UNDERSTANDING ANTISOCIAL, BORDERLINE & AVOIDANT PERSONALITY DISORDER

     There are some cases when a psychologist or counselor may suspect that a client is experiencing a certain type of personality disorder. According to (Butcher., Mineka., & Hooley. 2010), personality disorder is defined as “a gradual development of inflexible and distorted personality and behavioral patterns that result in persistently maladaptive ways of perceiving, thinking about, and relating to the world” (p. G-16). The general DSM-IV-TR also has a specific set of criteria that must be used when attempting to diagnose personality disorder for all clients. These criteria include the following:

1. The behavior must be inflexible and pervasive when compared to social norms.

2. The behavior must be stable and last over a long period of time.

3. The behavior causes major distress or impairment in occupational, social, or other functioning.

4. The behavior can’t be better explained by a different mental disorder.

5. The behavior can’t be explained due to substance use or general medical condition.

The specific types of personality disorder which are listed in the DSM-IV-TR also include: Cluster A - Paranoid | Schizoid | Schizotypal, Cluster B - Antisocial | Borderline | Histrionic | Narcissistic, Cluster C - Avoidant | Dependent | Obsessive-Compulsive and Personality Disorder NOS. These types also have a specific set of symptoms which can be caused by factors such as abuse and/or neglect during childhood. Since this can occur, the overall purpose of this work is to analyze how symptoms associated with 3 specific types of personality disorder may be directly related to childhood abuse and/or neglect. These types also include antisocial personality disorder, borderline personality disorder and avoidant personality disorder.

Antisocial Personality Disorder

     According to the (DSM-IV-TR. 1995-2010) individuals who have antisocial personality disorder will “regularly disregard and violate the rights of others. These behaviors may be aggressive or destructive and may involve breaking laws or rules, deceit or theft.” Research has shown that most people who suffer with this disorder also experienced serious and repeated physical and/or emotional abuse as children. This may include regular violent beatings and/or constant ridicule at the hands of a parent or guardian who also suffers from antisocial personality disorder. The symptoms associated with this particular disorder and how they may be directly related to prior child abuse are also as follows:

1. The individual exhibits lack of conformity by repeatedly completing acts that can lead to arrest. The reason for this is because the individual may have learned in childhood that following rules doesn’t matter because it was okay for parents to abuse even though that is illegal.
2. The person deceives others by conning for pleasure or personal profit, lying, and using aliases. This may be because the individual has learned from parents that there are certain ways to get what is wanted without worrying about what others think or feel.
3. The individual will exhibit impulsivity by never planning ahead. This could be because the individual learned in childhood that abuse can occur at any moment, so live spontaneously.
4. The person shows aggressive and irritable behavior by repeatedly fighting or assaulting others. This may be because the individual is imitating what was learned by watching a respected model.

5. There is a reckless disregard for the safety of others and self. This may be because there was no regard for the individual’s safety during childhood, so he or she doesn’t show it for others.
6. The individual is consistently irresponsible maintaining financial obligations and employment.

This might be because the person is experiencing a high overall level of low self- confidence, self-worth and feeling like he or she doesn’t belong. When this feeling occurs, the person may also have a reduced level of overall drive to personally succeed and/or help others.

7. The individual exhibits a lack of remorse when hurting, mistreating, or stealing from others. This may be because the individuals parents or guardian showed no remorse when the abuse occurred. Therefore, that lack of compassion and love toward people may continue to cycle.

Borderline Personality Disorder

     Individuals who have borderline personality disorder will regularly exhibit a pattern of instability with self-image, interpersonal relationships, and impulsivity that begins in early adulthood. Research has shown that most people who suffer with this disorder have also experienced abandonment and/or severe neglect as children. The symptoms associated with this disorder and how they may be directly related to prior abandonment and/or severe neglect are also as follows:

1. There are frantic efforts to avoid imagined or real abandonment. This may be because the individual fears the possibility of experiencing abandonment or neglect again.

2. There is a pattern of intense and unstable interpersonal relationships which is characterized by alternating between extreme idealization and devaluation. This may be stages of personality that are used in an attempt to keep or control people so no further abandonment or neglect will occur.

