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PERSONALITY Is an ingrained, enduring pattern of perceiving, behaving and relating to self, others and the environment

During personality development, the individual establishes traits that will enable him to observe, interact and think about himself and the environment

If the individual develops positive selfconcept, good body image and a sense of worth, he will have the characteristics of a healthy personality If the person develop inflexible, maladaptive behaviors (like manipulativeness, hostility, lying, poor judgment or alienation), it will interfere with his social or occupational functioning, the person thus will exhibit signs or personality disorders

The person denies the maladaptive behaviors he exhibits The maladaptive behaviors are inflexible Minor stress are poorly tolerated resulting in increased inability to cope with anxiety The person is in contact with reality although he has difficulty dealing with it Disturbance in mood Psychiatric help is rarely sought

Personality Trait are prominent aspects of personality that are exhibit in a wide range of personal context and social functioning. To be diagnosed as Disorder, the individual must demonstrate the criteria behaviors persistently and to such extent that they impair ability to function socially and

Definition: Are enduring patterns of inner experience and behavior that deviates markedly from the expectations of ones culture, is pervasive and inflexible, has an onset during adolescence or early adulthood, stable over time and leads to distress or impairment

It is a chronic psychological disorder with the following distinct features: Disturbance in self-image Inability to have successful interpersonal relationship Inappropriate range of emotions Different ways of perceiving self or world with resultant improper impulse control

Clients

suffer impairment in fulfilling a family, academe, employment or other functional roles They believe their problems stems from others. There is failure to recognize own behavior as source of difficulty

A. BIOLOGIC THEORIES Temperament: It is the biologic process of sensation, association and motivation that underlie the integration of skills and habits based on emotion

Four common temperaments (ingrained at age 3) 1. Harm avoidance temperament: these people exhibit the following: Fear of uncertainty Social inhibition Shyness with strangers Rapid fatigability Pessimistic worry of problems

Two common tendencies in harm temperament High harm avoidance: will result in maladaptive inhibition Low harm avoidance resulting in unwarranted optimism, unresponsiveness to potential harm or danger

2. Novelty Seeking Temperament: Two common tendencies in novelty seeking High Novelty Seeking Temperament: will result in quick tempered person prone to anger and outburst, curious and easily bored, impulsive, extravagant and fickle in relationships Low Novelty Seeking Temperament: are slow tempered, stoical (uncomplaining), frugal or thrifty, reserved, orderly, tolerant or monotonous

3. Reward Dependence Temperament Two common tendencies in Reward Dependence High Reward Dependence Temperament: are people who become overtly dependent on approval from others and readily assumes the ideas of others without regard for own beliefs. These people are tender hearted, sensitive and sociable Low Reward Dependence Temperament: are people who become withdrawn, detached, aloof and disinterested. People are practical, tough minded, cold-socially insensitive, irresolute, indifferent

4. Persistence Temperament: Two common Tendencies Highly Persistent temperament: are people who are hardworking, ambitious, overachievers who respond to fatigue or frustration as personal challenge Low Persistent Temperament: are people who are inactive, indolent (lazy) and erratic (unpredictable) and gives up easily when frustrated

There are 3 major Characteristic Traits: 1. Self-directedness: it is the extent to which a person is responsible, reliable, resourceful, goal oriented and self-confident Low self directed persons are irresponsible, or opposite to the above trait

2. Cooperativeness: it is the extent to which a person sees himself as integral part of human society High cooperative people are empathic, tolerant, compassionate, supportive and principled Low cooperative people are absorbed, intolerant, critical, unhelpful, revengeful and opportunistic

3. Self-transcendence: it is the extent to which a person considers himself to be integral part of the universe. High self-transcendent are people who are spiritual, humble and fulfilled Low self-transcendent are people who are self-conscious, materialistic and controlling, they have difficulty in accepting suffering, loss of control in terms of personal or material loss or death

Cluster A: People whose behavior appear odd or eccentric misfits (unusual, peculiar and strange) Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder

Cluster B: Disorders that show great impulsivity, and acting out with considering the consequence or the act or alternate actions. These people appears dramatic, highly emotional and erratic Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder

Cluster C: The disorder include predominant sense of anxiety and fearfulness Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder

Common Problem: Clients do not perceive their dysfunctional or maladaptive behaviors as a problem, it indeed sometimes becomes their pride.

