PSYCHOLOGY NEWSLETTER #3

VOL. 3 / APR 2019

Issue #

PSYCHOLOGY ENTHUSIAST CIRCLE

newsletter CLUSTER C ANXIOUS-FEARFUL MORE ABOUT PERSONALITY DISORDERS CAUSES & TREATMENT

THIS MONTH’S THEME: PERSONALITY DISORDERS CLUSTER A ODD-ECCENTRIC CLUSTER B DRAMATIC-EMOTIONAL

IT IS EASIER TO UNDERSTAND MANKIND IN GENERALTHAN ANY INDIVIDUAL MAN. Francois de la Rochefoucauld

Foche

2

Table of Contents Message from the Cores ------------------------Cluster A ----------------------------------------Cluster B -----------------------------------------Cluster C -----------------------------------------More About Personality Disorders ----------------------Past and Upcoming Activities ----------------------

2 4 6 11 16 21

1

Message from the Cores 4B Chloe Yeung , 4G Justin Lam, 4G Kinsey Yuen , 4G Angel Au

Personality is how we think, feel and behave. It is what defines us. Our upbringing and environment, specifically the types of parents a person has, can drastically affect and shape our personality. This is until we reach our late teens where our personality starts to form and solidify.

Some people have developed personalities that deviate from social norms or expectations, causing emotional distress or difficulties in functioning. These people suffer from what we call personality disorders, which problems will last for a long time if left untreated.

PERSONALITY DISORDERS AFFECT‌ Self-perception Emotional response Interpersonal relations Impulse control

2

According to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), personality disorders are commonly divided into 3 clusters, with 10 well-defined, specific types of personality disorders. There are mainly three clusters of personality disorders, namely clusters A, B and C. CLUSTER A – ODD-ECCENTRIC Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder CLUSTER B – DRAMATIC-EMOTIONAL Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder CLUSTER C – ANXIOUS-FEARFUL Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder In the following articles, each of the characteristics of the personality disorders will be explored cluster by cluster. Then, we will discuss the causes and treatment of personality disorders, as well as their significance.

3

Cluster A 1A Kristie Cheung, 3G Christy Ng

Social awkwardness and social withdrawal define Cluster A personality disorders. Individuals with this type of disorder tend to be socially reserved and reluctant to communicate, leading to a somewhat “detached” and “cold” outlook.

Paranoid Personality Disorder is characterized by a pervasive distrust and suspiciousness of other people. People with this disorder assume that others are out to harm them, take advantage of them, or humiliate them in some way. They put a lot of effort into protecting themselves and keeping their distance from others. They are known to pre-emptively attack others whom they feel threatened by. They also tend to hold grudges, are litigious, and display pathological jealousy. This highly affects them as they usually have difficulties in making friends and tend to be more socially awkward. Their thoughts are also easily distorted and may result in relationship problems as they are not willing to build close relationships due to the disbelief in others’ commitment, loyalty and trustworthiness. They are hypersensitive and take criticism poorly.

4

Schizoid Personality Disorder can be defined by a lack of interest in social relationships and a certain detachment or apathy. Individuals with this disorder often lack social connections and willingly retreat from forming social bonds.

Notably, many such patients have a detailed inner “fantasy world�.

SPD patients often lack communication skills and are content to remain passive in social situations, which compounds their difficulty in understanding other people. They have an aversion to forming emotional attachment; however, it is not uncommon for them to form bonds based on intellectual, familial, or physical relationships.

Schizotypal Personality Disorder can be characterized by extreme social anxiety and peculiar beliefs. For example, many individuals with this disorder may believe in superstition or paranormal events. They may also see strange shadows or flashes of light regularly, which feeds back into superstitious behaviour. They may also have unusual mannerisms and odd modes of dress, which can make forming relationships difficult.

Such people also find it difficult to read social cues and as such prefer to withdraw from society, leading to what may be construed as asocial behaviour. Some researchers suggest that childhood trauma can lead to the development of this disorder, but a genetic component has also been observed.

