The DSM Multiaxial Model

Axis Psychological Disorderrs

The disorders in the DSM are grouped in terms of a multiaxial model. Multiaxial literally means multiple axes. Each axis represents a different kind or source of information. Later, we concentrate on exactly what these sources are now, we just explain their purpose. The multiaxial model exists because some means is required whereby the various symptoms and personality characteristics of a given patient can be brought together to paint a picture that reflects the functioning of the whole person....

The Psychodynamic Perspective

Although the preceding contributions anticipate the modern view, arguably the most important historical development came in 1895 with the publication by Breuer and Freud on unconscious mechanisms in hysteria, stimulated by the famous case of Anna O. Both were fans of hypnosis, used to gain insight into Anna's unconscious conflicts, including her dislike for her father and her love for Breuer, who then left the case to Freud. Eventually, the two formed the theory that hysterical symptoms...

Variations of the Dependent Personality

Dependent Personality Disorder

In addition to the more prototypal cases described in this chapter, there are several variations of the dependent that express its combination with other personalities. Figure 8.1 provides a summary of these subtypes. Actual cases may or may not fall into one of these combinations. A mixture of both the dependent and avoidant patterns, the disquieted dependent is often found in an extreme form in institutional settings that minister to chronic ambulatory patients. Most live a parasitic...

The Self Defeating Masochistic Personality

Life is tough enough without making things even more difficult. Some people, however, deliberately put obstacles in their own way, seem to court suffering, and need to fail. Such individuals are called masochistic personalities, though they were termed self-defeating personalities in the DSM-III-R. Cursed with an uncanny sense for defeating themselves, they routinely set sail for stormy weather and call down setback, loss, frustration, and grief on themselves. When they do experience good...

The Sadistic Personality

Sadistic Borderline Personality Disorder

When most of us think of sadism, we think of either the violent psychopath or the use of dominance and pain to accentuate sexual pleasure. But there is a difference between sadistic behavior and a sadistic personality. Although psychopaths can be instrumen-tally aggressive and hostile to the point of murder, only when the knowledge that others are suffering gives the individual pleasure does behavior become sadistic. And only when the inflicting of psychological or physical pain becomes the...

Variations of the Histrionic Personality

Histrionic Personality Disorder

The norm is to receive more than one personality disorder diagnosis. Combinations with secondary patterns lead to colorations of the primary pattern, though occasionally subtypes appear merely as a combination of the major traits. Frequently seen subtypes of the histrionic personality are described in the following sections and summarized in Figure 9.1. Actual cases may or may not fall into one of these combinations. FIGURE 9.1 Variants of the Histrionic Personality. FIGURE 9.1 Variants of the...

The Interpersonal Perspective

As stated in previous chapters, the interpersonal perspective focuses on transactions between sender and receiver in interpersonal communication. Each participant negotiates the content of the exchange so that, ideally, both parties receive messages congruent with their self-image and feel validated. Communications that are not validating support some alternative conception of self and are experienced as anxiety provoking. Leary (1957) developed the interpersonal circle in an effort to refine...

The Biological Perspective

The history of the schizoid personality begins in early descriptive psychiatry and continues through later temperament and constitutional theorists. Early writers emphasized different characteristics of the modern prototype. For example, Ribot (1890) invented the term anhedonia to describe the diminished ability to experience pleasure, characteristic of the schizoid pattern. Similarly, A. Hoch (1910) described what he called the shut-in personality, using adjectives such as reticent, seclusive,...

The Evolutionary Neurodevelopmental Perspective

By definition, perspectives offer only limited insight into any given phenomenon. Because personality refers to the matrix of the total person, a theory adequate to embrace personality must exist at a level of analysis equal to personality itself. Perspectives are only parts, not wholes, and cannot accomplish this goal. According to the biopsychosocial-evolutionary theory (Millon, 1990 Millon & Davis, 1996), the narcissistic personality is passively self-oriented. Such individuals turn...

Variations of the Narcissistic Personality

Compensatory Narcissist

Few individuals in real life exist as the incarnation of an abstract psychological ideal. Instead, most persons combine aspects of two or more personality styles, though some combinations are more common than others. Whereas the previous section sharpened the contrast between various prototypes for explanatory purposes, in this section we portray narcissistic variants that are found as the disorder begins to shade toward other personalities (see Figure 10.2 for a summary). Actual cases may or...

The Cognitive Perspective

As with many other personality disorders, the cognitive style and defensive needs of narcissists merge almost seamlessly, always operating to support their sense of grandiosity. Narcissists play fast and loose with reality, altering and recomposing facts extemporaneously to reinforce their pet notions, a style Millon (1990) termed expansive. Some leaders of third-world governments or extremist political movements, for example, may mix dreams of omnipotence with paranoid trends (Miliora, 1995)....

Variations of the Paranoid Personality

Although the paranoid personality is a tightly knit syndrome, its features nevertheless combine with those of several other personalities, producing variations of the core prototype, described in the following paragraphs and summarized in Figure 13.1. Actual cases may or may not fall into one of these combinations. FIGURE 13.1 Variants of the Paranoid Personality. FIGURE 13.1 Variants of the Paranoid Personality. The fanatic paranoid pattern often resembles its less troubled cousin, the...

Carl G Jung Jungs Contribution to Personality Theory

Histronie Wut

Although Jung is among the seminal thinkers in personality, his contributions have rarely been applied in the personality disorders. Once Freud's primary disciple, Jung broke from Freud, insisting that there is more to mental life than sex. Most students are acquainted with his distinction between extroversion and introversion. Extroverts explain events from the viewpoint of the environment. They see the focus of life as being driven by events outside themselves and fix their attention firmly...