CLUSTER A A.1. PARANOID PERSONALITY DISORDER Defining Characteristics:

Distrust of other people and a constant unwarranted suspicion that others have sinister motives Places excessive trust in their own knowledge and abilities Searches for hidden meaning and hostile intentions from what others say or do Challenges the loyalty of friends and loved ones Common in males 0.5 2.5 of general population

Signs and Symptoms Paranoid Personality: a. Suspicion and distrust of others motives b. Refusal to confine in others c. Inability to collaborate d. Hypersensitive e. Inability to relax f. Need to be in control g. Self-righteous h. Detachment and social isolation i. Anger, jealousy and envy j. Bad tempered, irritability k. Lack of social support system

A.2. SCHIZOID PERSONALITY DISORDER Defining Characteristics: Detachment and social withdrawal Loners and solitary interest, an occupation with no close friends (remarkable social distance from family and unconcerned about others praise or criticism) Functions adequately in daily life but dont develop meaningful relationship May have other disorders like schizotypal, paranoid or avoidant personality disorder

Signs and Symptoms of Schizoid Personality: a. Emotional Detachment: lack of strong emotion b. Social withdrawal and loneliness: indifference to others feelings, praise of criticism c. Strong preference for solitary activities d. Litter desire or enjoyment of close relationships e. Lack of close friends / confidants f. No desire to be part of the family g. Little or no interest in sexual experiences h. Shyness, distrust, and failure in intimacy i. Feelings of utter unworthiness coexisting with feelings of superiority j. Self-consciousness and oversensitivity

A.3. SCHIZOTYPAL PERSONALITY DISORDER

Defining Characteristics:

a. Person is characterized by odd thinking and behavior, with pervasive and social interpersonal deficits b. Exhibits eccentric behavior with difficulty in concentrating: Peculiar mannerism Unusual speech, vague, metaphoric and hard to follow Magical thinking, strange fantasies, odd beliefs belief on extrasensory abilities) c. Represents mild schizophrenia, but are not psychotic because they dont experience hallucinations, delusions or disorganized thought d. During times of extreme stress, patients may experience cognitive or perceptual disturbances e. Typically have severe social anxiety because they are paranoid about others motives f. Is chronic in course and in some, progresses to schizophrenia g. Found 3% of the general population, slightly more common in men

Signs and Symptoms of Schizotypal Personality:


A. Disturbed thinking: Inaccurate belief that others behavior or the environment are meant to have effect on patient Odd beliefs on magical thinking (examples, his thoughts can influence environment or events Unfounded suspicion of being followed, talked or persecuted)

B. Behavior disturbance:
Odd or eccentric behavior or

appearance Inappropriate or flat affect Lack of close relationships other than immediate family Social isolation Excessive social anxiety not abated with familiarity Sense of feeling different

B.4. ANTISOCIAL PERSONALITY DISORDER


Defining Characteristics: Chronic behavior violating right of others predisposing criminal behavior Common features include: Impulsivity and recklessness Egocentric Disregard for the truth Lack of remorse Irritability and aggression Inability to tolerate boredom Irresponsibility at work, school or as parent In adolescence, it may co-exist with conduct disorder

Signs and Symptoms of Antisocial Personality: Violation of others rights Repeated unlawful acts Reckless disregard of own and others safety Deceitful, fraudulent and uses treachery Lack of remorse Consistent irresponsibility Power-seeking behavior - destructive tendencies Impulsivity- failure of planning Manipulative behavior Inability to maintain close personal or sexual relationships