5

Cluster B 2E Alice Gao, 3C Isaac Yu, 4E Ronny Or

Have you ever seen people acting in a dramatic and irrational way? Have you thought of categorising them as mad people?

Hold up for a bit. Perhaps they are only one of the thousands around the globe suffering from Cluster B personality disorder.

Here in this newsletter article, we will be looking deeper into the disorder from different aspects namely antisocial, histrionic and narcissistic. We will let you have a deeper insight into these patients and let you see them from a brand new perspective.

For an overview, all four have a genetic relationship with Mood disorder (eg. depression, bipolar disorder) As well as substance abuse disorder. Next, we are digging into them one by one.

“ANTISOCIAL” At first sight of the word ‘antisocial’, your brain might subconsciously generate images of people terrified of crowds in general and shielding themselves automatically with great reluctance in opening up. Yet, individuals diagnosed with antisocial personality disorder seldom demonstrate such characteristics, but rather bury them adeptly, deep under a facade of normality.

6

In fact, most antisocial people have long been engaging themselves in violent or aggressive acts since childhood age, continuously and constantly tormenting animals or even other citizens. With their minds guided by impulsive rages and ferocity, these aggressive features can be summed up as a particular disregard for others’ rights, in which a lack of genuine remorse for their wrongdoings can be easily observed.

Deceitful and manipulative at times as a result of a combined effect with the Conduct Disorder, antisocial people are often considered an unrelievable ‘toll’ on society, or even a ‘menace’ to the community.

“BORDERLINE” The cognitive mechanisms of patients of the borderline personality disorder can be summarized with one word -polarized. As shown in the picture, Their emotions and moods are often intense or even extreme, all due to their black-or-white thinking or all-or-nothing thinking, which categorizes others’ actions into two distinct blocks, ‘all good’ and ‘all bad’, and respond accordingly. With such misinterpretation, it is only natural that great distress may be caused under situations they cannot control, potentially leading to self-destructive behaviours when they attempt to cope.

7

Inconsistency is another a major common feature among people with borderline personality disorder. As their harsh views on the world are not just centred on their surroundings but also on themselves, their perceptions of their personal actions may vary and an strongly unstable sense of selfidentity will surface each time they find themselves ‘doing something wrong’. This in turn leads to radical and frequent changes in their lives, ranging from occupational changes to residential movements, and so on. These are all impulsive behaviours, causing more harm internally rather than to the external world.

“HISTRIONIC” Marilyn Monroe was no doubt a famous celebrity worldwide in the 1900s. Yet, her seductive personality and tendency of attention-seeking lead to a growing suspicion of her belonging to the group of people diagnosed with histrionic personality disorder. Self-indulgent so-called ‘drama queens’, these people often exaggerate any events occurring nearby with flamboyance and theatrics, aimlessly pursuing attention.

However much emotional expression they give, their expression is often of a shallow nature, vague and lacking in substantial detail.

This further suggests a absence of sincerity, which does not bode well for interpersonal relationships. As such, their dramatic but disingenuous actions embarrass acquaintances, especially 8

those who are not yet involved with intimate relationships with them, as their excessive arbor is easily apparent and may lead to others distancing themselves aways from those classified with histrionic personality disorder. Without being in the spotlight or the centre of attention, their self-confidence shatters and crumbles, causing them to be easily influenced by others’ suggestions and opinions.

“NARCISSISTIC”

Most of you have probably heard of the story of Narcissus, in which Narcissus was a man completely enamored by his own beauty, showing only disdain and contempt to his many pursuers. Then, we all know the consequence of his sense of superiority: when walking by a pool of water, he glimpsed his own stunning reflection and committed suicide due to the inability to obtain the object of his desire, or ‘himself’.

The above may sound like an unfortunate fairy tale containing a strong moral, but the protagonist Narcissus is in fact a typical example of people suffering from narcissistic personality disorder. Possessing a high sense of self-worth and self-esteem internally, these individuals often fantasize about 9

their own supreme intelligence or beauty, finding themselves entitled to special treatments and deserving of success. This forms an attitude of arrogance, with which interpersonal conflicts are triggered due to the condescending behaviour of narcissistic people. Yet, this haughty attitude is as easily distinguished as it is created; given that these people suddenly realize their own ‘averageness’ and human limitations, and that they are but no different from others in some areas.

