Avoidant Personality Disorder Case Study

The storyline of Charlie Brown is focused on a very small social circle of young children. One of the main animated character is Charlie Brown who has various insecurities. The author made a common connection between himself and the character. He was a child who others preyed on and made a mockery out of. The comical was used as an example of a great American un-success story, where the character failed at everything he attempted to do. Charlie Brown was always prone to bad luck.

Rationale for diagnosis: I arrived at the diagnosis of Borderline Personality Disorder for several different reasons. According to the American Psychiatric Association (2013), Borderline Personality Disorder is defined as “A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts.” One of the defining characteristics within this definition for Borderline Personality Disorder is “Frantic efforts to avoid real or imagined abandonment”. Robin’s case states that she would often verbally downgrade her companions and then a short time later she would end up worrying that she may have estranged them. Robin would then do something kind for her companions to keep them close and remain devoted to her. Robin meets this defining characteristic because, as stated, she becomes frantic when she feels that someone is going to abandon her and puts forth an effort to do something kind for them to avoid this abandonment. Another defining characteristic of Borderline Personality Disorder is “A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation”. (American Psychiatric Association, 2013). Robin's personal relationships with others were said to be quite abnormal; she would rapidly and with no reason shift from one mood to another. This seems to describe a pattern between Robin valuing her friends at times, yet also belittling them at other times in an extreme and alternating manner. Another characteristic that Robin possesses that is used in describing Borderline Personality Disorder is “Impulsivity in at least two areas that are potentially self-damaging”. (American Psychiatric Association, 2013). The two areas that Robin portrays acts of self-damaging are through substance abuse (in Robin’s case, alcohol) and binge-eating due to her having Bulimia Nervosa. On a side note, eating disorders, particularly bulimia, are common in people with Borderline Personality Disorder; almost 25% of bulimics have the disorder. (Zanarini, Reichman, Frankenburg, Reich, & Fitzmaurice, 2010), and, up to 67% of the people with this disorder are

Prior to establishing his theory post-World War II, Bowen studied the origins of schizophrenia and postulated that transgenerational maternal enmeshment was its cause. Bowen’s thoughts on this were similar to those on individuation. Though he believed psychoanalysis was too individualized for family therapy, the psychoanalytic notion that one’s interactions are driven by unconscious motivation was the theory’s germ of inspiration. Goldenberg & Goldenberg (2012) write that the most essential piece Bowen’s family systems theory is that the individual needs to resolve anxiety arising from their family of origin to find a sense of individuality. This concept is traceable to Bowen’s psychoanalytic roots as a psychiatrist.

The family system theory is a theory developed by Doctor Murray Bowen. It is a theory of human behavior that holds the view that a family is an emotional unit. The family system theory also uses system thinking to explain the complex interactions that exist in the family unit. According to Bowen, people have a tendency to feel disconnected from their families now and then. However, the feeling is just a feeling and not a fact. Bowne also acknowledges that family members have the potential to affect and influence each other to the extent that they appear to have the same emotional dispensation. Family members seek attention, approval, and support from each other thus the existence of a form of interdependence. Bowen, while developing the family system theory, looked at how families develop patterns so as to diffuse anxiety. According to Bowen, too much closeness or too much distance can trigger feelings of anxiety in the family (Titelman, 2014). External stressors and sensitivities can affect the family’s ability to think and respond to relationship dilemmas.

The DSM-5 defines avoidant personality disorder as “A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism… starting in early adulthood in many contexts” (Hyde 2017a). This is most evident in the passage where Zailckas explains her reasoning for avoiding her hall mates and roommate Wendi. She declares, “I don’t avoid you because I think I’m superior, I do it because I think I’m inferior. I do it because I think you don’t want me, and that lowliness is the reason that I drink, too” (p.

The three main clusters of personality disorders are odd and eccentric behavior, dramatic, emotional or erratic behavior, and anxious and fearful behavior. Cluster A, Odd and eccentric behavior are personality disorders characterized by social awkwardness and social withdrawal. These disorders show a stable pattern of remarkably unusual behavior and are commonly characterized by distorted thinking. An example is Paranoid Personality Disorder which is characterized by a pervasive distrust and suspiciousness of other people. Next cluster B is dramatic, emotional, or erratic behaviors and these disorders are characterized by shared problems with impulse control and emotional regulation. An example is Antisocial Personality Disorder which is characterized by a pervasive pattern of disregard for the rights of other people that often manifests as hostility and/or aggression. Lastly, Cluster C is anxious and fearful behavior and these personality disorders are share a high level of anxiety and represent range of symptoms for abnormal manifestations of apprehensiveness, timid, or frightened behavior. An example is Avoidant Personality Disorder which is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and a hypersensitivity to negative evaluation. People with this disorder are intensely afraid that others will ridicule them, reject them, or criticize them.

