Personality Disorders Flashcards by Julia Verberk

What is personality

Unique combination of relatively consistent traits and characteristics that psychologically distinguish one person from another

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Identity

Sense of self
- Can be stable and distinct from others

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Core aspects of personality

Identity and ability to relate to others

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Traits

Enduring predispositions that influence our behaviour across situations

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The five factor model

Openness
Conscientiousness
Extraversion
Agreeableness
Neuroticism

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General Definition of Personality Disorder

Long-term, rigid, wide-ranging pattern of thoughts, feelings, behaviour causing dysfunction

Generally noticeable by adolescence or young adulthood
- Can emerge as early as childhood
- Typically, not diagnosed until adulthood
- If diagnosed in adolescence must be present for 1 year
Very resistant to treatment

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Prevalence of personality disorders in USA

11% of adults

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Current types of Personality Disorders

CLUSTER A
- Paranoid personality disorder
- Schiziod personality disorder
- Schizotypal personality disorder
CLUSTER B
- Antisocial personality disorder
- Histrionic personality disorder
- Narcissistic personality disorder
- Emotionally unstable personality disorder
CLUTSTER C
- Avoidant personality disorder
- Obsessive compulsive personality disorder
- Dependent personality disorder

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Alternative Model to personality disorders

Not currently used
Continuum approach
Appears to be general personality pathology factor
Impairment in personality functioning and pathological personality traits

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Steps of diagnosing personality disorders

Step 1: Assess impairment in personality functioning
Step 2: Assess pathological personality traits
Step 3a: Apply criteria A and B specific personality disorders
Step 3b: Apply criteria A and B personality disorder-trait specified
Step 4: Apply other inclusion and exclusion criteria

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Step 1 of diagnosing personality disorders

ASSES IMPAIRMENT IN PERSONALITY FUNCTIONING
- Self: identity, self direction
- Interpersonal: empathy, intimacy
- generalized severity most important for determining current and future functioning
- Must score moderate of higher to meet criteria for any personality disorder

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Step 2 of diagnosing personality disorders

ASSESS PATHOLOGICAL PERSONALITY TRAITS
- Negative affectivity, detachment, antagonism, disinhibition, psychoticism (The bad five)

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Step 3 of diagnosing personality disorders

APPLY CRITERIA A AND B FOR SPECIFIC PERSONALITY DISORDERS AND TRAIT SPECIFIED DISORDERS
- Which disorder? or diagnosis of PD-trait specified

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Step 4 of diagnosing personality disorders

APPLY OTHER INCLUSION AND EXCLUSION CRITERIA
Are personality problems:
1. Inflexible and pervasive across situations
2. Stable across time, with onset at least adolescence or early adulthood
3. Not better explained by another disorder
4. Not due to substance use or other medical condition
5. Not explained by developmental stage or sociocultural environment

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Schizotypal Personality Disorder

Lifelong patterns of odd or peculiar behaviours driven by odd beliefs
Associated Features:
- Social isolation
- Suspiciousness + paranoia
- Preoccupation with bizarre fantasies
- Ideas of reference
- Cognitive + perceptual dysregulation
- Restricted range of emotions

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prevalence of schizotypal personality disorder

4.6%

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Biological theories of schizotypal personality disorder

Heritability: 82%
Similar genetic traits and neurological abnormalities to schizophrenia
dysregulation in dopamine
reduction in gray matter in temporal lobe
perhaps no impact to PFC
Similar cognitive deficits to schizophrenia

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Psychosocial theories of schizotypal personality disorder

Abuse or parent abuse, substance use, jail time

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Borderline Personality Disorder

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Instability of emotions, interpersonal relationships, and image
- Emotion dysregulation: impulsivity when upset, low emotional understanding, unwillingness to accept emotions
- Extreme sensitivity to perceived interpersonal slights
- Over-reliance on others, worries about rejection and abandonment

Prevalence of Borderline personality Disorder

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1.7% general population, 15-28% clinical population
- Increased risk in low SES, early puberty, more distress when young
- Women over men in clinical populations only

Is borderline personality disorder chronic

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Yes
- However 85% show remission in 10-15 years (better functioning but still affected)
- Relapse common

Biological theories of borderline personality disorder

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Heritability = 32-72%
Smaller amygdala and hippocampus
Structural and metabolic deficits in PFC