Emotional devastation can be resulted; and that is why narcissistic people do have fragile personalities, while possessing a sense of self-importance in their exterior.

10

Cluster C 3F Jade Duong, 4E Ronny Or

Anxiety is often present around us - during the tense moment prior to stepping into your exam centre, right before your debut as a performer on stage, the pressuring instance preceding your first time meeting your significant other’s family. All of the above are but particular examples which occur at different intervals in our daily lives, nothing to worry over, not a matter of concern.

Yet, picture this: a person being consistently and constantly plagued by anxiety, frequently facing fears and hiding his/her true emotions within a hollow shell. Imagine this, then divide the person into three clones depicting varying types of anxiety -- the first intensely afraid of others’ negative judgments, the second profoundly reliant on social support, and the last revolving around rules and regulations to an unnecessarily large extent. These precisely are the three types of personality disorders classified under Cluster C: Avoidant, Dependent and Obsessive-compulsive personality disorders respectively.

11

AVOIDANT PERSONALITY DISORDER Intensely afraid of ridicule and rejection from others around them, people suffering from the Avoidant Personality Disorder often exhibit a pervasive pattern of social inhibition, shutting the entire community out from their inner selves in fear of criticism -- as the name of the class itself suggests, ‘avoidant’ of interpersonal interactions. This, in turn, results in a limited social circle for them, for whom entrusting their confidence in others can prove to be rather difficult.

One famous person few knows as someone diagnosed with the aforementioned personality disorder is Michael Jackson.

An iconic pop star often appearing in dazzling performances with large audiences, it is definitely hard to imagine how he tends to avoid crowds and even the society in general.

Despite this, some aspects of his life also hint to his interpersonal problem; for instance, he built an amusement park on his property to avoid encountering loads of visitors at public parks, and he did not possess the typical mindset of soaking up his ‘stardom’ as many other celebrities do, disguising himself through various means to avoid others’ recognition in public. Commented on as ‘painfully shy’ by the few who personally knows him, he certainly is an appropriate representation of the Avoidant Personality Disorder.

12

DEPENDENT PERSONALITY DISORDER Relying on other people for comfort, reassurance advice and support all the time, these are people who suffer from Dependent Personality Disorder. It might be confusing when you don’t know how to differentiate between a person who feels insecure sometimes with a person dealing with DPD. But the main factor is that people with DPD need reassurance from others to function. When being alone, people with DPD will experience severe panic attacks and feel utterly hopeless and weak. They would behave submissively, have difficulty in expressing disagreement due to the fear of loss of support and approval, rely on people when it comes decision making, need repeated reassurance and will be overly sensitive criticism.

This disorder falls into Cluster C as its behaviour is defined as anxious and nervous; rather than cluster A and B, in which it’s about eccentric and erratic behaviour respectively.

This disorder usually appears in early adulthood but the cause of it remains unknown but biological and developmental factors such as having a family history of this disorder or had undergone abusive upbringing during adolescence may have a part in it. Majority of untreated patients will often take comfort in substance 13

abuse. Individuals with such disorder have a hard time making everyday decisions (e.g what clothes to wear on that day) without excessive advice and reassurance from others.

OBSESSIVE-COMPULSIVE PERSONALITY DISORDER Obsessive-compulsive personality disorder is very different from obsessive-compulsive disorder. Although they might sound similar, these are two very different conditions that should not be mixed up with. Obsessive-compulsive disorder, or known as OCD for abbreviation, is a condition in which the suffering individual is aware of their unreasonable behaviours, this disorder tends to be distressing as the individual knows that such behaviour is impairing their lives but still feel obliged to do so. This disorder involves disturbing and unwanted thoughts that cause the sufferer immense discomfort and anxiety, resulting in their escapism by engaging in repetitive behaviours and compulsions that they will regret doing later.

