substance abuse, and social contagion (imitating peer suicidal behavior). 8. Elimination Disorders impairment in ability to control either urination (Enuresis) or bowel movements (Encopresis) in the absence of an organic. Chapter 14 in the textbook does a good job of summarizing all the symptom criteria for each of the s discussed above. Additionally, theoretical perspectives and treatment approaches for each are also reviewed. Take time to look over each carefully. Then, read the case below and identify the and a treatment approach. Finally, try to conceptualize the case from one of the theoretical perspectives discussed in the textbook. Take a look at the case of Donna. Donna has just started nursery school. She is 3-years-old. Her parents are hoping her language skills will develop now that she will be in school as she has not yet developed language skills. As a result, communication between Donna and her parents has been difficult because she is not speaking in coherent words as of yet. Additionally, Donna is not expressive. For instance, she does not make eye contact or show facial expressions. Donna spends most of day in her playroom playing with the wheels on her Barbie car. Her parents are concerned because she will sit for hours doing this. If they try to stop her, she becomes very upset. What is Donna displaying? Autistic Disorder How should Donna be treated? There is no cure. However, early intervention has the best prognosis. The use of intensive behavioral treatment is the most PSY 2010, Abnormal Psychology 4

5 effective treatment method for Autism. Treatment would include the use of operant conditioning techniques using reinforcement to increase language and social skills. Treatment programs need to be highly structured and individualized. The National Institute of Mental Health s website at provides good information regarding the treatment of Autism Spectrum s. How would you conceptualize Donna s? From a cognitive-learning perspective, Donna is slow to learn because of perceptual deficits. She can only process and attend to one stimulus at a time, which limits her ability to integrate information and make associations. From a biological perspective, though, there is evidence that suggests that brain abnormalities along with environmental factors, such as exposure to viruses or toxins, lead to Autism. References What causes personality s? (n.d.). American Psychological Association. Retrieved from Kaufman, S. B. (2011). The peacock paradox: You can t help falling for them, and by the time you ve gleaned their true colors, you re hooked and possibly hurt. Welcome to the contradictory universe of narcissism. Psychology Today, 44(4), 56(8). Retrieved from Academic OneFile. Yager, J. (2010). Treatments for borderline personality. Journal Watch Psychiatry. doi: PSY 2010, Abnormal Psychology 5