• cognition
• affectivity
• interpersonal functioning
• impulse control

• have the persons problems been long-term and pervasive throughout life?
• are they related to a particular event or relationship?

• young
• students
• homemakers
• drug and alcohol abusers

• co-morbidity
• reliability and validity of diagnostic criteria
• axis i disorders interacting with the symptoms of the personality disorder

• a
• b
• c

• paranoid disorder
• schizoid disorder
• schizotypal disorder
• odd and eccentric behavior

• anti-social disorder
• borderline disorder
• histrionic disorder
• narcissistic disorder
• overdramatic behavior
• emotinal behavior
• erratic or unpredictable behavior

• avoidant disorder
• dependent disorder
• ocd disorder
• anxios behavior
• fearful behavior

• psychopath
• sociopath

• 4.5 percent males
• 0.8 percent females

• lack of remorse/shame
• poor judgement/failure to learn from experience
• extreme egocentricity/incapacity to love
• lack of emotional response to others
• impulsivity
• absence of nervousness
• unreliability
• untruthfulness
• insincerity

• core psychopathic personality traits
• antisocial lifestyle

• glibness and superficial charm
• grandiose sense of self-worth
• tendency towards pathological lying
• lack of empathy for others
• lack of remorse
• unwillingness to accept responsibility for one's actions

• impulsivity
• ustable lifestyle
• juvenile delinquency
• early behavioral problems
• lack of realistic long-term goals
• need for constant stimulation

• repeated engagement in behavior that are grounds for arrest
• deceitfulness (lying, false ids, conning)
• impulsivity or failure to plan ahead
• irritability and aggressiveness
• reckless disregard for safety of others
• irresponsibility
• lack of remorse

• brain abnormalities
• genetic inheritability

• defects in prefrontal lobes of cerebral cortex (area assoc with planning and morality
• deficits in area of the brain responsible for emotional processing

• heritability of criminality and psychopathy
• genetic predisposition

• neuropsychological defects
• response modulation hypothesis
• social cognitive

• psychopaths are unable to process any info that is not relevant to their primary goals and so psychopaths learn to avoid punishment when this is their main goal 
• if attention focused elsewhere, however, they ignore info that would allow them to avoid aversive consequences

• family - parent relationship
• early environment - child rearing
• socialization - abuse

• getting clients to feel worse about themselves and their situation
• confrontational approach
• group therapy

• frantic effort to avoid abandonment
• unstable interpersonal relationship - changes between idealizing and devaluing others
• identity disturbance
• impulsivity - spending, sex, substance, driving
• cemotional instability - few hours or days
• chronic feeling of emptiness
• temper, anger, recurrent fights
• stress-related paranoid thinking

• feelings of emptiness
• variable negative emotionality

• lack of awareness, understanding, or acceptance of emotions 
• inability to control intensity or duration of emotions, unwillingness to experience emotional distress as an aspect of pursuing goals
• inability to engage in goal-directed behaviors when experiencing distress

• neurotransmitter dysregulation
• brain abnormalities

• hypersensitive noradrenergic pathways - sexual abuse and effects on brain
• abnormalities in serotonergic receptors in brain - impulsivity

• smaller hippocampus
• smaller amygdala

• negative experience within family
• deficits in formation of self
• cognitive behaviorist - maladaptive thoughts

• disturbed childhood environment
• parental psychopathology
• childhood abuse

• overinvolved mother with child but inconsistent in her emotional responsiveness
• mother fails to bolster child's independent sense of self, setting stage for identity crisis and inability to commit to life goals
• child fails to develop healthy, independent self
• individual then perceives others in distorted way and build a false self fused with these distorted perceptions

• pressures of contemporary society - deficiencies in parenting
• diminished cohesion of society - instability within society
• parental relationship - conflicts between parents leads to an internally divided feeling

• emotional regulation on behalf of therapist
• keeping client grounded in reality
• clear treatment framework - setting goals
• determining need of support or confrontation
• dialectical behavior therapy (dbt)
• medication
• hospitalization

• regulating emotions
• developing interpersonal effectiveness
• leaning to tolerate emotional distress
• developing self-management skills
• core mindfulness

• discomfort when not center of attention
• inappropriate sexually seductive/provocative
• rapid shifts/shallow expression of emotion
• physical appearance to draw attention
• speech is excessively impressionistic/lacking detail
• self-dramatization. theatricality, exaggerated emotion
• high suggestibility
• misinterpretation of relationships as more intimate than they really are

