Personality, Disorders, and Development Distinctions

The Six Personality Theories

• Psychoanalytic (Freud). Personality shaped by unconscious conflicts. Id, ego, superego. Defense mechanisms. Developmental stages.
• Humanistic (Rogers, Maslow). Personality develops through self-actualization. Unconditional positive regard, real vs. ideal self.
• Biological/Evolutionary. Personality largely inherited. Eysenck on arousal, Buss on evolutionary mating strategies.
• Behaviorist (Skinner, Pavlov). Personality = learned behavior patterns. Environment determines behavior.
• Social cognitive (Bandura). Personality = interaction of behavior, cognition, environment. Reciprocal determinism.
• Trait theory. Personality = stable traits. Allport, Cattell (16 PF), Eysenck (PEN), Big Five (OCEAN).

Key distinction: where does personality come from?

• Psychoanalytic = unconscious conflicts.
• Humanistic = self-actualization drive.
• Biological = genes/brain.
• Behaviorist = environment.
• Social cognitive = interaction of all three.
• Trait = stable dispositions (descriptive, not causal).

OCD vs. OCPD (The Classic MCAT Trap)

• OCD (Obsessive-Compulsive Disorder). Obsessions (intrusive unwanted thoughts) + compulsions (behaviors to neutralize). EGO-DYSTONIC - the person finds the symptoms distressing and irrational.
• OCPD (Obsessive-Compulsive Personality Disorder). Pervasive pattern of perfectionism, rigidity, control. EGO-SYNTONIC - the person thinks their way is correct.

Key distinction: OCD sufferers want to stop; OCPD sufferers don’t see a problem. OCD is an anxiety-related disorder. OCPD is a personality disorder (Cluster C).

DID vs. Schizophrenia (Another Classic Confusion)

• Dissociative identity disorder. MULTIPLE distinct personality states take control. Memory gaps between states. Linked to severe childhood trauma. One person has multiple “alters.”
• Schizophrenia. ONE identity, but with hallucinations, delusions, disorganized thought. Psychotic disorder. Not related to “split personality.”

Key distinction: DID = multiple identities. Schizophrenia = broken thought/perception within one identity. Popular culture confuses them constantly; the MCAT does not.

Somatic Symptom Disorder vs. Conversion vs. Illness Anxiety vs. Factitious vs. Malingering

• Somatic symptom disorder. Real distressing physical symptoms + excessive worry about them. Symptoms may or may not have medical basis.
• Conversion (functional neurological symptom) disorder. Neurological symptoms (blindness, paralysis) with NO medical basis. Not conscious.
• Illness anxiety disorder. Preoccupation with having/getting an illness. Few or no actual symptoms.
• Factitious disorder. Intentionally producing/faking symptoms to assume the SICK ROLE (internal motivation).
• Malingering. Intentionally faking symptoms for EXTERNAL GAIN (money, drugs, avoiding work). NOT a mental disorder - it’s deception.

Key distinctions:

• Real symptoms + real worry → somatic symptom disorder.
• Neurological signs with no cause → conversion.
• Fear of illness with few symptoms → illness anxiety disorder.
• Intentional faking for sick role → factitious.
• Intentional faking for external reward → malingering.

Bipolar I vs. Bipolar II vs. Cyclothymic

• Bipolar I. At least ONE manic episode (lasting ≥1 week). Depression common but not required.
• Bipolar II. At least one hypomanic episode (≥4 days, less severe than mania) + at least one major depressive episode. NO full manic episode.
• Cyclothymic disorder. Chronic (≥2 years) alternation of hypomanic and depressive symptoms, not meeting full episode criteria.

Key distinction: Bipolar I requires full MANIA. Bipolar II requires hypomania + depression. Cyclothymic is a milder, chronic version. One full manic episode upgrades bipolar II to bipolar I.

MDD vs. Persistent Depressive Disorder (Dysthymia)

• MDD. Episodic. ≥5 symptoms for ≥2 weeks. Severe impairment.
• Persistent depressive disorder. Chronic (≥2 years, 1 year in children). Less severe than MDD. Low-grade but continuous.

Key distinction: MDD = severe episode. PDD = chronic low-grade. “Double depression” is when MDD episodes occur on top of PDD.

Positive vs. Negative Symptoms of Schizophrenia

• Positive. ADDITIONS. Hallucinations, delusions, disorganized speech/behavior.
• Negative. SUBTRACTIONS. Flat affect, avolition, alogia, anhedonia, social withdrawal.

Key distinction: positive adds; negative takes away. Positive symptoms respond better to antipsychotics; negative symptoms are harder to treat.

Typical vs. Atypical Antipsychotics

• Typical (first-generation). Haloperidol, chlorpromazine. D2 receptor blockers. Effective for positive symptoms, cause movement side effects (tardive dyskinesia).
• Atypical (second-generation). Risperidone, olanzapine, clozapine. D2 + serotonin receptor blockers. Better for negative symptoms, fewer movement side effects, but metabolic risks.