B.5. BORDERLINE PERSONALITY DISORDER Defining Characteristics: a. Disorder marked by pattern of instability in interpersonal relationships, mood, behavior and self-image b. Distortions in cognitive and sense of self leads to frequent changes in goals, jobs, career plans, friendships, values, even sex identity c. Sees herself as fundamentally bad or unworthy, misunderstood, mistreated, empty, with little idea of who she really is

d. Acts with impulsivity e. Has intense stormy relationships f. Perceptions of family shifts frequently from great admiration and love to intense anger and dislike (called splitting) g. Extreme sensitivity to rejection and reacting with anger h. Incidence is 2-3% of the general population, common in females

Signs and Symptoms Borderline Personality: a. Four categories of major signs: Unstable relationships Unstable self-image Unstable emotions Impulsivity

b. Assessment findings (borderline) include:


Unstable interpersonal relationship Fear of abandonment: Desperate attempts to maintain relationship Manipulation Limited coping Inability to develop healthy sense of self Uncertainty about major issues (self-image and identity, life goals, values, career choices, friends, sexual orientation) Rapid dramatic mood swings: euphoria to anxiety to rage Acting out of feelings instead of expressing them Inappropriate anger Unpredictable, self-damaging behavior

B.4 HISTRIONIC PERSONALITY DISORDER:

Defining Characteristics: a. Pervasive pattern of excessive emotionality and attention seeking behavior drawn to momentary excitement and fleeting adventure b. Charming, dramatic and expressive, can easily hurt, vain, demanding, and capricious, inconsiderate c. Speech is excessively impressionistic if not theatrical, gestures are exaggerated Use of grandiosity

d. Innate need to be the center of attention at all times


Exaggerated illness to gain attention Interrupt others so they can dominate Seek constant praise Emphasis on physical appearance

e.

Low sense of self-identity, usually identifies with others f. Incidence of 2-3% in general population common in women

Signs and Symptoms of Histrionic:


Constant craving for attention Flirtatious, seductive behavior Vanity, over investment in appearance, exhibitionism Self dramatization impulsivity Egocentricity Intolerance of frustration, impatience Dread of growing old Manipulative or angry outburst, tantrums Depression Suicidal gestures and threats

B.7. NARCISSISTIC PERSONALITY DISORDER


Defining Characteristics:
a. Self-centered, self-absorbed, lacks empathy for others, takes advantage of people to achieve his own needs Inflated sense of self Tries to maintain an image of perfection and invincibility to hide weak (but beneath the image, there is insecurity and low self-esteem)

b. Expects to be recognized as superior Preoccupation with fantasies of brilliance Believes he is special and entitled to favor Expect others to comply with wishes automatically Believes he should associate only with special or high status people c. Achievement driven or oriented

d. Delusion of greatness may be shattered by a threat to his ego Physical illness Loss of job or relationship Emptiness and depression despite success e. Found less than 1% of general population about three times as many males f. Develops early adulthood but may not be identified until midwidlife

Signs and Symptoms Narcissistic:


a. Arrogance b. Self-centered c. Unreasonable expectations of favorable treatment d. Grandiose sense of self-importance e. Exaggeration of achievement f. Preoccupation with fantasies of success, power, beauty, brilliance, or ideal love g. Constant desire for attention and admiration h. Lack of empathy towards those he offended i. Taking advantage of others to achieve own goals j. May exhibit rage, shame, humiliation in response to criticism k. Poor reality testing

CLUSTER C C.8. AVOIDANT PERSONALITY DISORDER

Defining Characteristics a. Feelings of inadequacy, extreme social anxiety, social withdrawal and hypersensitivity to others opinion b. Low self-esteem, poor selfconfidence, dwelling on their weakness c. Yearns social relationships but fears being rejected or embarrassed

d. Frequently may have other psychiatric disorders:


