Abnormal Psychology

Personality Disorders 569

Reiland’s behavior seems extreme, but is it so extreme that it indicates a person-

ality disorder, or is it just an emotional outburst from a mother of young children

who is feeling overwhelmed? In order to understand the nature of Reiland’s prob-

lems and see how a clinician determines whether an individual’s problems merit a

diagnosis of personality disorder, we must focus on personality, and contrast nor-

mal versus abnormal variations of personality.

When you describe your roommate or new friends to your parents, you usually

describe his or her personality—enduring traits and characteristics that lead a per-

son to behave in relatively predictable ways across a range of situations. Similarly,

when you imagine how family members will react to bad news you’re going to

tell them, you are probably basing your predictions of their reactions on

your sense of their personality characteristics. Such characteristics—or per-

sonality traits—are generally thought of as being on a continuum, with a

trait’s name, such as “interpersonal warmth,” at one end of the continuum

and its opposite, such as “standoffi shness,” at other end of the continuum.

Each person is unique in terms of the combination of his or her particular

personality traits—and how those traits affect his or her behavior in vari-

ous situations.

In this section we examine in more detail the DSM-IV-TR category

of personality disorders and then the specifi c personality disorders that it

contains.

What Are Personality Disorders?

Some people consistently and persistently exhibit extreme versions of per-

sonality traits, for example, being overly conscientious and rule-bound or,

like Reiland, being overly emotional and quick to anger. Such extreme and

infl exible traits that arise across a variety of situations can become maladaptive

and cause distress or dysfunction––characteristics of a personality disorder. Let’s

examine the defi nition of personality disorders more closely.

As Table 13.1 notes, personality disorders refl ect

persistent thoughts, feelings, and behaviors that are

signifi cantly different from the norms in the individ-

ual’s culture (Criterion A). Specifi cally, these differ-

ences involve the ABCs of psychological functioning:

• affect, which refers to the range, intensity, and

changeability of emotions and emotional respon-

siveness and the ability to regulate emotions;

• behavior, which refers to the ability to control im-

pulses and interactions with others; and

• , cognition (mental processes and mental contents)

which refers to the perceptions and interpretations

of events, other people, and oneself.

In addition, the differences in the ABCs of psy-

chological functioning are relatively infl exible and

persist across a range of situations (Criterion B in

Table 13.1). Criterion B highlights how central these

maladaptive personality traits are to the way the

individual functions—the traits exert an infl uence

in a wide variety of situations and the individual

has extreme diffi culty thinking, feeling, and behav-

ing any differently. This rigidity across situations in

turn leads to distress or impaired functioning, as it

did for Sarah, in Case 13.1. To be diagnosed with

a personality disorder, the maladaptive traits

Personality disorders are characterized by a

pattern of infl exible and maladaptive thoughts,

feelings, and behaviors that arise across a range

of situations. This woman might be diagnosed

with a personality disorder if she consistently got

angry with little provocation and had diffi culty

controlling her anger in a variety of settings.

Billy E. Barnes/Photo Edit

Table 13.1 • DSM-IV-TR General Diagnostic Criteria

for a Personality Disorder

A. An enduring pattern of inner experience and behavior that deviates markedly from

the expectations of the individual’s culture. This pattern is manifested in two (or more)

of the following areas:

(1) cognition (i.e., ways of perceiving and interpreting self, other people, and events)

(2) affectivity (i.e., the range, intensity, lability, and appropriateness of emotional

response)

(3) interpersonal functioning

(4) impulse control

B. The enduring pattern is infl exible and pervasive across a broad range of personal and

social situations.

C. The enduring pattern leads to clinically signifi cant distress or impairment in social,

occupational, or other important areas of functioning.

D. The pattern is stable and of long duration and its onset can be traced back at least to

adolescence or early adulthood.

E. The enduring pattern is not better accounted for as a manifestation or consequence

of another mental disorder.

F. The enduring pattern is not due to the direct physiological effects of a substance

(e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma).

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders,

Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.