Whereas a person suffering from obsessive-compulsive personality disorder (OCPD) tends to think their way of doing things is “the best and right way”. They would be overlycontrolling of their environment and others, wanting others to obey and conform to the strict rules they set, which results in abusive relationships. For someone who has OPCD, it’s all about orderliness and rules. They fail to flexible as they have a strong desire to complete tasks in a rigid manner. Unlike OCD, it does not involve having disturbing and unwanted thoughts. The actions of a person with OCPD is not due to 14

wanting to escape from the thoughts they suffer, but due to a strong sense of perfectionism. That person will also be very self-critical and will base themselves on achievements.

Rather than being distressed, they will find pleasure in repeating their own set of rules, completely lacking selfrealization that they are indeed doing something wrong and will often refuse to seek medical help.

IN CONCLUSION‌ These 3 personality disorders share a high level of anxiety. It is absolutely unfortunate if one has to suffer from any one of those disorders as such is potentially destructive and chaotic to one’s entire life if not receiving proper medical treatment.

Perhaps through this article, you will be able to understand a bit more about these disorders. If you know someone you are close with has been diagnosed with one of these disorders, encourage them to seek proper medical treatment. It is common that someone with mental personality issues will be in denial at first, but if received needed support, they can slowly overcome their resistance and start receiving medical treatment. Although you might not personally understand, it’s better to try and help them as much as you can.

15

More About Personality Disorders 3E Anson So, 4E Cyrus Chan

Currently, there is no definitive proven cause of personality disorders. However, there are a few possible causes and risk factors as below: CHILD ABUSE AND NEGLECT Child abuse and neglect play a huge part in the development of personality disorders. Verbal abuse can lead to borderline, narcissistic, obsessive-compulsive or paranoid personality disorders while physical abuse can lead to antisocial personality disorder.

SOCIOECONOMIC STATUS Socioeconomic Status has also been investigated as a potential cause of personality disorders. Recent research has pointed out that there is a correlation between low socioeconomic status and a higher tendency of a person having personality disorders. The research has also noted that positive personality traits such as altruism and prudence, and higher intelligence quotient is associated with a higher socioeconomic status.

GENETICS 16

While research on genetic influences on personality disorders are significantly lacking, researchers are looking into genes for traits like anxiety and fear which are associated with personality disorders in certain individuals diagnosed with personality disorders.

TREATMENT While the concept of personality disorders may seem distant, it is not uncommon. It is estimated that over 1.1 billion people worldwide suffer from a personality disorder. That means that every 7 people there is one suffering from personality disorders.

If you meet someone with a personality disorder, there are a few things that you should do depending on the stage of acceptance that they are in: 1. Unaware. The majority of people living with a personality disorder don’t realize they have one, even if they realize they aren’t easy to live with. It’s best to share your concern by giving someone specific examples of problem behaviours and follow up by offering the resources needed to find a doctor or make or attend an appointment.

2. Denial. Most people who are told they have a personality disorder don’t believe it. It isn’t uncommon for them to get angry or defensive. Keep trying to share your concerns if someone is refusing help. Be consistent in your efforts and seek help from family and friends if necessary.

17

3. Resistance. When people first begin to accept there’s a problem, they fight the belief that it’s serious. They resist getting medical treatment and believe they can change their behaviours on their own. At this stage, encourage a family member or friend to make medical help a part of their personal treatment plan. However, in order to avoid future problems, Hersch recommends discussing therapy as a timed, temporary form of treatment with an end date in mind.

4. Flakiness. Once they start therapy or medication, people with personality disorders often skip or stop treatment without warning. Be there to remind them that no one is perfect, no one is always at the top of their game, and that tomorrow offers new chances to make healthier choices.

5. Acceptance. After receiving the support needed to overcome denial, resistance and struggles with staying in treatment, patients with these disorders may come to a place of acceptance. In these situations, treatments are seen as a top priority and appreciated as tools for healthy living.

As for treatment, there is a multitude of methods that therapists are currently using to treat personality disorders.

