Chapter 12 - Personality Disorders Flashcards Preview

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Flashcards in Chapter 12 - Personality Disorders Deck (73):
1

personality disorders

pattern of inner experience and behaviour that is not deemed appropriate considering individual's cultural expectations

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key features of diagnosis

1. Pattern manifestation in 2+ areas (Cognition,emotion, interpersonal functioning or impulse control)

2. Rigid and consistent pattern across many contexts

3. Distress/ impairment

4. Stability and long duration of symptoms

5. Behaviour not caused by another mental illness

6. Behaviour not caused by substance abuse

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cluster A

odd and eccentric disorders - paranoid, schizoid, schizotypal

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cluster B

dramatic, emotional, or erratic disorder - antisocial, borderline, histrionic, narcissistic

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cluster C

anxious and fearful disorders - avoidant, dependent, and obsessive-compulsive

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onset of PD

adolescence or early adulthood

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Areas of pattern manifestation

Cognition
Emotion
Interpersonal Functioning
Impulse control

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How should Personality Disorders be assessed

Through structured interviews

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Diagnostic issues in PDs

Low reliability (time and people)
Gender/ Cultural issues
Co-morbidity/overlap
Weak treatment efficacy
Poorly understood etiology

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Etiology Theories

Psychodynamic
Attachment Theory
Cognitive Behavioural
Biological

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Psychodynamic Theories

parent-child relationships leads to

inadequate sense of self

Issues relating to other people

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Attachment Theories

Poor parent-child attachment > Poor adult attachment > Interpersonal relationship problems

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Cognitive Behavioural Theories

Rigid, inflexible schemas
Invalidating environment
Modelling inappropriate behaviours

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Biological Theories

Genetics
Brain Functioning
Emotion Regulation

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How many Criterion must be met for a Paranoid PD diagnosis

4+ criteria

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Paranoid Personality Disorder more common in which gender

males

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Paranoid Personality Disorder

Pervasive distrust and suspicion of others

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Schizoid Personality Disorder

Pervasive disinterest in social relationships and restricted affect

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How many criterion must be met for a schizoid PD diagnosis

4+ criteria

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Schizoid PD and social skills

They don't have social skills and are not interested in learning them

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Schizotypal Personality Disorder

Pervasive pattern and social deficits, discomfort in interpersonal relationships, and perceptual distortion or eccentricities

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Treatment of Schizotypal Disorder

Anti-Psychotics and Anti-Depressants

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Schizotypal PD

Males

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How to Cluster A PDs differ from schizophrenia

Schizophrenia is more severe
Schizotypal PD may be a mild form of schizophrenia

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Can Cluster A PDs predict psychotic disorders

Cluster A PDs can be a precursor

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When may Cluster A PDs appear

Childhood and Adolescents

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Are Antisocial and Psychopathy the same disorder

No they are different

Not all people with antisocial are psychopaths

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Which is more severe Antisocial PD or Psychopathy

Psychopathy is more severe

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Is psychopathy a formal diagnosis

No, there is no formal diagnosis of psychopathy

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Most psychopaths have Antisocial PD

true

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Most Antisocial PD individuals are psychopaths

False

Only a small proportion have Antisocial PD individuals have psychopathy

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Antisocial PD

Pervasive disregard for and violation of the rights of others

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How many criterion must be met for a Antisocial PD

3+ criteria

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Must have conduct disorder prior to the age of 15 to be diagnosised with Antisocial PD

true

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reliability of Antisocial PD

high behavioural reliability

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treatment of Antisocial PD

psychotherapy (aimed at symptoms and behaviour)
Meds (Manage threatening behaviour)

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Factors for psychopathy

1. Interpersonal and affective ( superficially charming, grandiose, pathological lying, lack of remorse)

2. Antisocial behaviour and lifestyle (Easily bored, lack of realistic long-term goals, impulsive, irresponsible)

3. Promiscuous (casual sexual relationships)

4. Many short-term relationships

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assessment of psychopathy

psychopathy checklsit

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Can psychopathy predict future violence

yes

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psychopaths can commit what kinds of violence

Cold blooded
Goal oriented
Sadistic and Gratuitous

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Biological Theories of Psychopathy

hypoactive amygdala and genetics

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Environmental theories of Psychopathy

abusive environment and disturbed living arrangements

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Primary psychopaths

lack fear

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secondary psychopaths

sensitivity to rewards

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Treatment of Psychopathy

reatment- resistant
Contingency management

Intensive supervision
Preventive Detention

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borderline PD

Pervasive instability in interpersonal relationships, self-image, and affect with marked impulsivity

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How many criteria are needed for BPD

5+ riteria

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Biological etiology

mild brain dysfunction

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Childhood experiences causing BPD

Child abuse/neglect
Child sexual abuse
Attachment problems with parents
Modelling

Linehan's Biosocial Theory

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Linehan's Biosocial Theory

BPD is a dysfunction of emotion regulation

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Treatment for BPD

DBT

4 Modules over 12 months

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BPD medication treatment

Anti-depressants
Anti-psychotics
Anti- Convulsants

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What are anti-convulsants used for in BPD

Emotional instability
Impulsivity

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Histrionic PD

Excessive emotionality and attention-seeking

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How many symptoms are needed for a HPD diagnosis

5+ symptoms

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Cultural consideration of HPD

Behaviour must be distressing or impairing functioning

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Narcissistic PD

Pattern of grandiosity, need for admiration and lack of empathy

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How many symptoms are needed for a NPD diagnosis

5+ symptoms

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What is NPD associated with

Frequent internet and social media use

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Cluster C PDs

Avoidant PD
Dependent PD
Obsessive-compulsive PD

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Avoidant PD

Social Inhibition, feelings of inadequacy and hypersensitivity to negative evaluation

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comorbidity

co-occurrence in the sae person of two or more different disorders

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overlap

similarity of symptoms in two or more different disorders

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personality of paranoid personality disorder

humourless, eccentric, hostile, jealous, and preoccupied with power and control

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difference in paranoid schizophrenia and paranoid personality

severity of paranoid beliefs - in paranoid personality they are non-bizzare

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personality of schizoid personality disorder

loners, cold, indifferent towards others, no desire to have any sort of relationships or go out, don't desire sexual relations

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what do low doses of antipsychotic drugs release in schizotypal personality disorder

cognitive problems, social anxiety. antidepressant medication can also produce these effects

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Antisocial PD diagnosis requires what 7 violation of rights of others

nonconformity, callousness, deceitfulness, irresponsibility, impulsivity, aggressiveness, and recklessness

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polythetic approach

subset of symptoms or behaviours is required for a diagnosis, unlike most medical diagnosis

70

fearlessness hypothesis (Antisocial PD)

Antisocial PD individuals have a higher threshold for feeling fear than do the other people

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dependent personality disorder

rely on someone else to make decisions - seek advice and direction from others

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cognitive restructuring

basis for change along with skills training and behavioural practices

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dialectical behaviour therapy

more for BPD, acceptance by the therapists of the patients demanding and manipulative behaviors