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1、n1)Biologicaln2)Psychoanalyticn3)Cognitiven4)Interpersonaln5)Evolutionaryn6)Statistical-Traitn7)Descriptive-DSMPerspectives Recapn1)Biologicaln2)Psychoanalyticn3)Cognitiven4)Interpersonaln5)Evolutionaryn6)Statistical-Traitn7)Descriptive-DSMPerspectivesInterpersonal PerspectiveInterpersonal Perspecti
2、venLife is about relationshipsnCooley and MeadnLooking Glass SelfnOur sense of self is determined by the feedback that others provideHarry Stack SullivannPersonality is the“recurrent set of interpersonal situations which characterized a persons life”nWe are not self-contained entitiesnSome forms of
3、mental illness are interpersonalLearys CircumplexKieslerWiggins CircumplexPrinciple 1 Interpersonal StylePrinciples 2 Vector lengthPrinciple 2 Vector lengthA=fluidB=rigidWiggins CircumplexWiggins CircumplexWiggins CircumplexDominanceIntrovertedArroganceUnassumingExtravertedWarmColdSubmissiveNARANTPA
4、RSZDAVDDEPHIST1=therapist position startC=avoidant clientT2=therapist position end of therapyC=clientT1=therapist positionstart of therapyT2=therapist positionat end of therapyEvolutionary PersonologyThe“Millon”InventoriesMCMI-III(disorders,18+)MIPS(personalitystyles,18+)MACI(disorders,ages13-19)PAC
5、L(Strack,1991)AdjectivebasedmeasureofnormalpersonalityEarly Theory Biosocial Learning TheoryActivePassivedetached dependentindependentambivalentSource of reinforcementCoping strategyEarly TheoryActivePassivedetachedAvoidant(AVD)Schizoid(SZD)AVD=hypersensitive,inadequate,socially inhibitedSZD=emotion
6、less,extremely introvertedEarly TheoryActivePassivedetachedSchizotypalSZTSZT=eccentric,odd,“mild schizophrenia”,anxiousEarly TheoryActivePassivedependentHistrionicHSTDependentDEPHST=attention seeking,excessively emotionalDEP=submissive,clingy,indecisive,insecurely attachedEarly TheoryActivePassivede
7、pendentBorderlineBDLBDL=unstable relationships,moods and identity,impulsiveHistoryActivePassive independentAntisocialANTNarcissisticNARANT=interpersonally callous,impulsive,recklessNAR=entitled,arrogant,lacking empathyHistoryActivePassiveindependentParanoidPAR=mistrusting,suspicious,interprets motiv
8、es of others asmalevolentHistoryActivePassiveambivalentNegativisticNEGCompulsiveCOMNegativistic=oppositional,resisting,stubbornCompulsive=controlling,orderly,perfectionisticHistoryActivePassiveambivalentBorderlineHistoryActivePassivedetachedavoidant schizoiddependenthistrionicdependentindependentant
9、isocialnarcissisticambivalentnegativisticcompulsiveMCMI-I(1983)Loevinger(1957)TestConstructionProcedure1)Theoretical2)Internalstructural(reliability)3)External(validity)MCMI-II(1987)DSM-III-R(1987)11officialPDs2unofficialPDs(sadistic,self-defeating)Sadistic=enjoys inflicting pain,cruel,demeaningSelf
10、-defeating=good things dont last,dont deserve good thingsActivePassivedetachedavoidant schizoiddependenthistrionicdependentindependentantisocialnarcissisticambivalentnegativisticcompulsivediscordantsadisticself-defeatingBiosocial Theory RevisedMCMI-IIIMCMI-IIIThreepolaritiesExistentialAim:Pleasure-P
11、ainCopingStyle:Modify-AccommodateReplicationStrategy:Self-OtherAllPDsablendofthesepolarities.Schizoid versus AvoidantMCMI-IIITheodoreMillon(1994)175items(20-30minutes)1ValidityIndex3ModifyingIndices14Pdscales(11mild,3severe)10clinicalsyndromes(7mild,3severe)ages18+Statistical-TraitApproaches1)Examin
12、ecorrelatesofpersonalitydisordersNomotheticRelationshipbetweenPDsandBigFive2)ExaminesingleprofileIdeographicInferpersonalitydisorderfrom“spikes”MMPIMMPI-2MinnesotaMultiphasicPersonalityInventory-2MMPI-2StarkeHathawayamedicalpsychologistJovianMcKinleyaneuropsychiatristUniversityofMinnesotaHospitals“t