Unbeknownst to many, mental illness is very prevalent in society today. The National Comorbidity Survey Replication (NCS-R) performed a study on the prevalence of mental illness among adults. The results were 32.4% of adults admitted to having some kind of mental illness within the last 12 months (Bagalman & Napili, 2014). However two thirds of these people do not seek treatment. Treatment is not sought out because of the stigma mental illness has (Thompson, 2011). People do not want to be labeled as needing medication for their illness. Mental illness can be treated and psychotic breaks prevented if people did not have a

Antisocial describes someone who is unable, or chooses not, to spend time with other people, and sometimes expresses their feelings in an unkind or rude way. People with Antisocial Personality Disorder (sociopath, psychopath) try to get their way without being considerate of others. They show spontaneous behavior, which humiliates or harms other people. They do not lack any feeling for or understanding of norms, nor have they any feeling of guilt. They do not seem to be able to plan actions or to act with foresight. Antisocial PD occurs more often in men than in women. Psychosocial predictors (which can be confounded by genetic factors) are among other things antisocial behaviors of the father, alcohol abuse of the

Antisocial personality disorder seems to be the underlying source of many other mental disorders. Maybe it is the result of the other disorders or maybe it is the beginning stage of them. Most would think an antisocial personality disorder would mean the person does not like to be in social atmospheres. This is true; however, the antisocial personality disorder is much, much more than just a personal attitude of I do not like other people or being in places with a lot of people socializing. It may not be so much they do not like being in these places; yet, more of they cannot be in these situations. The bad part of this disorder is there really being no real treatment and the few that do seek help and start therapy with medication typically

For my primary diagnosis, I have chosen Social Anxiety Disorder 300.23 (F40.10) with a Z code of Social Exclusion or Rejection V62.4 (Z60.4). I have chosen the Z code of Social Exclusion or Rejection because of the case study symptomatology and certain aspects of details of Nadine’s case. Nadine is afraid of being humiliated and is afraid of going to public places, based off of the strong evidence of her past experiences of being bullied at school. Another possible Z code could be Parent -Child Relational Problem V61.20 (Z62.820) given the criteria of feelings of estrangement and hostility expressed by Nadine toward her mother. She expresses that she does not want to “be anything like her mother”(quoted from case study).

Bowen family systems theory is based on the view that the family is an emotional unit. The theory uses systems thinking to describe the interactions and relationships within the family. Given families are deeply

The Bowen family systems theory can utilize to understand the Gillison’s family dynamics. According to the Bowen Center for the Study of the Family (2016) the Bowen family system theory views family as an emotional unit that utilizes systems thinking to comprehend the complexity of the interactions within the unit. The theory describes families as having a major influence on their member’s thoughts, feelings and actions, which leads them to feel as if they are composed of the same “emotional skin”. The members of families, according to this theory, are driven by each other’s attention, approval, and support. The members therefore, react to each other’s expectations and wants and needs. The family is therefore interdependent. One change in one member’s function leads to a change in the functioning of the others. This is evidence in the case of the Gillison family.

The reason Lisa would be diagnosed with the anti-social personality disorder is she displays all the symptoms and characteristics of it. The DSM V defines antisocial personality disorder as “a pervasive pattern of disregard for the rights of other people and self” (Hoermann, Zupanick, and Dombeck, 2013). The symptoms of this consists of manipulation to one’s own benefit or pleasure, impulsivity, hostility (physically and/or verbally), a disregard for safety of self or others, inability for intimate relationships, irresponsibility, and lack of remorse (Edens, Kelley, Lilienfeld, Skeem, and Douglas, 2015). Personality disorders are put into clusters and antisocial personality disorder is a cluster B, which is noted to be one of the hardest of all the disorders to treat besides the Border line personality disorder that is grouped in here (Barlow and Durand, 2015. pg 453,460,463-464). In the case of Lisa Rowe she displays the characteristics of antisocial personality disorder as she is manipulative to the benefit of herself, is very impulsive, and displays hostility in her harsh dialogue towards other patients that in one scene of the movie also shows the other symptom

Imagine waking up in the morning, believing that one has the right to do what he wants and take what he can, from whomever and wherever. The day will be filled with callous, deceitful, violent, reckless and endangering acts to which one is immune to the pain others may suffer (Antisocial personality part 1, 2000). This is how a person with anti-social personality disorder behaves daily. In this paper, the topic of Anti-social personality disorder, its definitions, causes, symptoms, and treatments will be discussed.

The avoidant behavior an individual uses creates a lack of a human relationship. The less a person develops a relationship with someone, the more alone they will be. Avoidant behaviors include most of the social anxiety characteristics such as, lack of eye contact, preferred aloneness, and inability to hold a conversation. Claire uses avoidant behaviors such as lack of eye contact and lack of ability to create a relationship with an individual, specifically her roommates. As demonstrated with Claire, she gets invited to social gathering but continues to decline. The more she declines the less her roommates are going to ask her to participate with them, thus the cycle of social