Emotional theories of borderline personality Disorder

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Difficulties with emotional regulation
- Less willingness to tolerate emotional distress
- Greater variability in mood
- More negative emotional baseline and slower return to emotional baseline

Psychosocial theories of borderline personality disorder

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Childhood instability and parental psychopathology
Childhood neglect and abuse
History of emotional invalidation (Causes difficulty with understanding, accepting and controlling emotions, rely on others too much and use indirect strategies to seek support)

Cognitive theories of borderline personality disorder

- Hyperattention to negative emotional stimuli - Memories are more negative - More negatively biased interpretations - Rumination - Negative views of others and of relationships - May not differentiate view of themselves from view of others

Splitting

Viewing self and others as all good or all bad, cycling through these views - Leads to instability in relationships - Characteristic of borderline personality disorder

Narcissistic Personality Disorder

Broad patterns of grandiosity, need for admiration, lack of empathy - Exaggeration of achievements and talents - May react strong to criticism Shallow relationships, emotional expressions - May be overly choosy about who they associate with - Charming, yet difficulty with long term relationships - Exploit others to gain power; controlling overbearing Some experience covert feelings in inadequacy

Prevalence of narcissistic personality disorder

6.2% of adults

Biological theories of narcissistic personality disorder

33-59%

Psychosocial theories of narcissistic personality disorder

Differences in upbringing - Unrealistically positive assumptions - Narcissism as a response to rejection or unmet emotional needs History of childhood adversity - Physical abuse and neglect - Parents that have experienced abuse - Parents with psychopathology

Antisocial Personality Disorder

- Pervasive patterns of disregard for and violation of the rights of others - Considered both personality and a conduct disorder - Gratifying own desires, violation of major social norms - Poor impulse control, high thrill seeking - Must be evident by patterns of disordered conduct before the age of 15

Prevalence of Antisocial personality disorder

1-4%

Psychopathy

Superficial charm, grandiose sense of self-worth, patterns of deceitfulness, manipulative, lack of remorse

Sociopath

A label used to describe a person whose psychopathic traits are assumed to be due to environmental factors

Biological theories of Antisocial personality disorder

- Heritability: 38-69% - Implications for serotonin system - Differences in PFC (abstract reasoning, concentration, goal formation, planning, self-awareness) - Differences in amygdala - Differences in striatum - Low arousability (low resting heart rate, low skin conductance, excessive slow-wave EEG patterns, leads to low fear, stimulation seeking)

Psychosocial theories of antisocial personality disorder

- Child abuse and neglect - Modeling of antisocial behaviour - Lack of punishment or being rewarded for antisocial behaviour

Avoidant Personality Disorder

Excessive avoidance of interpersonal interactions - Feelings of inadequacy (prone to shame and low self-esteem, feel inferior and socially inept) - Fears of criticism and rejection (will avoid situations where criticism is possible, assume everything they do is wrong) Negative affectivity and detachment - Appear shy inhibited, nervous Social isolation and loneliness

Prevalence of avoidant personality disorder

1.5-2.5%

Biological theories of avoidant personality disorder

Heritability about 64%

Psychosocial theories of avoidant personality disorder

Emotional neglect, lower standards of care Rejection early in life - Parents less affectionate, more guilt-engendering, less encouraging

Cognitive theories of avoidant personality disorder

Expectations of rejection Discount positive feedback

Obsessive-Compulsive Personality disorder

- Pervasive patterns of inflexibility and preoccupation with orderliness, perfection and control - Interpersonal difficulties (rigidly bound to rules, stubborn, difficulty appreciating others, sensitive to flaws, relate to others in terms of status) - Excessive commitment to work and productivity (bare self-esteem on productivity and meeting unreasonably high goals, difficulty with perfectionism) - Persist even if their approach is failing - Grim, strict, tensely in control of their emotions, lack spontaneity

Prevalence of obsessive-Compulsive personality disorder

2-8% prevalence in USA

Biological theories of obsessive-Compulsive personality disorder

Heritability: 27-78% - Reduced grey matter volume including PFC

Cognitive theories of obsessive-Compulsive personality disorder

Intolerance to flaws

Psychosocial theories of obsessive-Compulsive personality disorder

History of physical neglect

Personality Disorders Flashcards

(46 cards)