Read this text. Imagine a child has a genetic vulnerability to antisocial personality disorder. In what ways do you think the child's environment may have prompted the development of this personality disorder?
The term personality refers loosely to one's stable, consistent, and distinctive way of thinking about, feeling, acting, and relating to the world. People with personality disorders exhibit a personality style that differs markedly from the expectations of their culture, is pervasive and inflexible, begins in adolescence or early adulthood, and causes distress or impairment. Generally, individuals with these disorders exhibit enduring personality styles that are extremely troubling and often create problems for them and those with whom they come into contact. Their maladaptive personality styles frequently bring them into conflict with others, disrupt their ability to develop and maintain social relationships, and prevent them from accomplishing realistic life goals.
The DSM-5 recognizes 10 personality disorders, organized into three different clusters. Cluster A disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. People with these disorders display a personality style that is odd or eccentric. Cluster B disorders include antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and borderline personality disorder.
People with these disorders usually are impulsive, overly dramatic, highly emotional, and erratic. Cluster C disorders include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder (which is not the same thing as obsessive-compulsive disorder). People with these disorders often appear to be nervous and fearful. Table 15.2 provides a description of each of the DSM-5 personality disorders:
DSM-5 Personality Disorder | Description | Cluster |
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Paranoid | Harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders | A |
Schizoid | Lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder | A |
Schizotypal | Exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder | A |
Antisocial | Continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds | B |
Histrionic | Excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others' attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention | B |
Narcissistic | Overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes they are entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy | B |
Borderline | Unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures | B |
Avoidant | Socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing | C |
Dependent | Allows others to take over and run their life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on their own; feels uncomfortable or helpless when alone | C |
Obsessive-Compulsive | Pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done their way; reluctant to spend money | C |
Slightly over nine percent of the U.S. population suffers from a personality disorder, with avoidant and schizoid personality disorders the most frequent. Two of these personality disorders, borderline personality disorder and antisocial personality disorder, are regarded by many as especially problematic.
The prevalence of borderline personality disorder in the U.S. population is estimated to be around 1.4%, but the rates are higher among those who use mental health services; approximately 10% of mental health outpatients and 20% of psychiatric inpatients meet the criteria for diagnosis. Additionally, borderline personality disorder is comorbid with anxiety, mood, and substance use disorders.
Genetic factors appear to be important in the development of borderline personality disorder. For example, core personality traits that characterize this disorder, such as impulsivity and emotional instability, show a high degree of heritability. Also, the rates of borderline personality disorder among relatives of people with this disorder have been found to be as high as 24.9%. Individuals with borderline personality disorder report experiencing childhood physical, sexual, and/or emotional abuse at rates far greater than those observed in the general population, indicating that environmental factors are also crucial.
These findings would suggest that borderline personality disorder may be determined by an interaction between genetic factors and adverse environmental experiences. Consistent with this hypothesis, one study found that the highest rates of borderline personality disorder were among individuals with a borderline temperament (characterized by high novelty seeking and high harm-avoidance) and those who experienced childhood abuse and/or neglect.
The DSM-5 has included an alternative model for conceptualizing personality disorders based on the traits identified in the Five Factor Model of personality. This model addresses the level of personality functioning such as impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning. In the case of antisocial personality disorder, the DSM-5 identifies the predominant traits of antagonism (such as disregard for others' needs, manipulative or deceitful behavior) and disinhibition (characterized by impulsivity, irresponsibility, and risk-taking). A psychopathology specifier is also included that emphasizes traits such as attention seeking and low anxiousness (lack of concern about negative consequences for risky or harmful behavior).
Table 15.3 shows some of the differences in the specific types of antisocial behaviors that men and women with antisocial personality disorder exhibit.
Men with antisocial personality disorder are more likely than women with antisocial personality disorder to | Women with antisocial personality disorder are more likely than men with antisocial personality to |
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Researchers who are interested in the importance of environment in the development of antisocial personality disorder have directed their attention to such factors as the community, the structure and functioning of the family, and peer groups. Each of these factors influences the likelihood of antisocial behavior. One longitudinal investigation of more than 800 Seattle-area youth measured risk factors for violence at 10, 14, 16, and 18 years of age. The risk factors examined included those involving the family, peers, and community. A portion of the findings from this study are provided in Figure 15.20.
Figure 15.20 Longitudinal studies have helped to identify risk factors for predicting violent behavior.
Those with antisocial tendencies do not seem to experience emotions the way most other people do. These individuals fail to show fear in response to environment cues that signal punishment, pain, or noxious stimulation. For instance, they show less skin conductance (sweatiness on hands) in anticipation of electric shock than do people without antisocial tendencies. Skin conductance is controlled by the sympathetic nervous system and is used to assess autonomic nervous system functioning.
When the sympathetic nervous system is active, people become aroused and anxious, and sweat gland activity increases. Thus, increased sweat gland activity, as assessed through skin conductance, is taken as a sign of arousal or anxiety. For those with antisocial personality disorder, a lack of skin conductance may indicate the presence of characteristics such as emotional deficits and impulsivity that underlie the propensity for antisocial behavior and negative social relationships.
Source: Rice University, https://openstax.org/books/psychology-2e/pages/15-11-personality-disorders
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