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PS2028 - Mental Health and Clinical Psychology > L12 - Personality Disorders 1 > Flashcards

L12 - Personality Disorders 1 Flashcards

1
Q

What is the 5-factor model of personality?

A
  • Openness: artistic, curious, wide interests
  • Conscientiousness: efficient, organised, responsible, planful
  • Extraversion: Outgoing, energetic, talkative
  • Agreeableness: Appreciative, kind, sympathetic and trusting
  • Neuroticism: anxious, tense, worrying
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2
Q

What is personality?

A
  • How did you develop personality traits and how old you were when you noticed personality
  • Meta-analysis conducted of 152 longitudinal studies on stability of personality traits by age and found stability increases with age, plateauing in 50s to 70s
  • Personality is the set of unique traits and behaviours that characterise an individual
  • Our personality influences how we engage with the world, how we develop and sustain relationship, and how we choose to spend our time
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3
Q

What are clinical features of personality disorders?

A
  • Problems with identity or sense of self
  • Chronic interpersonal difficulties
  • The person’s enduring pattern of experience and behaviour deviates markedly from the expectations of their cultures
  • Must be inflexible, pervasive across broad range of personal and social situations
  • Must be stable and of long duration, onset at adolescents/early adulthood
  • Causes significant distress and impairment in functioning
  • Manifests in 2+ areas: cognition, affect, interpersonal functioning or impulse control
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4
Q

What is the cluster A clinical features of personality disorders?

A
  • Paranoia: Suspiciousness and mistrust of others with little/no evidence: males = females
  • Schizoid: Detachment from social relationships, restricted range of emotions: males > females
  • Schizotypal: Cognitive =/perceptual distortions, eccentricities of behaviour/speech M>F
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5
Q

What is the cluster B clinical features of personality disorders? (HNAB)

A
  • Histrionic: excessive emotionality =, attention seeking, F>M
  • Narcissistic: Grandiosity, need for admiration, lack of empathy M>F
  • Antisocial: Persistent pattern of disregard for and violation of the rights of others M>F
  • Borderline: Instability of interpersonal relationships, self-image, affect, and marked impulsiveness F =M
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6
Q

What is the cluster C clinical features of personality disorders?

A
  • Avoidant: Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation, F>M
  • Dependant: Need to be taken care of, submissive and clinging behaviour, fear of separation, F>M
  • Obsessive compulsive: Preoccupation with orderliness, perfectionism, mental and interpersonal control, M>F
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7
Q

What is the relationship between age and diagnosis?

A
  • PD diagnoses are typically made in adulthood
  • Evidence of onset in adolescence/early adulthood is required
  • Not all personality traits that appear in childhood will persist
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8
Q

Relationship between culture and diagnosis?

A
  • Core aspects of personality are influenced by culture
  • Culture influences what behaviours, norms, personality traits are acceptable
  • Personality disorders must be carefully considered in the context of culture
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9
Q

What is the prevalence of personality disorders?

A
  • Life prevalence rate is about 10%
  • About 75% comorbidity
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10
Q

What are Challenges in Diagnosing and researching personality disorders?

A
  • Diagnostic criteria are not sharply defined
  • Diagnosis relies on inferred traits or consistent patterns of behaviour
  • Diagnostic categories not mutually exclusive
  • Personality characteristics are dimensional in nature
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11
Q

What is the Dimensional approach to Personality Disorders?

A
  • Categorical systems assume mental health disorders are discrete with boundaries between normality and illness
  • Dimensional systems can include: seeing symptoms as being a continuum rather than a category
  • Identifying and measuring the traits that underlie PDs
  • Mapping PD symptoms onto established models of personality
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12
Q

What are the pros of categorical approach to PDs?

A
  • Maps onto decision to offer treatment(diagnosis = yes)
  • Directs the clinical approach and appropriate treatment
  • Clearer communication about condition
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13
Q

What are the cons of categorical approach to PDs?

A
  • Dichotomous
  • Limited support from evidence (e.g.,clusters)
  • Diagnoses are heterogenous
  • High amounts of comorbidity
  • Poor diagnostic reliability and stability over time
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14
Q

What are the pros of dimensional approach to PDs?