Individual psychotherapy is the most common method.

Therapy methods such as group therapy, family therapy and milieu therapy are also used to treat certain kinds of personality disorders. In addition to therapy, psychological education, self-help groups and psychiatric medications are also used to assist in treating the patient. The practice of 18

mindfulness is also considered a possible way out for personality disorder patients.

SOCIAL SIGNIFICANCE Families commonly endure episodes of explosive anger and rage, extreme depression (e.g., person rarely gets out of bed), self-mutilation (self-inflicted cuts and burns), and suicide attempts by family members with personality disorders. These individuals are often referred to treatment by loved ones who recognize a troubling pattern, or who have reached their personal limit in trying to cope with them.

Individuals with personality disorders, particularly Antisocial Personality Disorder and Borderline Personality Disorder, are more likely to abuse drugs and alcohol. Use of illegal drugs and alcohol have been found to be closely associated with violent crimes, including murder, rape, assault, and child and spousal abuse. A 3-year study conducted by the National Center for Addiction and Substance Abuse of Columbia University showed that illegal drugs and alcohol contributed to the imprisonment of 4 out of every 5 inmates in our nation’s prison system. Over half of those individuals in the criminal justice system have severe personality disorders, particularly Antisocial Personality Disorder or Borderline Personality Disorder.

People with severe personality disorders are high-cost, persistent, and intensive users of mental health services. One in every 20 individuals suffers from a personality disorder. Up to 10% of those in outpatient mental health treatment clinics 19

have a personality disorder, and almost 15% of individuals in inpatient psychiatric care have a severe personality disorder.

Individuals with personality disorders usually present for therapy with presenting issues other than personality problems, most often with complaints of depression and anxiety. For example, among patients with Borderline Personality Disorder, major depression has been observed in up to 74% of these individuals, and Panic Disorder has been found to occur in 10% to 25% of these individuals.

Individuals with personality disorders are also more likely to have an eating disorder or a history of significant trauma.

About one-third of people who frequently use general health services (and for whom no clear medical diagnosis is found) have severe personality disorders.

Individuals with personality disorders are more likely to be stigmatized and blamed for their illness, relative to other psychiatric and medical disorders. Relative to other psychiatric disorders, personality disorders have been less understood and recognized, and treatment options and appropriate supportive housing have been less available.

20

Past and Upcoming Activities 4G Justin Lam, 4G Kinsey Yuen, 4G Angel Au

Since the publication of our second newsletter on Valentine’s Day, we’ve held two activities, namely our second discussion forum and Catharsis.

DISCUSSION FORUM -BEHAVIOURAL PSYCHOLOGY Our second discussion forum on behavioural psychology was held on 25th March. Learning and discussing the effects of conditioning and more. We also hope that our presentation and handout helped to enhance your understanding of behavioural psychology.

STRESS RELIEF WEEK - CATHARSIS We are grateful for having had the chance to be part of the Student Union’s Fun Fair during the Stress Relief Week, Catharsis. On the 11th of April, we held a booth in the Fun Fair during the Stress Relief Week, aiming to relieve students’ stress 21

by laughter, as well as explaining the psychological knowledge behind.

We sincerely hope that you have enjoyed our activities and we thank you for your participation. In the coming months we will be holding some more, and we hope to see you there!

MAY – Q&A COMPETITION On the 7th of May, we will be holding a Q&A quiz, testing participants on their knowledge of psychology. Prizes will be given to the winners, so don’t hesitate to join this fun and rewarding event!

JULY – PSYCHIATRIC-RELATED FACILITIES VISIT We will visiting Halfway House and their Wellness Centre on the 6th of July in collaboration with the New Life Psychiatric Rehabilitation Association. Halfway House provides a transitional period of residential care to facilitate ex-mentally ill persons to achieve an optimal level of functioning for the purpose of community reintegration. Participants will be able to learn more about the psychiatry and the underprivileged population of this society.

Newsletter design and layout by 4B Chloe Yeung.

22

spcc psych ec.

23