Schema Theory Of Personality Disorder

I have chosen to use the behavior of personality disorder to complete this paper. Personality disorder has a wide array of ten different specific personality disorder. The American Psychiatric Association (2013) defines a personality disorder as a lasting pattern of inner beliefs and behaviors that differ largely from one’s culture. The patterns manifest in two or more of the following areas: cognition, affectivity, interpersonal functioning, and impulse control. This disorder has an onset in adolescence and early adulthood. The ten disorders are categorized into three clusters: A, B, C. Cluster A covers disorders that appear odd or eccentric: paranoid, schizoid, and schizotypal personality disorders. Cluster B covers disorders appearing erratic,
emotional, and dramatic: antisocial, borderline, histrionic, and narcissistic personality disorders. Cluster B covers disorders appearing anxious or fearful: avoidant, dependent, and obsessive- compulsive personality disorders.
Each disorder is diagnosed by distinct diagnostic criteria. The following is a brief description of each disorder. Paranoid personality disorder is the continued distrust and suspiciousness of others without justification, continuously bears grudges, and perceives innocent remarks or actions as malicious. Schizoid personality disorder is the detachment from close relationships and limited expression of emotions in personal settings. Schizotypal personality disorder continued deficits in social and personal relationships, eccentric behavior, with odd distorted beliefs or thinking. Antisocial personify disorder is the disregard for social norms and lawful behaviors, also violation of the right of other. This disorder is associated with conduct disorder. Borderline personality disorder is defined as significant impulsivity and instability with relationships, self-image, and emotions. Histrionic personality disorder is the extreme emotional reactions and attention seeking behaviors. Narcissistic personality disorder is the constant need for admiration, great sense of entitlement, and grandiosity. Avoidant personality disorder is the persistent feeling of inadequacy, as well as active avoidance of social interaction and intimate relationships due to the fear of rejection, disapproval, and criticism. Dependent personality disorder is the fear of separation and extreme need to be taken care of which produces behaviors such as submissiveness and clinginess. Obsessive-compulsive personality disorder is the pattern of persistent extreme need for order, perfection, and control. Personality change due to another medical condition is the drastic change in one’s personality due to presenting psychological effects of a medical condition. Other specified personality disorder applies to individuals displaying some symptoms of personality disorder but do not meet the full diagnostic criteria; the clinician communicates the reasons the client does not meet criteria. The last is unspecified personality disorder applies to individuals displaying some symptoms of personality disorder but do not meet the full diagnostic criteria; the clinician does not communicate reasons the client does not meet diagnostic criteria.
Due to the wide array of personality disorders, this paper will focus on connection of theory with personality disorders in general. The theories discussed throughout in relation to personality disorders are schema theory and cognitive theory.
Cognitive Theory explores and explains the mental processes and development.
This theory explains human behavior by understanding mental processes. Cognitive behavioral therapy is the reshaping of negative thought patterns to positively change negative behaviors. Schema theory is derived from Cognitive Theory. Schema theory was developed for clients who did not progress well from cognitive behavior theory. Schema theory is the focus on identify maladaptive schemas and the negative coping skills connected to the schemas. The idea of schema is everyone develops schemas during childhood, some schemas more damaging than others. Schemas are developed when various needs of a child are not met. Some of the needs are love, attention, emotional connections, and security. When a child’s needs are not met, the individual can develop maladaptive schemas. There are eighteen maladaptive schemas: abandonment/instability, mistrust/abuse, emotional deprivation, shame, dependence, social isolation, vulnerability to harm, enmeshment, failure to achieve, entitlement, subjugation, insufficient self-control, self- sacrifice, approval-seeking, negativity, emotional inhibition, unrelenting standards, and punitiveness. The coping skills associated with the above maladaptive schemas can cause one to develop psychological issue such as personal
disorders.
The theory helped me conceptualize personality disorders because as described above many of the disorders have a connection with maladaptive schemas. For example, individuals diagnosed with cluster B personality disorders have deep issues with lack of attention, loneliness (abandonment), emotional inhibition, negativity, and attention seeking. Cluster C personality disorders have issues associated with maladaptive schemas, such as social isolation, approval-seeking, dependence, and enmeshment.
