12. Personality Disorders Flashcards
(61 cards)
1
Q
What is personality?
A
An individual’s unique and relatively stable pattern of behaviours, thoughts and feelings
2
Q
Advantages of the categorical models as used in DSM
A
- Ease of conceptualisation and communication
- Familiarity
- What has been used - change would req. maj. shift
- Consistency for clinical decisions
3
Q
Disadvantages of the categorical models as used in DSM
A
- Distinction between between presence vs. absence is arbitrary
- Degrees of mild, moderate and severely impaired are lost
- Diagnosis can take a considerable amount of time
4
Q
Advantages of Dimensional Model (FFM)
A
- Resolution of classifactory dilemmas
- Does not rely on arbitrary cut offs
- Retention of detailed info
- Suits patients who are not prototypical
- Diminishes stereotyping by providing more precise info
- Flexibility (can go to categorical from dimensional back not vice versa)
5
Q
Disadvantages of Dimensional Model (FFM)
A
- Lack of apparent clinical utility
- A problem for both research & practice
- May impede the ID of discrete etiologies & treatments
6
Q
Neuroticism
A
- strong predictor of psychopathology
- Chronic level of emotional adjustment and instability
- high n = emotional distress
- susceptibility to negative affect
- unrealistic ideals
7
Q
Extraversion
A
- Quantity/intensity of:
- preferred interpersonal interactions
- activity level
- need for stimulation
- capacity for joy
8
Q
High extraversion =
A
sociable, active, talkative, optimistic, fun, affectionate; susceptibility to positive affect
9
Q
Facets of extraversion
A
Warmth, Gregariousness, Assertiveness, Activity, Excitement seeking, Positive emotions
10
Q
Openness to Experience
A
active seeking and appreciation of experiences
11
Q
Agreeableness
A
refers to types of interactions from antagonism to compassion
12
Q
Conscientiousness
A
degree of organization, persistence, control, motivation
13
Q
Criteria for Personality disorders
A
Enduring pattern of inner experience and behav. that deviates markedly from cultural expectations
14
Q
PDs Must by manifested by 2 or more of
A
- Cognition
- Affect
- Interpersonal functioning
- Impulse control
15
Q
What is the pattern of PDs?
A
Inflexible and pervasive
16
Q
Cluster A: Odd eccentric
A
- Paranoid
- Schizoid
- Schizotypal
17
Q
Cluster B: Dramatic, emotional, erratic disorders (BAD)
A
Antisocial
Borderline
Histrionic
Narcissistic
18
Q
Cluster C: Anxious and fearful disorders (SAD)
A
- Avoidant
- Dependent
- Obsessive-compulsive
19
Q
Paranoid PD and FFM
A
- High levels of neuroticism specifically on the anger/hostility subtype
Low levels of agreeableness
20
Q
There is a threeway link between ASPD and?
A
Psychopathy and criminality
21
Q
SCR and psychopathic participants
A
Non-psychopaths have a higher response to threatening stimuli
- Distressing stimuli does not appear to cause distress
- neutral same as non-psychopaths
22
Q
Histrionic PD
A
Excessive emotional reactivity and attention-seeking
2-3% prevalence rate, 10-15% in clinical settings. Diagnosed more frequently in females than males.
23
Q
Narcissistic PD
A
Pervasive sense of personal grandiosity
Wide range of prevalence estimates (2-16% in clinical populations; < 1% in general population).
24
Q
Borderline PD
A
essential feature of which is a pattern of marked impulsivity and instability of affects, interpersonal relationships and self image
25
Linehan's research of the areas of dysregulation in BPD
B-I-S-C-E-S
- Emotional dysregulation
- Interpersonal dysregulation
- Behavioral dysregulation
- Cognitive dysregulation
- Self dysregulation
26
Lifetime prevalence of BPD
1 - 2 percent non-clinical
27
Linehan's Diathesis-Stress Theory of BPD
- Emotional dysregulation in the child > Great demands on family > Invalidation by parents through punishing or ignoring demands > Emotional by child to which parents attend > Back to beginning
28
BPD and FFM
High levels of neuroticism - subtypes anxiety anger/host - impulsiveness, vulnerability
- openness - fantasy
29
Avoidant PD
Characterized by a heightened sensitivity to pain, ambivalence about receiving reinforcement from others, and active detachment caused by increased sensitivity to perceived rejection and humiliation
30
Dependent
Interpersonal pattern that involves dependency on and submission to others
Little empirical support for this diagnosis
31
Prevalence of Dependent PD & gender differences
Women>men – closely related to sexual stereotypes. Prevalence = 1.5%.