Alpf Medical Research Personality Disorders

Although the term masochistic was coined in reference to a specific male sexual perversion, it quickly became associated with the feminine and submissive. Hence, it has become a politically charged construct that has been dropped from the DSM-IV. The masochistic personality also has several normal variants that are often described as saintly. For example, Oldham and Morris's (1995) self-sacrificing style lives to serve others. Millon's yielding style is moving closer toward the pathological end...

Variations of the Compulsive Personality

Having described the pure compulsive in some detail, we now move on to variations of the basic pattern. The compulsive combines with several other personality disorders, giving a different coloration to the resulting pattern. A brief guide to the subtypes of the compulsive personality is given in Figure 7.1. Actual cases may or may not fall into one of these combinations. FIGURE 7.1 Variants of the Compulsive Personality. FIGURE 7.1 Variants of the Compulsive Personality. More than any other...

Variations of the Antisocial Personality

Antisocial Personality Disorder

Subclassifying antisocials, psychopaths, and criminals has been a hobby of social scientists for more than a century. Some schemes are based on the types of crimes committed or the severity of the crime, rather than on clusters of trait characteristics. Other schemes are based on methodology-driven approaches, such as cluster analysis. All such schemes fail to recognize the importance of considering other personality characteristics in addition to those of the major pattern. In contrast, the...

Gender Bias in the Diagnosis of Personality Disorders Do Clinicians Have Gender Expectations

Cloninger Model

Do certain personality disorders favor men and others favor women The answer may depend on where you look. Because more women than men seek treatment for mental disorders, there are usually more women among the patients in mental health centers. Conversely, because more men than women are veterans, you would expect more male patients at Veterans Administration hospitals. Nevertheless, certain personality disorders do seem weighted toward a particular gender. For some researchers (Kaplan, 1983...

Variations of the Avoidant Personality

Avoidant Personality Subtypes

Allison represents a reasonably pure or prototypical representation of an avoidant personality. However, as with most personality patterns, whether problematic or not, not all avoidant patterns closely resemble our panicky undergraduate. While Allison's style doesn't really combine characteristics of other disorders with her basic avoidant pattern, most avoidants exhibit features of other personality disorders, such as the schizoid, dependent, depressive, negativistic, schizotypal, and paranoid...

Albert Ellis and Carl Rogers Finding Your Own Therapeutic Style

Although Albert Ellis was originally trained as a psychoanalyst, he is an important figure in the history of the cognitive therapy movement. His transformation is striking, as it represents a philosophical shift from that which is deep and mysterious in human nature, namely the unconscious, to that which is more or less obvious, the rational process and errors of reasoning. The movement Ellis founded is called rational-emotive therapy. According to Ellis, logical reasoning is the foundation of...

The Negativistic Passive Aggressive Personality

Passive Aggressive Personality Disorder

Some people just seem unsure of which way to turn in life. Ever ambivalent, they vacillate between uneasy feelings of dependence and an equally uneasy desire for self-assertion. Simultaneously needy and independent, they agree to conform to requests for performance, but nevertheless have strong issues with authority and resent external control. Inevitably, they feel misunderstood, unappreciated, and disillusioned. As their discontent deepens, they begin to find fault with the way others treat...

Variations of the Schizotypal Personality

The evolutionary model (Millon, 1990) holds that the schizoid and avoidant shade gently into the schizotypal thus, these personalities naturally form structural subtypes for this pattern (see Figure 12.1). Actual cases may or may not fall into one of these combinations. The insipid schizotypals represent a structural exaggeration of the passive-detached pattern. Like the schizoid, they are notably insensitive to feelings, seem indifferent to the external world, and appear drab, unmotivated,...

The Discouraged Borderline

The discouraged borderline is mixed with the dependent or avoidant patterns. Such individuals pursue a strategy of submissive attachment to just one or two significant others. FIGURE 14.1 Variants of the Borderline Personality. FIGURE 14.1 Variants of the Borderline Personality. Prominent personality traits include not only avoidance of competition, loyalty, and humility but also masochistic subordination and a parasitic clinginess. By exclusively relying on a single someone, discouraged...

The Depressive Personality

Personality Disorder Scheme

Almost imperceptibly at first, then more and more, you begin to feel sad, empty, or irritable. Gradually, things that used to fascinate you are no longer interesting. Hobbies, favorite recreations, and spending time with the ones you love are no longer pleasurable and may even seem burdensome. The day becomes dominated by feelings of lethargy, being tired, run down, or overwhelmed by life. Your movements and mental processes may seem to move in slow motion, thoughts crawling like molasses....

The Self Destructive Borderline

All borderlines are at times self-destructive, perhaps to the point of self-mutilation. In the self-destructive borderline subtype, however, self-destruction serves the needs of a comorbid masochistic pattern. Like the petulant borderline, the self-destructive type is unable to find a comfortable niche with others. Unlike the petulant type, self-destructive borderlines do not become increasingly testy and bitter over time. Instead, their masochistic traits cause them to turn inward, where...

Can Schizotypal Disorder Disintergrate Into Frankschizophrenia

Schizotypals are often described as odd and eccentric and seemingly engrossed in their own world. Most researchers believe that the schizotypal personality lies on a continuum with schizophrenia called schizotypy. Schizotypals, like schizophrenics, experience both positive and negative symptoms. As one of the three structurally defective personalities (the paranoid and the borderline are the other two), schizotypals are set apart from other personalities in that they rarely find a comfortable...