Lecture 20: Borderline Personality Disorder

Question 1

Personality - patterns of (5) that are ________ of a person across ____ and across ______

Answer 1

1. Perception
2. Cognitive
3. Emotion
4. Motivation
5. Action

Characteristics of a person across time and across contexts

Question 2

Five Factor Model of Personality consists of how many factors and how many aspects?

Answer 2

5 factors, each with 2 aspects

Question 3

5 factors of the FFM

Answer 3

1. Openness
2. Conscientiousness
3. Extraversion
4. Agreeableness
5. Neuroticism

Question 4

Openness aspects are interest in _____ and ______
It’s been found to be positively correlated with (3)

Answer 4

Ideas and aesthetics

1. Eccentricity
2. Unusual beliefs
3. Impulsivity

Question 5

Conscientiousness aspects are ______ and ______
It is positively correlated with (3)

Answer 5

Industriousness and orderliness
1. Perfectionism
2. Agreeableness
3. Anxiousness

Question 6

Extraversion aspects are ______ and _______
It is positively correlated with (3)

Answer 6

Enthusiasm and assertiveness
1. Agreeableness
2. Attention seeking
3. Conscientiousness

Question 7

Agreeableness aspects are _____ and ______
It is positively correlated with (1)

Answer 7

Compassion and politeness
1. Openness

Question 8

Neuroticism aspects are ________ and _______
It is positively correlated with (10)

Answer 8

Volitility and withdrawal

1. Emotional lability
2. Anxiousness
3. Insecurity
4. Preservation
5. Depressivity
6. Anhedonia
7. Submissiveness
8. Hostility
9. Perfectionism
10. Distractibility

Question 9

Personality disorder - a disturbance to the _______ _______ _______ that control ______ ______ resulting in _______ _______

Answer 9

1. Basic mental processes
2. Adaptive actions
3. Adaptive deficits

Question 10

Adaptive deficits of personality disorder (3)

Answer 10

1. Representations
2. Self-regulation
3. Relationships

Question 11

Adaptive Deficits in Representations i.e ______ and _______ consist of (3)

Answer 11

Thoughts and beliefs

1. Self e.g. NPD thoughts of superiority
2. Others e.g. Paranoid personality and beliefs about untrustworthiness
3. World e.g schizotypal personality and beliefs about mind reading

Question 12

Adaptive deficits in Regulation consist of (3)

Answer 12

1. Thoughts e.g NPD and excessive thoughts about status
2. Emotions e.g. histrionicperaonlity and exaggeration of emotion
3. Physiology e.g BPD and sympathetic nervous system arousal

Question 13

Adaptive deficits in Relationships consist of (2)

Answer 13

1. With strangers e.g antisocial personality/tendency to exploit others
2. With familiars e.g. schizoid personality and lack of interest in relationships

Question 14

In combination these three problems of adaptive deficits in representations, regulation, and relationships contribute to _________

Answer 14

Inflexibility

Question 15

Inflexibility types (4)

Answer 15

1. Perceptual inflexibility
2. Cognitive inflexibility
3. Emotional inflexibility
4. Behavioral inflexibility

Question 16

Example of perceptual inflexibility

Answer 16

Obsessive compulsive personality and selective attention for disorder

Question 17

Example for cognitive inflexibility

Answer 17

Avoidant personality and recurrent thoughts of personal inadequacy

Question 18

Example of emotional inflexibility

Answer 18

Antisocial personality and difficulty experiencing empathy for others

Question 19

Example of behavioral inflexibility

Answer 19

Dependent personality and difficulty taking initiative

Question 20

DSM-5 groups personality disorders into 3 clusters (3)

Answer 20

1. Eccentric
2. Dramatic
3. Fearful

Question 21

Cluster A: Eccentric consist of (3)

Answer 21

1. Paranoid personality disorder
2. Schizoid personality disorder
3. Schizotypal personality disorder

Question 22

Cluster B: Dramatic consist of (4)

Answer 22

1. Narcissistic personality disorder (NPD)
2. Histrionic personality disorder
3. Borderline personality disorder (BPD)
4. Antisocial personality disorder

Question 23

Cluster C: Fearful consist of (3)

Answer 23

1. Avoidance personality disorder
2. Dependent personality disorder
3. Obsessive compulsive personality disorder (OCD)

Question 24

Onset of BPD is typically in _______ or _____ ________. Symptoms increase/decrease over time

Answer 24

Adolescence/early adulthood
Decrease over time

Question 25

Who is more diagnosed with BPD between men and women?