A
  • More reliable (across raters and time)
  • Help to understand heterogeneity within disorders and lack of clear boundaries
  • Information about ‘subthreshold’ traits and symptoms
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15
Q

What are the cons of dimensional approach to PDs?

A
  • Hard to adopt into healthcare
  • Seen as more cumbersome
  • More difficult to communicate
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16
Q

What is the assessment of PDs?

A
  • History
  • Interpersonal functioning
  • Assessment over time
  • Observation of emotional expression, non-verbal communication
  • Informants
  • Identify areas that are difficult for them, treatment goals and build therapeutic alliance
17
Q

Why are personality disorders a controversial diagnosis?

A
  • Stigma of being seen as a difficult person
  • See experiences as a natural reaction to adversity
  • Challenges in making a diagnosis
    BUT
  • Helpful to understand self and communicate to others
  • Validation/relief
  • Access to appropriate treatment
18
Q

What are the challenges in studying the causes of PD?

A
  • Relatively new areas of study
  • High levels of comorbidity among PDs
  • Reliance on retrospective approaches: personality traits may be heritable
  • Impact of childhood experiences
19
Q

What is BPD?

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:
  • Frantic efforts to avoid real/imagined abandonment
  • Pattern of unstable/intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
  • Identity disturbance: markedly and persistently unstable self-image
  • Impulsivity in at least 2 areas that are damaging
  • Recurrent suicidal behaviour, gestures, threats of self-mutilating behaviour
  • Affect instability due to a marked reactivity of mood
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger
  • Transient, stress-related paranoia ideation
20
Q

What are the genetic factors of BPD?

A
  • Diagnosis of BPD is 4x higher in the biological relatives of patients with BPD compared to relatives of people without BPD
  • Genes may account for 40% of variance in the disorder
21
Q

What are the environmental factors of BPD?

A
  • People with BPD report a large number of negative, even traumatic events in childhood: include abuse and neglect, separation and loss
  • Diathesis-Stress theory of BPD: Early vulnerability and Environmental risk
22
Q

What is Parental PD as a risk to Child Development?

A
  • Through transmission of genetic vulnerability and env stress of living with a parent who had a PD
  • Impact of parental behaviour and disorganised family life as stressor, is parent experiences a PD and is not receiving support
  • Effects of rearing behaviour or brain chemistry and the formation of attachment
23
Q

What is the sensitivity to rejection?

A
  • BPD may include a genetic predisposition to greater sensitivity and reactivity to interpersonal cues (e.g., rejection)
  • Rejection sensitivity: personality dimension that involves disposition to expect and avoid anticipated or perceived threats of rejection
  • Measured through self-report; experimentally(cyberball)
  • Individuals with BPD (vs. controls)
  • expect rejection more across several situations
  • perceive receiving the ball less in cyberball studies (difference larger in inclusion conditions)
  • experience great negative affect after rejection/exclusion
24
Q

Emotion Processing in BPD?

A
  • Adverse experiences in childhood may help explain why people with BPD experience fear of abandonment, less trust of others
  • Ability to correctly read cues about the emotions states of others is an important skill for interpersonal functioning and wellbeing
  • If individuals with BPD experience higher rejection sensitivity = individuals with BPD will detect negative emotion states in others more quickly/accurately
25
Q

Study looking at emotion processing in BPD?

A
  • 44 women with BPD diagnosis, adverse childhood experience and no BPD diagnosis and 15 controls
  • Methods: Emotion identification and recognition
  • Individuals with BPD earlier prediction of anger: misidentification of anger
  • Ability to detect happiness not significantly different from other groups
26
Q

What are treatments and outcomes for PDs?

A
  • PDs represent relatively enduring, pervasive and inflexible patterns of behaviour
  • Different possible goals of therapy
  • Client resistance to change because they don’t see need to change
  • Relationship formation challenges
  • Antidepressant medications: SSRIs to Dialectical Behaviour Therapy: DBT

PS2028 - Mental Health and Clinical Psychology (18 decks)

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