Personality disorders Flashcards
(46 cards)
What are personality disorders?
Enduring forms of psychopathology based in personality traits
Unlike clinical syndromes, PD’s do not wax and wane
PDs must be present from…
adolescence or early adulthood into adulthood
Which DSM introduced the multiaxial system?
DSM III
- Personality disorders are assignned to axis II
- Abandoned in DSM-5
In the DSM-4
PDs were in their own category - axis II along w intellectual disabilities, etc
In the DSM-5
- Diagnosed the same way as other clinical syndromes
PD implications?
- PD influences course or outcome of other mental disorders
- PDs stable
- PD diagnoses allow for a rationale for longer term treatment
- Requires more long term treatment and different treatment approach
When are PDs usually diagnosed?
Not till late adolescence/ early adulthood. This is when personality crystallises.
Which approach/view of PDs is being pushed in the field?
Dimensional model
- PDs as extreme variant of normal personality - not just one aspect, but multiple dimensions where one is falling on the extreme
- Difficulties of degree rather than kind; problems of degree= dimensions, kind=categories
What is the categorical model of PDs?
- People w PDs are qualitatively different people, qualitatively different conditions
Dimensional approach to PD diagnosis
- We should adopt approach to diagnosis analogous to intellectual disability
- Extreme degree on dimension (e.g. intelligence) + impairment in function -> disorder
DSM-5 Section III PD model proposed?
Criterion A: Impairments in self and interpersonal functioning
- Level of Personality Functioning Scale LPFS: identity, self-direction, empathy, and intimacy
Criterion B: Personality profile
- Personality types consistent with DSM-IV but defined by trait profiles
5 Broad Domains of Personality in DSM-5?
Five Personality Trait Domains
- Negative affectivity (vs. emotional stability)
- Detachment (vs. extraversion)
- Antagonism (vs. agreeableness)
- Disinhibition (vs. conscientiousness)
- Psychoticism (vs. lucidity)
Proposed DSM-5 Section III PD model example: APD
Criterion A. Impairment on self- and interpersonal functioning
- Get into serious legal or related trouble (self)
- Unable to form close meaningful relationships with others (interpersonal)
Criterion B. Pathological personality traits in the following domains:
- Antagonism and disinhibition
Why was the proposed dimensional model not adopted as the sole means of diagnosis?
- Lack of agreement on appropriate personality dimensional framework
- Was however included in section III; categorical diagnosis + dimensional rating
Current PD model in DSM-5?
- Retention of previous PDs in DSM-5
- Dimensional model included as “Alternative DSM-5 Model for PDs”
General diagnostic criteria for PDs
A) An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas:
- Cognition
- Affectivity
- Interpersonal functioning
- Impulse control
B) The enduring pattern is inflexible across a broad range of personal and social situations
C) Clinically significant distress or impairment
D) Pattern is stable and can be traced back at least to adolescence or to early adulthood
E) Not better accounted for as a manifestation or consequence of another disorder
F) Not due to substance or medical condition
Personality traits must be ____, ___, and _____, to count as PDs
Inflexible, maladaptive, cause functional impairment and/or distress
_____ must be considered in diagnosing PDs (4)
Ethnic, cultural, religious, social background
In the DSM 5, there are ___ PDs organised into ___ clusters
10 PDs, 3 clusters
A - Paranoid, Schizotypal, Schizoid
B - Borderline, Antisocial, Narcissistic, Histrionic
C - Avoidant, Dependent, Obsessive-compulsive
Characteristics of Paranoid Personality Disorder
- Suspicious of almost all people in almost all situations
- Hypersensitive to criticism
- Reluctant to confide in others - affects relationships
- Differs from SZ - no hallucinations/delusions/etc
- Perceived as cold, humourless, devious, scheming
- Bears grudges, reads into things
Characteristics of Schizotypal Personality Disorder
- Pervasive pattern of social and interpersonal deficits marked by discomfort with/reduced capacity for close relationships
- As well as by cognitive and perceptual distortions, eccentric behaviours
- Odd beliefs or magical thinking
- May express beliefs in things beyond cultural norms
- Suspicious/ paranoid
Characteristics of Schizoid Personality Disorder
- Detached from others; different from paranoid type who are afraid
- vs. simply lack of interest
- Unable to experience social warmth or form strong attachments
- Display constrict affect
- Can be successful in work if it requires little social contact
- Lack odd behaviours, thoughts, speech, or experiences of schizotypal PD
- Perceived as aloof, cold, distant
Cluster A PDs
Men > Women
Schizotypal most prevalent - also, some go on to develop schizophrenia
_______ have increased prevalence in relatives of individuals w schizophrenia
Schizotypal and schizoid PD