guest lecture on personality disorders Flashcards
(39 cards)
What is the definition of a personality disorder?
A personality disorder is an enduring pattern of behavior and inner experience that deviates from cultural norms, is pervasive, inflexible, stable over time, and leads to distress or impairment, with onset in adolescence or early adulthood.
What are the three clusters of personality disorders in the DSM-5?
Cluster A – Odd/Eccentric: Paranoid, Schizoid, Schizotypal
Cluster B – Dramatic/Emotional/Erratic: Antisocial, Borderline, Histrionic, Narcissistic
Cluster C – Anxious/Fearful: Avoidant, Dependent, Obsessive-Compulsive
What diagnostic criteria must be met to diagnose a personality disorder in youth?
- Symptoms must be pervasive
- Persistent for more than a year
- Not limited to a developmental period
- Not attributable to another mental disorder
What methods are used to assess personality disorders in youth?
Structured interviews (e.g., Childhood Interview for Borderline Personality Disorder), self-report measures (e.g., Borderline Personality Features Scale for Children), multi-informant assessments, and longitudinal assessments to evaluate symptom stability.
What are the main issues with the categorical diagnosis of personality disorders in the DSM-5?
- Inter-category comorbidity (overlap between disorders)
- Intra-category heterogeneity (variability within a single disorder)
- Arbitrary diagnostic thresholds
- Stigma associated with rigid categories
What is the core concept of Dimensional Diagnosis?
Personality traits exist on a spectrum, ranging from maladaptive (problematic) to adaptive (healthy).
What is one advantage of the Dimensional Diagnosis model?
It recognizes the complexity of personality disorders (PDs) and does not limit them to a single category.
Why is Dimensional Diagnosis beneficial for goal-setting in treatment?
It allows for more flexibility in setting treatment goals, recognizing that PDs can vary along a spectrum.
What does DSM Section III – Alternative Model (AMPD) combine?
It combines dimensional and categorical approaches to diagnosing personality disorders.
What are the two main criterias of the alternative model (AMPD)?
- Impairment in personality functioning (self-functioning and interpersonal functioning)
- Pathological personality traits: negative affectivity, detachment, disihibition, antagonism, psychoticism
Which personality disorders are included in DSM Section III – Alternative Model (AMPD)?
ASPD (Antisocial), AvPD (Avoidant), BPD (Borderline), NPD (Narcissistic), OCPD (Obsessive-Compulsive), StPD (Schizotypal), and PD-TS (Personality Disorder Trait-Specified).
What does BPD look like?
Instability of interpersonal relationships, self-image, and emotions, with marked impulsivity beginning in early adulthood and present in various contexts.
What are the main markers of BPD in youth?
Self-harm and Risk-taking behavior
What are the most common comorbidities with BPD?
depression, conduct, oppositional, ADHD, and anxiety
What family history factors increase the risk of developing BPD?
Family history of substance use, anxiety, antisocial personality, and mood disorders are all risk factors for BPD.
What does Linehan’s biosocial theory say about BPD development?
BPD develops from a biological vulnerability to emotion dysregulation, compounded by growing up in an invalidating environment where one’s feelings are ignored or punished.
In an invalidating environment, a person’s emotions are dismissed, leading them to feel their feelings don’t matter and struggle with emotion recognition and regulation.
What does Fonagy’s mentalization model focus on in BPD?
Focuses more on attachment and self-development.
It emphasizes the role of insecure attachment, emotional hypersensitivity, and deficits in mentalizing (understanding oneself and others) in the development of BPD.
disrupted attachment lead you to be very attuned to what could go wrong. Hypermentalizing: overthinking what other people are thinking of you. Kills your own self esteem. Poor development of the self.
What is the main treatment for BPD
DBT (Dialectical Behavior Therapy)!
It targets emotion dysregulation, distress tolerance, and interpersonal difficulties.
What does MBT aim to achieve in treating adolescents with BPD?
MBT reduces self-harm and depression. It improves mentalization and reduces attachment avoidance.
Is pharmacotherapy a recommended treatment for BPD?
pharmacotherapy is considered a potential option for managing symptoms, but evidence-based therapies like DBT and MBT are the primary treatments.
What is the “stepped care approach” in treating BPD?
A stepped care approach involves different levels of treatment depending on the severity of symptoms, helping to make care more accessible.
It’s often used in systems where there’s a limited availability of services, ensuring that people who need more care get it, while those who need less can still benefit from lower-intensity support.
What is the role of Cognitive Developmental Psychotherapy (CDP) in BPD treatment?
CDP is effective for treating non-suicidal self-injury but faces challenges in treating the full spectrum of adolescent BPD symptoms.
Why is diagnosing personality disorders (PDs) in adolescence controversial?
Adolescents’ personalities may be too unstable to justify a PD diagnosis, and certain features of personality pathology may be normative for their age.
What does the “Reducing Stigma” section suggest about the language used for PD diagnoses?
Using less stigmatizing terminology, such as the AMPD model and the ICD-11, and emphasizing treatment goals rather than a fixed personality disorder label, helps reduce stigma. It also encourages self-advocacy from adolescents.