There have been many studies conducted to show the correlation between the use of schema theory and the decrease personality disorder symptoms. Many of the articles have come to the same conclusion of the use of the model of schema mode theory can be very affective in the use of treating various personality disorders. Farrell, Shaw, & Webber (2009), utilized a schema- focused approach to provide group treatment for patients with borderline personality disorder. The group consisted of fifteen participants divided into five smaller groups. Each group was provided therapeutic staff familiar with the schema-focused treatment. The therapeutic staff utilized a unique technique called re-parenting, it allows the patients to fill in early childhood emotional gaps, and building a strong foundation of healthy personal functioning. At the end of the trial, individuals in the schema focused group had no strong presenting symptoms. The participates no longer met the diagnostic criteria for borderline personality disorder.
Fassbinder, E., Schweiger, U., Jacob, G., & Arntz, A.
(2014), utilized schema mode model to rehabilitate persons with personality disorder. Researchers utilized schema mode model to correct thoughts and emotions amongst persons diagnosed with personality disorders. The end results of the use of the model displays that it fosters healthy emotions, thoughts, and behaviors. Therapeutic process includes assisting client to identify schemas, educating client about schemas throughout the process, and client triggers of schemas (Unger, 1994). The helping process would be utilizing emotions, behaviors, and cognitive processes to address the underlying feelings of helplessness, needy behavior, loneliness, and
abandonment.
A study showed four specific schemas are directly shown to trigger borderline and cluster C personality disorders: abused and abandoned, angry/impulsive mode, the punitive parent, and detached protector (Arntz, A., Klokman, J., & Sieswerda, S., 2005). During the study both participant groups watched a movie containing the above schema modes. The participants diagnosed with personality disorders experienced negative emotions in connection with their diagnosis due to the movie. The participants with no diagnosis reported no emotional reaction to the schemas within the movie. The results clearly showed maladaptive schemas from child have a significant impact on individuals diagnosed with a variety of personality disorders.
Welburn, K., Coristine, M., Dagg, P., Pontefract, A., & Jordan, S. (2002), utilized the Schema Questionnaire Form Short along with the Brief Symptoms Inventory, to study whether the results from each participant’s questionnaires have any correlation between self-reported symptoms and schemas. The results of the study found many correlations between schemas and mental disorders. For example, vulnerability to harm, self-sacrifice, and insufficient self-control showed a significant connection to paranoia; paranoia representing a diagnostic criteria for cluster A personality disorders.
This study verifies the validity of the Early Maladaptive Schema Questionnaire- Short Form when used with clients diagnosed with common clinical symptoms. The results show the Early Maladaptive Schema Questionnaire is a valuable tool in the assessment of personality disorders and most importantly the primary EMSs that may preoccupy a client’s thinking (Glaser, B. A., Campbell, L. F., Calhoun, G. B., Bates, J. M., & Petrocelli, J. V., 2002).
In this study, patients diagnosed with cluster C traits of personality disorder, who were in the cognitive therapy group that utilized schema-focused theory showed greater interpersonal improvement than those in the group of treatment as usual. The cognitive therapy group provided treatment in two phases. The first phase was used to reduce cognitive and behavioral distortion, as well as promoting self-awareness. The second phase is focused on addressing maladaptive schemas in interpersonal, cognitive, and behavioral areas (Gude, T., & Hoffart, A., 2008).
The article written by Dieckmann, E., & Behary, W. (2015), supports the use of schema therapy for narcissistic personality disorder. The schema therapy utilizes reparenting, addressing the patient’s basic emotional needs, and techniques to activate emotional cognitive and behavioral beliefs. Due to the lack of attachment in early childhood for individuals diagnosed with narcissistic personality disorder, it is important for the therapist to use reparenting to allow the individual to reconstruct health attachment and develop healthy maladaptive coping skills.
A review of each study produces similar results, as it relates to using schema focused theory to treat individuals with various personality disorders.