• traits- longstanding and consistent personality patterns
• state- behaviors that come and go such as mood stage and many DSM axis I conditions

• psyc disorders on axis one and PD on axis II
  • ex: axis I: PTSD, axis II: borderline PD

• activation- novelty seeking
• mediated via dopamine in reward/pleasure center

• harm avoidance
• mediated by serotonin (fight/flight)

• reward dependence
• mediated via norepinepherine (homeostasis system)

• enduring pattern of inner experience and behavior that
  • deviates marketdly from expectation of individual's culture
  • pervasive and inflexible
  • onset in adolescence or early adulthood
  • stable over time
  • leads to distress and impairment

• deeply ingrained, inflexible nature
• maladaptive, especially in interpersonal contexts
• relatively stable over time
• significantly impairs function
• egosyntonic (behaviors do not distress the person directly)
• distresses those close to person

• enduring pattern of inner experience and behavior that deviates markedly from expectation of individual's culture
• manifested in two or more of the following areas
  • cognition
  • affectivity (range, intensitby, appropriateness of emotional response)
  • interpersonal functioning
  • impulse control

Odd or eccentric

• paranoid PD
• schizoid PD
• schizotypal PD

• unwarrented suspiciousness and tendency to misinterpret the actions of others as threatening, or deliberately harmful
• stereotype of militia, hate groups, isolated bombers or killers
• clinical signs
  • normal vigilance
  • delusional d/o
  • paranoid schizophrenia

• detachment from others
• restricted range of emotional expression and lack of interest in activities
• sterotype of socially awkward, isolated computer hacker
• potential differential diagnosis- Asperger's, autism

• deficits in interpersonal relationships and distortions in both cognition and perception
• stereotype of clairvoyant mystic
• neurological signs
  • increase homovanillic acid levels
  • aberrant eye tracking
  • cognitive deficits
  • electrophysiological abnormailites
  • brain abnormalities
    • increase temporal horn size
    • increase CSF volume
    • temporal lobe and thalamic abnormalities

dramatic, emotional, erratic

• narcissitic PD
• antisocial PD
• histrionic PD
• borderline PD

• grandiosity, lack of empathy and a need for admiration
• stereotype of weathly real estate tycoon who enjoys firing people

• guiltless, exploitative and irresponsible behavior with the hallmark being conscious deceit of others
• stereotype of cold, callous criminal

• excessive emotional expression and attention seeking behavior
• stereotype: Scarlette O Hara in Gone with the Wind

• pervasive instability in moods, interpersonal relationships, self image, behavior
• often disrupts family and work life, long term planning, and individuals sense of self identity
• usually suffer from disrder of emotional regulation
• stereotype- Glenn Close in Fatal Attraction

Describe cluster C PD's

anxious or fearful

• obsessive compulsive
• avoidant
• dependent

• rigidity, perfectionism, orderliness, indecisiveness, interpersonal control, emotional constriction
• stereotype of Felix Unger in Odd Couple

• inhbition, introversion, anxiety in social situations
• stereotype is Cowardly Lion in Wizard of Oz

• submissive behavior and excessive needs for emotional support
• ex: Dr. Watson in Sherlock Holmes

• immature defenses (denial, projection, acting out, splitting)
• intermediate (neurotic)- repression, dissociation, intellectualization, displacement, reaction formation
• mature defenses- altruism, humor, sublimation, anticipation

• pateint's experience of doctor as though the person is signfiicant person from patient's past
• relationship is re-enacted, not just remember
• early attachments and internal representations color future interactions

• doctor's emotional reactions to a patient
• may be particularly strong when dealing with PD patients
• may lead to ones own behavior becoming problematic and interfering with patient management

• identifiy diffusion
• primitive defense mechanisms
• intact reality testing