32
OCPD
Extreme perfectionism, precoccupation with details, rules, lists, etc.
OCD is ego-dystonic while OCPD is usually ego- syntonic.
33
OCPD prev & gender
Prevalence is unknown (1%?). More common in men than women.
34
Areas of PDs involved in etiology and treatment (6)
- Genetic factors
- Temperament and Attachment
- Internal working model
- Learned Factors
- Psychoanalytic Factors
- Other factors (e.g., cognitive, social learning)
35
The role of self in personality disorders
- important. obviously. wtf
36
The role of behaviourism in our self identity
You are who you were rewarded for being, and not who you were punished for being
37
Ego Dystonic
Thoughts, images and feelings that a person regards as alien, unwanted and inconsistent with self-image
38
Ego Systonic
Denoting aspects of a person's thoughts, impulses, attitudes and behaviour that are felt to be consistent with the self-conception
39
Facets of Openness to Experience
Fantasy, Aesthetics, Feelings, Actions, Ideas, Values
40
High Openness =
imaginative, like novel ideas
41
High Agreeableness =
soft-hearted, good-natured, trusting, helpful, forgiving
42
Facets of Agreeableness
Trust, Straightforwardness, Altruism, Compliance, Modesty, Tendermindedness
43
High Conscientiousness
organized, reliable, hard-working, self-directed
44
Facets of Conscientiousness
Competence, Order, Dutifulness, Achievement Striving, Self-Discipline, Deliberation
45
Avoidant PD and FFM
○ Neuroticism - high on ST of anxiety, depression, self-consciousness and impulsiveness
○ Extraversion - lower level - ST - warmth, gregariousness, and excitement seeking
46
Schizotypal PD
○ Odd and peculiar ideation and behaviors resulting in interpersonal difficulties, magical thinking, superstitious beliefs, odd appearance.
47
Prevalence of Schizotypal PD
3 % gen pop
48
male to female ratio of Schizotypal PD diagnosis
unknown
49
Diagnostic criteria for Paranoid PD (cat a)
A pervasive distrust and suspicion of others such that their motivation is interpreted as malevolent, beg. early adulthood indicated by four or more of the following?
50
The symptoms that must be satisfied in Cat A of Paranoid PD (7)
4 or more
- Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
- Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
- Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
- Reads hidden demeaning or threatening meanings into benign remarks or events.
- Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
- Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
- Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
51
Diagnostic Criteria Paranoid PD Cat B
Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.
52
Schizoid PD
• Indifference to social relationships, loners, appear cold and indifferent, flat affect, lack of social skills
53
Prevalence and gender ratio of Schizoid PD
Prevalence not clearly established, but is < 1%; 2:1 (male:female).
54
Antisocial PD
○ A long-standing pattern of irresponsible behavior that violates the rights of others; unstable work patterns, illegal activities, aggression, failure to honour financial responsibilities, lack of monogamous relationships, etc.
55
Antisocial PD Prevalence & male to female ratio
○ Prevalence rates vary from 0.2 to 9.4% (average = 3%). Males > females (2:1 to 7:1).
56
Three contributing causes of Antisocial PD
○ Family environment
○ Biological – genetic links 52% MZ; 21%DZ
○ Self-regulation and fearlessness
57
DSM criteria of BPD (Cat A)
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, as indicated by five (or more) of the following:
58
Cat A indicators of BPD (9)
At least five of:
-Frantic efforts to avoid real or imagined abandonment.
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance: markedly and persistently unstable self-image or sense of self.
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms.
59
BPD male to female ratio
○ Between 62 and 75% diagnosed are female.
60
Avoidant Personality DSM Crit. Cat A
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
61
DSM Cat A indicators of Avoidant PD (7)
Four or more of the following:
Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
Is unwilling to get involved with people unless certain of being liked.
Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
Is preoccupied with being criticized or rejected in social situations.
Is inhibited in new interpersonal situations because of feelings of inadequacy.
Views self as socially inept, personally unappealing, or inferior to others.
Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
