6 personality disorders Flashcards
(32 cards)
What does the term “personality disorder” generally refer to?
a diagnostic category of mental-health disorders characterised by a difficulty in relating to the world and to other people
inflexible and maladaptive thinking patterns with often negative impact on the immediate environment
What are the four defining features of personality disorders?
- distorted perception and thinking patters
- problematic emotional responses
- over- or under-regulated impulse control
- interpersonal difficulties
What are the three Clusters in the DSM-5?
Cluster A (the “odd, eccentric” cluster);
Cluster B (the “dramatic, emotional, erratic” cluster); and,
Cluster C (the “anxious, fearful” cluster).
What personality disorders does Cluster A contain?
paranoid personality disorder
schizoid personality disorder
schizotypical personality disorder
social akwardness, social isolation and withdrawal
dominated by distorted thinking
What are defining features of paranoid PD?
distrust and suspiciousness
- 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 preemptively attack others whom they feel threatened by.
- They tend to hold grudges, are litigious, and display pathological jealously.
- Distorted thinking is evident. Their perception of the environment includes reading malevolent intentions into genuinely harmless, innocuous comments or behavior, and dwelling on past slights.
For these reasons, they do not confide in others and do not allow themselves to develop close relationships.
- Their emotional life tends to be dominated by distrust and hostility.
What are defining features of schizoid PD?
social detachment and restricted range of emotional expression
- choose solitary activities and seem to take little pleasure in life
- loners prefer mechanical or abstract activites with little interaction, appear indifferent of both criticism and praise
- emotionally aloof, detached or cold
- oblivious to social nuance and social cues causing them to appear socially inept and superficial
- restricted emotional range and failure to reciprocate gestures or facial expressions cause sdull, bland, inattentive appearance
What are defining features of schizotypical PD?
acute discomfort in social settingsand have areduced capacity for close relationships
- perceptual and cogntivie distortions and/or eccentric behaviour hallucinations that only they can see
- odd beliefs, inconcistent with social/cultural norms
- found more frequently in families with schizophrenia, genetic commonalities
What personality disorders does Cluster B entail?
Borderline Personality Disorder
Narcissistic Personality Disorder
Histrionic Personality Disorder
Antisocial Personality Disorder
What are defining features of BPD?
tend to experience intense and unstable emotions and moods that can shift fairly quickly
impulsivity, substance abuse, sexual liaisons, self-injury, overspending, binge eating
polarized, over-simplified, all-or-nothing terms
harsh judgments
unstable sense of self
intense emotional reactions - difficulties regulating these
great distress - self-destructive behaviours
What are clinical features of BPD?
life-threatening disorder
prevalence between 2 and 6%
30% of inpatient psychiatric samples and 22% outpatient samples
95% have received individual therapy over four years
72% psychiatric hospitalisation
up to 84% of self-injury across lifespan
10% suicide
What are defining features of narcissistic PD?
sense of self-worth, powerful sense of entitlement
special treatment is deserved, uniquely talented, especially brilliant and attractive
preoccuied with fantasies of unlimited success and power, superiority
no effort in daily life and no energy to actual life goals
arrogant haughty
feel devastated when they realise they have normal, average human limitations
conflictual relationships and superficial ones
status - sense of importance
self-judgments - require a lot of admiration from other ppl
What are defining features of histrionic PD
excessive emotionality and attention seeking
drama
uncomfortable when they are not the center of attention
flirtatious, seductive
flamboyant and theatrical, exagerated degree of emotional expression
yet it is vague, shallow, and lacking in detail
often embarasses friends or others
flighty and frickle - uncomfortable being alone
imagine more intimacy than actually present
easily influenced by others suggestions and opinions
What are defining features of antisocial PD?
disregard for the rights of other people, hostility or aggression
deceit and manipulation
first appear during childhood
- hurt or torment animals or people
- engage in hostile acts such as bullying or intimidating others
- disregard for property - destruction
- deceit, theft, violations (conduct disorder, a juvenile form of ASPD)
- often in dangerous and risky situations
- impulse urges without considering the consequences
- no remorse, no responsibility
What are diagnostic criteria for BPD according to the DSM-5?
A. pervasive patten of instability of interpersonal relationships, self-image, and affects, and marked impulsivity
- frantic efforts to avoid abandonment
- extreme idealisation and devaluation
- identity distubance
- impulsivity -> self-harming
- suicidal behaviour
- affective instability, mood reactivity
- chronic feelings of emptiness
- inappropriate anger
- stress related paranoid ideation
Which personality disorders are part of Cluster C?
avoidant personality disorder
dependent personality disorder
OCPD
What are defining features of avoidant PD?
social inhibitions, feelings of inadequacy, hypersensitivity to negative evaluation
intensely afraid others will ridicule them, reject them or criticize them
limited social skills
small circle
they are not good enough - negative self talk and thoughts
distant, shy, restricted, stiff
What are defining features of dependent PD?
strong need to be taken care of by other people
fear of losing support of others
clingy manner
always seeking human interaction and support
What are defining features of OCPD?
preoccupied with rules, regulations, and orderliness
at the expense of flexibility, openness and efficiency
perfectionist tendencies
rigid, unable to delegate tasks
controlling, stubborn
How do cultural characteristics impact the diagnosis and treatment of PDs?
Culture is understood in terms of a context. Context refers to the social and environmental specificities of the local world in which individuals and groups develop. These specificities or specific elements include
(1) subjective perceptions, which indicate systems for interpreting human interactions and experience;
(2) social structures that limit and allow diverse possibilities of activity and access to resources across individuals in a particular society;
(3) the local physical environment, which sets standards for the group’s interactions with natural resources and technology; as well as
(4) the individual situations, which are variable across persons and over time
What is cultural imperialism?
a social process by which values, experiences, and culture of the dominant group are viewed as a universal norm while groups or individuals who vary from this group are considered as inferior, deviant, or inadequate.
How does culture impact psychiatric assessment?
(1) Culture shapes and directs the content, meaning, configuration, and the phenomenology of symptoms.
(2) Ethnopsychiatric diagnostic rationales as well as practices of grouping symptoms into patterns, including common culture-bound syndromes found in societies around the world.
(3) Culture provides a matrix for the interpersonal situation of the diagnostic interview.
(4) Since the clinical encounter is often inter-cultural, the dynamics of cross-cultural work are crucial for understanding and refining diagnostic categories and practices.
(5) Culture gives overall conceptualizations of the diagnostic systems, which usually become the products of their time and circumstances.
What are some biological factors of BPD?
biological dysfunctions and environmental factors
neurochemical factors
serotonergic systems
cholinergic activity
dopaminergic activity
lower endogenous opiod levels
reduced hippocampal and amygdala volumes
hyperactivity of amygdala
reduced activity in prefrontal cortex
weakening of prefrontal inhibitory control may contribute to hyperactivity in amygdala
reduced basal parasympathetic activity (vagal tone) may be trait-like marker for emotional sensitivity
heightened negative arousal at baseline
What are some environmental factors of BPD?
invalidating environment
chronically and inadverently negates, rejects or dismisses an individuals behaviour and emotional expression
punishes emotional displays and reinforces emotional escalation
oversimplifies ease of problem solving and meeting goals
traumatic home environment
lack of secure attachment base
social baseline theory (Coan, 2008) - childs ability to regulate emotions is disrupted by lack of accessibility to and responsivity of caregivers
What are some genetic influences on BPD?
potential genetic component
definite and broad type
35% and 38% MZ
7% and 11% DZ