( Social phobia) (Schizoid / Dependent personality) (Agoraphobia) (Obsessive-compulsive) (GAD) (Dysthemia: mild depression) (Major depressive disorder) (Somatoform) (Dissociative) (Schizophrenia)

e. About 0.5 to 1% of the general population, equal in both males and females

Signs and Symptoms of Avoidant Personality Disorder: a. Shyness, timidity, social withdrawal b. Reluctance to speak or converse c. Constant mistrust d. Testing others sincerity

e. Difficulty starting and maintaining relationships f. Perfectionism g. Rejection to those who dont live up high standards h. Tenseness and anxiety i. Low self-esteem, loneliness j. Feelings of being unworthy

C.9. DEPENDENT PERSONALITY DISORDER


Defining Characteristics: a. Extreme need to be taken care of, clinging behavior and fear of separation and rejection b. Let others make important decisions for self with constant need for reassurance: Comply passively and transfers responsibility to others Seek others to dominate and protect them

c. Stays in abusive relationships: Becomes suicidal when breakup of romantic relationship is imminent Urgently seeks another relationship after a close relationship ends d. Overly sensitive to disapproval e. Avoids position of responsibility f. Occurs 1.5% in the general population, slightly more in females

Signs and Symptoms of Dependent Personality: a. Submissive b. Self-effacing (unassuming) and apologetic c. Low self-esteem d. Lack of initiative e. Incompetent: there is need for constant assistance f. Intense unremitting need to be loved

g. Anxiety and insecurity h. Feelings of pessimism i. Hypersensitive to criticism j. Clinging and demanding behavior k. Fear of losing relationship l. Dependence on a number of people m. Difficulty in decision making n. Avoidance of change o. Exaggerated fear of losing support and approval p. Complaints of fatigue, lethargy and depression

C. 10. OBSESSIVE-COMPULSIVE PERSONALITY Defining Characteristics: a. Pervasive desire for perfection and order Relentless anxiety about getting things perfect b. Places great deal on pressure on self and others not to make mistakes Believes his way of doing thing is the only right way Forces self and others to follow rigid moral principles Literal compliance with rules

f. Overwhelming need to control environment Suffers severe procrastination Difficulty to start task because of need to sort out priorities correctly g. Lifelong pattern of rigid thinking may lead to poor social skills, distress and poor occupational and social functioning h. May have other disorders of

Signs and Symptoms of ObsessiveCompulsive Personality: a. Behavioral, emotional and cognitive rigidity b. Perfectionism c. Severe self-criticism d. Indecisiveness (vacillation and indecision) e. Controlling manner f. Poor sense of humor

g. Cold, distant, formal: there is difficulty expressing tender feelings and emotional constriction h. Solemn, tense demeanor i. Excessive discipline j. Aggression, competitiveness and impatience k. Bouts of intense anger when things stray from own idea.

Interventions must be individualized to meet each clients needs

Persons with disturbance in Cognition:

- Reinforce reality if client verbalizes illusions or feelings of depersonalization - Help client to select someone he trusts to minimize suspicious or delusional thoughts - Encourage to validate perceptions before making action that may precipitate difficulties - Explore with client present maladaptive coping mechanisms and the purpose they serve

- Explore alternate coping mechanisms to reduce stress - Assist the client to develop insight regarding the purpose of intervention

Encourage verbalization of feelings of anger, hostility, worthlessness or hopelessness Give attention and support when client expresses feelings honestly and openly - Encourage to share feelings with others - Provide safe environment if client expresses suicide ideation or mutilation

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Explore reasons the client has regarding difficulty establishing interpersonal relationship Explore self-concept and self-esteem Explore perception of how others view him Provide positive feedback on your observation Encourage to socialize at least one person daily

State limits & behaviors expected of him Enforce all limits without apologizing Be direct & confront the client when limits are not observed Discuss consequences of failure to observe limits Discuss behavior with the client in a nonjudgmental manner

Thank You