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PSC 168 > Chapter 16: Personality Disorders > Flashcards

Chapter 16: Personality Disorders Flashcards

1
Q

Personality disorder patterns fall into two or more of the what areas?

A
  • Distorted perceptions (of self, others, events)
  • Affectivity (intense, labile, inappropriate)
  • Interpersonal relationships (too clingy, push peeps away)
  • Impulse control (difficulty controlling anger, immediate wants)
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2
Q

What is the DSM-V definition of personality disorders?

A
  • PDs are patterns of maladaptive inner experiences and behavior
  • Pattern is stable and of long duration
  • Onset goes back to at least adolescence/early childhood
  • Pattern is inflexible and pervasive across a broad range of situations
  • Significant subjective distress or impairment from this pattern
  • Pattern deviates markedly from the expectations of the individual’s culture
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3
Q

What did Sigmund Freud have to say about personality disorders?

A
  • “Character disorders” not just patterns of “traits”, but the entire dynamic of personality
  • Entails the defense mechanisms which are pretty much set by the end of adolescence
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4
Q

What is the problem of treating personality disorders?

A

Person must want to change and be treated

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5
Q

What are the 3 clusters of personality disorders according to the DSM-V?

A
  • Odd, eccentric (weird)
  • Dramatic, emotional (wild)
  • Anxious, fearful (worried)
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6
Q

What are the 10 different personality disorders distinguished by the DSM-V? Which cluster does each fit in?

A
  • Odd, eccentric = paranoid, schizoid, schizotypal
  • Dramatic, emotional = antisocial, histrionic, narcissistic, borderline
  • Anxious, fearful = avoidance, dependent, OCD
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7
Q

What are the problems with the DSM personality disorder model?

A
  • Organization of PDs into distinct, discrete categories is misleading
  • Even “normal” people have some symptoms
  • Too much overlap among them –> comorbidity
  • Most people fit characteristics of several personality disorders
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8
Q

What are the characteristics of paranoid PD?

A
  • Suspects (w/o bias) that others are exploiting or deceiving him/her
  • Can’t trust anybody, always doubts and anticipates deceit
  • Bears grudges, is unforgiving, keeps score
  • Is hypersensitive to remarks of others
  • Always feel under attack and quickly gets angry
  • Tends to be controlling
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9
Q

What are the characteristics of schizoid PD?

A
  • Neither desires nor enjoys close relationships (including family)
  • Lacks close friends or confidants
  • Almost always chooses solitary activities
  • Takes pleasure in few activities, if any
  • Has little, if any, interest in having sexual experiences with another person
  • Appears indifferent to both the praise and criticism of others
  • Shows emotional coldness, detachment, or flattened affectivity
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10
Q

What are the characteristics of schizotypal personality disorder?

A

Poor interpersonal relationships:
-lack of close friend or confidants other than first-degree relatives
-Excessive social anxiety that doesn’t diminish w/ familiarity and tends to be associated w/ paranoid fears rather than negative judgment about self
-Inappropriate or constricted affect
Peculiar thoughts and behaviors:
-Odd thinking and speech
-Odd beliefs or magical thinking that influences behavior
-Unusual perceptual experiences
-Ideas of reference

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11
Q

What is the DSM-V criteria for antisocial PD?

A
  • Not conforming to social norms
  • Deceitful
  • Impulsive
  • Aggressive
  • Reckless disregard for safety of self and others
  • Consistently irresponsible
  • Lack of remorse
  • Evidence of “conduct disorder” before age 15
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12
Q

What are the social deviance characteristics of antisocial PD according to Robert Hare?

A
  • Early behavioral problems
  • Adult antisocial behavior
  • Lack of responsibility
  • Impulsivity
  • Need for excitement
  • Poor behavioral controls
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13
Q

What are the emotional-interpersonal characteristics of antisocial PD according to Robert Hare?

A
  • Glib and superficially charming
  • Shallow emotions
  • Deceitful and manipulative
  • Lack of empathy
  • Lack of remorse and guilt
  • Egocentric and grandiose
  • Sense of entitlement
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14
Q

List the comorbidities of antisocial PD.

A
  • Substance abuse disorders
  • Other PDs
  • ADHD
  • Learning disabilities
  • History of childhood abuse and neglect
  • Reactive Attachment Disorder
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15
Q

When is the onset of antisocial PD?

A

By age 15 or earlier

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16
Q

Describe the course of antisocial PD.

A
  • Chronic course that is difficult to change

- Some improvement in level of violence after age 40

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17
Q

What is the one year prevalence of antisocial PD?

A

3.5%

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18
Q

What is the gender ratio of antisocial PD?

A

4:1 (male: female)

19
Q

What is the biological etiology of antisocial PD?

A
  • Thrill seeking trait due to low arousal
  • High pain threshold
  • Low level of fear and anxiety
  • Slow to classically condition
  • Genetic factors
20
Q

What are the environmental factors that contribute to antisocial PD?