Answer 25

Women

Question 26

1. Is BPD heritable? 2. Is BPD cross cultural?

Answer 26

1. There is some evidence 2. Potentially, more research needed to confirm

Question 27

People with BPD tend to be 1. High/low in neuroticism 2. High/low in agreeableness

Answer 27

1. High 2. Low

Question 28

People with BPD typically have adaptive deficits in (3)

Answer 28

1. Representations 2. Regulation 3. Relationships

Question 29

Examples of adaptive deficits in representations for people with BPD (2)

Answer 29

1. Self e.g. self-concept is often unstable 2. Others e.g. others are often idealized/devalued

Question 30

Examples of adaptive deficits in regulation for people with BPD (3)

Answer 30

1. Thoughts e.g. negative intrusive thoughts 2. Emotions e.g. intense negative emotion (can be provoked/unprovoked) 3. Physiology e.g. sympathetic arousal, over-activation of threat system and HPA axis

Question 31

Examples of adaptive deficits in relationships for people with BPD (2)

Answer 31

1. With strangers: might be difficult to detect BPd in casual relationships 2. With familiars e.g. intense and turbulent relationships are common

Question 32

In combination with adaptive deficits in representations, regulation, and relationships there is a pattern of inflexibility in 4 areas. Give example for all.

Answer 32

1. Perceptual e.g. transient delusions/hallucinations 2. Cognitive e.g. limited perspective taking 3. Emotional e.g. limited empathy 4. Behavioral inflexibility e.g. limited experimentation with change

Question 33

Etiology of BPD (6)

Answer 33

1. Caregiver psychopathology: disinhibition/mood disorders 2. Caregiver style: unavailable, inconsistent, controlling, invalidating 3. Caregivers who don’t soothe children —> leads to child not internalizing self-soothing strategies 4. Caregivers who punish a child’s instinctual needs for autonomy/control —> leaving child with choice between autonomy/relatedness 5. Trauma 6. Family instability

Question 34

Defense mechanisms

Answer 34

Mostly unconscious mental processes that help people cope with negative thoughts/emotions, intrapersonal/interpersonal conflicts, or other stressors

Question 35

Defense mechanisms for people with BPD (6)

Answer 35

1. Idealization 2. Devaluation 3. Splitting 4. Projection 5. Projective identification 6. Acting out

Question 36

Idealization

Answer 36

unrealistically positive representations of a person as “all good”

Question 37

Devaluation

Answer 37

Unrealistically negative representations of a person as “all bad”

Question 38

Splitting

Answer 38

Alternating between idealization and devaluation

Question 39

Projection

Answer 39

The attribution of negative characteristics of oneself to others

Question 40

Projective identification

Answer 40

Projective combined behavior intended to induce the target of the projection to behave in a way that confirms the projected content

Question 41

Acting out

Answer 41

Expressing negative emotions through behaviors rather than word (Often extreme)

Question 42

Neurobiology of BPD (6) 1. Over/under activation of the threat system including the amygdala, which mediates (2) 2. Over/under activation of the sympathetic nervous system, which mediates ______ or _______ response 3. Over/under activation of the prefrontal cortex, which mediates (3) 4. Reward system has ______ _____ _______ in between rewarding stimuli/non-rewarding stimuli 5. Volume increase/reduction in hippocampus and amygdala 6. High/Low oxytocin levels in people with BPD/caregivers

Answer 42

1. Over, (1) Fear, (2) Anxiety 2. Over, Flight or fight 3. Over, (1) executive functioning, (2) emotion regulation, (3) behavioral inhibition 4. Less clear difference 5. Volume reduction 6. Low

Question 43

Oxytocin is a hormone released from the _______ gland, and mediates (2).

Answer 43

Pituitary gland, mediates: 1. threat sensitivity 2. social bonding

Question 44

Low oxytocin levels predicts 1. High/low threat sensitivity 2. High/low levels of affection Toward children

Answer 44

1. High 2. Low

Question 45

Low levels of affection likely contribute to High/low traits of insecure attachment

Answer 45

High rates

Question 46

People with BPD may have what kind of attachment styles (3)

Answer 46

1. Avoidant 2. Anxious 3. Dismissive

Question 47

Treatment of BPD (4)

Answer 47

1. Dialectical behavioral therapy 2. Insight-oriented therapy 3. Exogenous oxytocin 4. SSRI’s

Question 48

Dialectical behavior therapy (DBT) is a form of ______ ______ _______ that emphasizes (4)

Answer 48

CBT! 1. Mindfulness 2. Distress tolerance 3. Interpersonal effectiveness 4. Emotion regulation

Question 49

Interpersonal effectiveness i.e

Answer 49

Asking for what you want from others and setting boundaries with others

Question 50

DBT often involves “_______ _______” over the telephone between psychotherapy sessions

Answer 50

Crisis coaching

Question 51

Insight oriented therapy - a _______ relationship that can help promote (2)

Answer 51

Therapeutic 1. More secure attachment style 2. Stabilization of identity

Question 52

Exogenous oxytocin’s can help by (2)

Answer 52

1. Lowering threat sensitivity 2. Promote social bonding

Question 53

SSRI’s can help by contributing to better _____ ______ but is still controversial

Answer 53

Mood stability