13、obeusedlocally”“Finishedby1956”MMPIEightoriginalscales:HypochondriasisDepressionHysteriaPsychopathicDeviantParanoiaPsychastheniaSchizophreniaHypomaniaEmpirical KeyingItem AnalysisComparison of MMPI and MMPI-2MMPI566 total items16 repeated items4 validity scales10 clinical scalesStandardized on 724 i
14、ndividuals with mean educational of 8th grade.Whites onlyMMPI-2(1989)567 total itemsno repeated items7 validity scales10 clinical scalesStandardized on 2,600 individuals with mean education of 13 yearsRepresentative of gender,ethnicity,and SES levelDo not copy/studyInterpretationTscores,M=50,SD=10ah
15、ighscoreisabove65TTof65orgreater,8%ofpopulationMMPIInterpretationSingleSpikeTwopointcodes(verycommon)e.g.,2-7codetypeTriadse.g.,1,2,3(neurotictriad)e.g.,6,7,8(psychotictriad)ContentScales,HarrisLingoes,Supplemental,etc.CriticalItemsGeneral Scale InterpretationsPositive slopepoor day-to-day functioni
16、ngNegative slopeemotional turmoil and dissatisfaction with lifeBasic Clinical ScalesScale 1-HypochondriasispoorphysicalhealthgastrointestinaldifficultiesScale 2-Depressiondepression,poormorale,lackofhopegeneraldissatisfactionwithoneslifegeneralapathy,physicalsymptoms(sleepdisturbances,gastrointestin
17、al)excessivesensitivity,lackofsociabilityScales 3-Hysteria1)adenialofproblemsorvulnerabilities2)complaintsofreasonablyspecificsomaticproblemsScale 4 Psychopathic DeviateangryrebelliousnessagainstruleshostileinterpersonalrelationshipsinabilitytoprofitfromexperienceangeratfamilyScale 5 Masculinity-Fem
18、ininityvocationalandavocationalinterestsaestheticpreferences,activity-passivitypersonalsensitivityScale 6:Paranoiainterpersonalsensitivitymoralself-righteousnessfeelingsofpersecutionsuspiciousness.prognosisintherapyispoortendtoexternalizeScale 7:Psychastheniageneral discontent with the worldobsessio
19、nal concernsanxietyindecision,poor concentration,self-devaluationScale 8:SchizophreniaconfusedthoughtprocesseshallucinationssocialandinterpersonalalienationdepressionanddissatisfactionScale 9:Hypomaniahighenergyoutputdistractibilityandlackofpersistenceextroversionandstimulationseekinggrandiosityamor
20、alityScale 0:Social IntroversionhighscoresindicateintroversionlowscoresindicateextraversionCase Study-Jeffrey Dahmer1960-1994Milwaukee/OhioareaSentencedto957years17malemurdervictimsSerialkillerCase StudyJeffreyDahmerLink1Link2Link3Link4Link5DescriptiveDSMDSM PDsCalledmanythingsCharactertypesFreudNeu
21、roticstylesShapiroCharacterdisordersHorneyPersonalitydisordersDSM-III(1980)DefinedAPersonalityDisordersisanenduringpatternofinner experience andbehaviorthatdeviates markedlyfromtheexpectationsofanindividuals culture,ispervasiveandinflexible,hasanonset in adolescence or early adulthood,isstableoverti
22、me,andleads to distress or impairment.(p.629)Multiaxial SystemScanp.6anddiscussAxial RelationshipsAxisI=AxisII*AxisIVExample:Depression=dependent*divorceMeasurement Question1)Interview2)StructuredInterview(SCID)3)PersonalityInventoriesMMPI-2NEO-PIRMCMI-IIISpecificInventoriesPCL-RHow common?Mattiaand
23、Zimmerman(2001)13%Questions and Controversies1)Doespersonalityexist?2)Categoriesordimensions?3)Whichdimensionalsystem?Big5,Big3,Big164)Rampantco-morbidityAxisIandIIQuestions and Controversies5)Reliabilityissues6)Constructvalidityissues7)Bestmeansofassessingisnotclear8)DistinctionbetweenAxisIandIIisu
24、nclearQuestions and Controversies9)Genderbias10)Paucityoftreatmentstudies11)Whichcriteriashouldbeused?12)HeterogeneitywithdiagnosisProposals for DSM-V1)AbandonPDsaltogetherRegroupwithAxisIdisorders2)Prototypematching3)DimensionalApproaches18modelsbeingconsideredTheBigFiveNEOACSZDLAVDHLDEPHHSTHNARHHANTLLCOM hSZTHLLBDLNLLPARHL
Personality Disorders in Modern LifeJamie Dyce人格障碍在现代生活的杰米戴斯