A
  • Inconsistent parenting style
  • Fathers often antisocial; mothers have PDs
  • Alcoholism and other substance abuse in family
  • Poor role models, poverty, high crime neighborhood, bad schools, no jobs, etc.
21
Q

What are the therapy treatment options for antisocial PD?

A
  • Insight approaches
  • Empathy training in peer group setting
  • Operant conditioning in controlled environment
22
Q

What are the medications that help treat antisocial PD?

A
  • Anti-convulsants for aggression and anger
  • SSRIs for impulse control problems
  • Hormonal drugs to increase estrogen and decrease testosterone
23
Q

What is the DSM-V criteria for histrionic PD?

A
  • Needs to be center of attention
  • Self dramatization and exaggerated emotions
  • Sexually seductive
  • Rapidly shifting and shallow emotions
  • Speech is vague and lacks detail
  • Very suggestible
  • Exaggerate degree of intimacy w/ others
  • Easily bored, impulsive
  • Want their needs to be gratified immediately
24
Q

What did Sigmund Freud call histrionic PD?

A

Hysterical

25
Q

What is the DSM-V criteria for narcissistic PD?

A
  • Grandiose sense of self-importance
  • Requires excessive admiration
  • Fantasies of success, brilliance, beauty, ideal love
  • Believes to be special, unique
  • Has a sense of entitlement
  • Manipulative
  • Lacks empathy
  • Is often envious of others
  • Arrogant, condescending, contemptuous
26
Q

What is the DSM-V criteria for borderline PD?

A
  • Affective instability (mood flips)
  • Inappropriate intense anger
  • Impulsivity in at least 2 areas that are potentially self-damaging
  • Pattern of intense interpersonal relationships that are short-lived, and alternate between idealization and devaluation
  • Frantic efforts to avoid real or imagined abandonment
  • Suicidal behaviors, self mutilation
  • Chronic feelings of emptiness
  • Identity disturbance
  • Transient psychotic states
27
Q

What are the biological factors that contribute to borderline PD?

A
  • Predisposition for modd instability

- Disregulated amygdala

28
Q

What problems in early childhood contribute to borderline PD?

A
  • Poor attachment

- Childhood abuse or neglect

29
Q

List the comorbidities of borderline PD.

A
  • Mood disorders
  • PTSD
  • Dissociative disorders
  • Alcohol and drug abuse
  • Eating disorders (esp. bulimia)
  • Other PDs
30
Q

When is the onset of borderline PD?

A

Childhood precursors w/ peak in adolescence/young childhood

31
Q

What is the course of borderline PD?

A

Symptoms often lessen after age 40

32
Q

What is the one year prevalence of borderline PD?

A

2%

33
Q

What is the gender ratio of borderline PD?

A

3:! (female: male)

34
Q

What is the psychotherapy treatment for borderline PD?

A
  • Interpersonal psychodynamic therapy
  • Cognitive-behavioral therapy
  • Need for boundaries, structure, consistency
  • Likely to be long-term therapy
35
Q

What medications help treat borderline PD?

A
  • SSRIs for impulse control and depression
  • Anti-convulsants for mood swings and anger
  • New psychotics for anger and paranoia
36
Q

What kinds of meds are not recommended to treat borderline PD? Why?

A

Benzodiazepines b/c they further disinhibit impulses

37
Q

What is the DSM-V criteria of avoidant PD?

A
  • Fear of being criticized or rejected
  • Views self as inferior
  • Unwilling to get involved w/ people unless certain of being liked
  • Restraint in intimate relationships
  • Is inhibited in new relationships
  • Doesn’t take personal risks
  • Avoids occupational activities that involve interpersonal contact
38
Q

List the comorbidities of avoidant personality disorder.

A
  • Panic attacks
  • Agoraphobia
  • Depression
  • Childhood abuse issues
  • Substance abuse
39
Q

How is avoidance personality disorder treated?

A

Similarly to generalized and chronic social phobia

40
Q

What is the DSM-V criteria for dependent PD?

A
  • Can’t make decisions w/o others’ advice
  • Needs others to assume responsibility
  • Difficulty expressing disagreement for fear of losing support
  • Sense of helplessness
  • Unrealistic fears of being left to care for self
  • Immediately seeks new relationship when one relationship ends
41
Q

List the comorbidities of dependent PD.

A
  • Chronic mild to moderate depression (dysthymia)
  • Anxiety disorder
  • PTSD, ongoing domestic violence
  • Substance abuse
  • Somatization disorder
42
Q

How is dependent PD treated?

A

Needs to include independence skills and help w/ building a support network

43
Q

What is the DSM-V criteria for obsessive-compulsive PD?

A
  • Preoccupied w/ details, rules, lists, order, organization
  • Perfectionism at expense of task completion
  • Excessive devotion to work
  • Poor at team work
  • Inflexible about morality, values
  • Stubborn, rigid
  • Stingy
  • Hoarding behavior
44
Q

Obsessive-compulsive PD is similar to what Sigmund Freud called what?

A

Anal Character

PSC 168 (18 decks)

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