Key distinction: typicals block dopamine aggressively → movement problems. Atypicals hit serotonin too → fewer movement side effects but weight gain and metabolic issues. Clozapine is most effective but risks agranulocytosis.

The Ten Personality Disorders (Three Clusters)

• Cluster A (“odd or eccentric”). Paranoid, schizoid, schizotypal.
• Cluster B (“dramatic, emotional, erratic”). Antisocial, borderline, histrionic, narcissistic.
• Cluster C (“anxious or fearful”). Avoidant, dependent, obsessive-compulsive personality (OCPD).

Key distinction:

• A = weird (paranoid, loner, magical thinking).
• B = wild (antisocial, unstable, dramatic, grandiose).
• C = worried (avoidant, dependent, perfectionist).

Schizoid vs. Schizotypal vs. Schizophrenia

• Schizoid. Cluster A personality disorder. Detached from social life by PREFERENCE. Not psychotic. “A loner who wants to be alone.”
• Schizotypal. Cluster A personality disorder. Eccentric thinking, magical beliefs, odd speech. Milder cousin of schizophrenia but not psychotic.
• Schizophrenia. Actual psychotic disorder. Hallucinations, delusions, disorganized thought.

Key distinction: schizoid = detached. Schizotypal = odd/eccentric. Schizophrenia = psychotic. Similar-sounding names, different severity.

Freud’s Psychosexual Stages

(Birth →) Oral → Anal → Phallic → Latency → Genital

• Oral (0-1). Mouth. Fixation → smoking, overeating, dependency.
• Anal (1-3). Bowel control. Fixation → rigidity or messiness.
• Phallic (3-6). Genitals. Oedipus/Electra complex. Fixation → vanity, recklessness.
• Latency (6-12). Sexual feelings dormant.
• Genital (12+). Mature sexuality.

Erikson’s Psychosocial Stages

Each a CRISIS between two poles, across the full lifespan:

1. Trust vs. mistrust (0-1).
2. Autonomy vs. shame/doubt (1-3).
3. Initiative vs. guilt (3-6).
4. Industry vs. inferiority (6-12).
5. Identity vs. role confusion (12-18).
6. Intimacy vs. isolation (young adult).
7. Generativity vs. stagnation (middle age).
8. Integrity vs. despair (old age).

Key distinction from Freud: Erikson spans the whole lifespan; Freud stops at adolescence. Erikson’s stages are about social/psychological development, not sexual.

Kohlberg’s Stages of Moral Development

Three levels, two stages each:

• Preconventional. Stage 1: obedience/punishment. Stage 2: self-interest/exchange.
• Conventional. Stage 3: good-boy/good-girl. Stage 4: law and order.
• Postconventional. Stage 5: social contract. Stage 6: universal ethical principles.

Key distinction: preconventional = consequences for me. Conventional = following norms and laws. Postconventional = abstract principles that can override laws.

Piaget’s Cognitive Development

Four stages:

• Sensorimotor (0-2). Object permanence.
• Preoperational (2-7). Symbolic thought, egocentrism, fails conservation.
• Concrete operational (7-11). Conservation, logic on real things, empathy.
• Formal operational (12+). Abstract and hypothetical reasoning.

Key distinction from Freud and Erikson: Piaget is COGNITIVE (thinking). Freud is SEXUAL. Erikson is PSYCHOSOCIAL (identity and relationships). Three separate frameworks, each useful for different questions.

Vygotsky vs. Piaget

• Piaget. Development driven by the child’s own discovery. Mostly self-directed.
• Vygotsky. Development driven by SOCIAL interaction with more knowledgeable others. Zone of proximal development.

Key distinction: Piaget says the child explores alone. Vygotsky says the child learns through guided interaction. Modern research sees value in both.

Defense Mechanisms (The Easy-to-Confuse Set)

• Repression. Unconscious forgetting of anxiety-provoking memories.
• Suppression. Conscious choice to avoid thinking about something.
• Denial. Refusing to acknowledge reality.
• Projection. Attributing your own unacceptable feelings to others.
• Displacement. Redirecting emotion to a safer target.
• Rationalization. Creating logical-sounding excuses.
• Reaction formation. Expressing the OPPOSITE of your true feelings.
• Sublimation. Channeling unacceptable impulses into socially acceptable activity. Most mature.
• Regression. Reverting to earlier developmental behavior under stress.
• Intellectualization. Avoiding emotion through abstract analysis.

Key distinction (by scenario):

• Forgot the traumatic event entirely → repression.
• Chose not to think about it right now → suppression.
• Won’t admit it happened → denial.
• Accuses others of your own flaw → projection.
• Takes it out on someone safer → displacement.
• Justifies with a logical-sounding reason → rationalization.
• Overcompensates in the opposite direction → reaction formation.
• Channels impulse into art/sport → sublimation.
• Throws tantrum as an adult → regression.
• Focuses on facts to avoid feeling → intellectualization.