• help client develop more effective ways of approaching problems and situations
• work on goals
• teach client how to think more precisely and objectively
• self-monitoring strategies to keep impulsive tendencies in check
• assertiveness skills to improve interpersonal relationships

• grandiose sense of self-importance
• fantasies of success, power, brilliance, beauty, ideal love
• they are "special"/understood only by the "special"
• need for excessive admiration
• sense of entitlement
• exploitative interpersonal style
• lack of empathy
• envy of others/others are envious
• arrogant behaviors and attitudes

• elitist
• amorous
• unprincipled
• compensatory

• unjustified suspicion harm, exploitation, deception
• unjustified doubes loyalty and trustworthiness
• reluctance to confide/others use info against them
• hidden threats in harmless remarks or events
• tendency to bear grudges
• perception of personal attack not apparent to others and counterattacking in response
• unjustified suspicious about faithfulness of partner of spouse

• someone who suffers from mistaken assumption about the world and who attributes personal problems and mistakes to others
• assumptions that people have to vigilant to avoid being harmed related to feelings of low self-efficacy leading paranoid people to believe they cannot detect harmful intentions of others and have to be on guard

• people are malevolent and deceptive
• they'll attack you if they get the chance
• you can be OK only if you stay on your toes

• must be careful to avid setting unrealistically high goals for therapy because progress with these individuals is likely to be low and limited in scope
• helping the client work on styles of communication by role playing and in vivo exposure

• ideas of reference
• odd beliefs or magical thinking
• unusual perceptual experiences/bodily illusions
• odd thinking and speech
• suspiciousness or paranoid ideation
• inappropriate or constricted affect
• eccentric behavior and appearance
• lack of close friends other than relatives
• excessive social anxiety associated with paranoia

similar to those used to treat schizophrenic patients

• establishing therapeutic alliance before confronting distortions of reality or tying to persuade them to take anti-psychotic medication

• avoidance fear criticism, dissapproval, rejection
• unless certain of being liked no relationships
• intimate relationships fear of being shamed, ridiculed
• preoccupation with being criticized social situation
• feelings of inadequacy
• feel they are socially inept, unappealing, inferior
• reluctant to take risks, try things fear of embarrassment

• relatives of people with social phobia with and without avoidant personality disorder higher risk for experiencing excessive social anxiety
• more prevelant in the parents of people who developed schizophrenia in childhood

• hypersensitive to rejection die to childhood experiences of extreme parental
• criticism as they believe as a result that they are flawed and unworthy of others regard
• sensitivity to rejection causes them to misinterpret seemingly neutral or positive remarks

• breakdown negative cycle of avoidance by making client see the irrationality of these beliefs in supportive atmosphere
• graduated exposure to increasingly threatening social situations 
• training in specific skills to improve intimate relationships

• difficulty w/ decisions w/o advice or reassurance
• need for others to assume responsibility for them
• difficulty disagreeing b/c fear of loss of support
• difficulty initiating projects b/c low self-esteem
• excessive lengths to obtain nurturance and support
• discomfort or helplessness when alone
• pursuit of another relationship as source of care following end of another relationship
• preoccupation with fear of taking care of self

• insecurely attached, constantly fearing abandonment
• low self-esteem causes they to rely on others for guidance and support

• unassertiveness and anxiety dominate over making independent decisions
• dependent folks believe they are inadequate and helpless and unable to deal with problems on their own and
• as result find someone else who will take care of them and relieve them of obligation to make independent decisions

• more optimistic than most because of motivation to change
• structured ways for client to practice increasing levels of independence in carrying out daily activities
• client learns to id actual areas of skill deficits and to acquire abilities necessary to perform skills

• details, rules, order, organization, schedules to extent that point of activity is lost
• perfectionism interfering with task completion
• devotion to work/productivity at expense of leisure
• overconscientious, scrupulous, inflexible about morality, ethics, values
• inability to discard worn-out worthless objects
• reluctance to delegate tasks to others
• miserly spending style toward self and others
• rigidity and stubbornness

• based on problematic way of viewing self
• unrealistic expectations about being perfect and avoiding mistakes
• if fail to achieve ideal they regard themselves as worthless

• thought stopping

• focus on root of problem in some cases of personality disorders and change in others
• therapeutic alliance
• draw upon multiple theoretical perspectives
• challenge because of chronic and persistent nature and difficulty in identifying qualities