3. There is an identity disturbance which causes a persistent unstable sense of self or self-image. This may be due to feelings of low self-esteem or self-worth from being abandoned or neglected.

4. There is an increased level of impulsivity in at least two areas which include sex, spending, reckless driving, substance abuse and binge eating. This may be due to subconscious feelings that initiate a desire to self-harm or punish after feeling unwanted or unloved by others.

5. The individual will exhibit self-mutilating behavior or suicidal behavior that includes recurrent threats and gestures. This may be due to feelings of self-loathing and worthlessness after being abandoned and/or neglected by people that were supposed to be loved ones.

6. Due to a marked reactivity of mood, there is an affective instability that lasts for a few hours. This may be due to an inability to process stress in a normal manner because it was not learned during a crucial stage of development.

7. The individual is experiencing a chronic feeling of emptiness. This may be because the individual was not shown adequate affection as a child and therefore, always feels alone.

8. There is a high level of anger that may be uncontrollable and inappropriate at times. This might be because the individual has kept negative feelings about being abandoned and/or neglected bottled up. Therefore, these feelings may have grown and are getting uncontrollable.

9. The person exhibits a transient paranoid state that is usually stress related. This may be due to being psychologically overwhelmed by subconscious feelings of abandonment and/or neglect.  

Avoidant Personality Disorder

     Individuals who have avoidant personality disorder will regularly exhibit feelings of inadequacy, hypersensitivity to criticism or rejection and social inhibition beginning in early adulthood. Research has shown that most people who suffer with this disorder also experienced frequent or infrequent ridicule and/or humiliation by other family members during childhood. The symptoms associated with this disorder and how they may be directly related to prior ridicule and/or humiliation are also as follows:

1. The individual avoids occupational activities due to fear of disapproval, criticism or rejection. This may be because the individual is conditioned to expect the negative behaviors from others.

2. The individual only interacts with people when certain of being liked. This may be a defense mechanism to avoid not being liked by others who will ridicule or humiliate.

3. There is restraint in intimate relationships due to a fear of being ridiculed or shamed. This may be because the individual wants to avoid getting close enough to risk experiencing that behavior.

4. The individual is preoccupied with being rejected or criticized in social situations. This may be because the individual experienced so much of that behavior that it is now expected.

5. Interpersonal situations are inhibited due to continuous feelings of inadequacy. This may be because avoiding interpersonal situations to prevent inadequacy was learned in childhood.

6. The individual views self as personally unappealing, socially inept, or inferior to others. This may be because the individual was forced to feel inadequate and less worthy at an early age.

7. There is reluctance to take personal risks or engage in activities because of embarrassment. This may be because engaging in less risks and activities reduces the chance of embarrassment.

Summary

     As previously stated, there are some cases when a psychologist or counselor will suspect that a client is experiencing personality disorder. Therefore, the general DSM-IV-TR has a specific set of criteria that must be used when considering this diagnose for all clients. These criteria also state that the behavior must be inflexible and pervasive when compared to social norms, stable and last over a long period of time, cause significant distress or impaired function in certain areas, and not be explained by a different mental disorder, substance use, or general medical condition. The specific types of personality disorder which are listed in the DSM-IV-TR include: Cluster A - Paranoid | Schizoid | Schizotypal, Cluster B - Antisocial | Borderline | Histrionic | Narcissistic, Cluster C - Avoidant | Dependent | Obsessive-Compulsive and Personality Disorder NOS.  These also involve symptoms which may be related to some type of prior abuse and/or neglect. Therefore, the overall purpose of this work was to analyze how symptoms associated with antisocial personality disorder, borderline personality disorder and avoidant personality disorder may be directly related to childhood abuse and/or neglect.

References:

BehaveNet: APA Diagnostic Classification DSM-IV-TR. Copyright (2000). American Psychiatric Association. Retrieved on January 10 2013 via the World Wide Web at http://behavenet.com/apa-diagnostic-classification-dsm-iv-tr

Butcher, J. N., Mineka, S., & Hooley, J. M. (2010). Abnormal Psychology (14^th Ed.). Boston, MA. Allyn & Bacon, Pearson Higher Education.