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Personality Disorders Flashcards

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1
Q

PERSONALITY DISORDERS

A 
Characterized by inflexible and enduring behavior patterns that impair social functioning
• Symptoms are pervasive &
persistent
• People with PDs experience
difficulties with their identity
and relationships
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2
Q

DSM APPROACH TO CLASSIFICATION: Cluster A

A

Odd or eccentric behavior

  • paranoid
  • schizoid
  • schizotypal
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3
Q

DSM APPROACH TO CLASSIFICATION: Cluster B

A

Dramatic, emotional, or erratic behavior

  • antisocial
  • borderline
  • histrionic
  • narcissistic
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4
Q

DSM APPROACH TO CLASSIFICATION: Cluster C

A

Anxious or fearful behavior

  • avoidant
  • dependent
  • obsessive compulsive
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5
Q

3 Personality Disorders

A

Paranoid PD
Schizoid PD
Schizotypal PD

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6
Q

Schizotypal PD

A

DIstorted reality

  • Odd ideas
  • Eccentricity
  • Unusual experiences
  • Superstition, religiosity
  • suspiciousness
  • reclusiveness
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7
Q

Schizoid PD

A

Social Withdrawal

  • Aloof
  • Uninterested in others
  • Solitary
  • unaffected by praise and criticism
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8
Q

Paranoid PD

A

Delusional/Paranoid

  • Paranoia
  • Distrustful
  • Doubts Loyalty
  • Keeps grudges
  • Easily offended
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9
Q

Paranoid PD: DSM-5 Criteria

A

Presence of 4 or more symptoms of distrust and suspiciousness:

  • Unjustified suspiciousness of being harmed, deceived, or exploited
  • Unwarranted doubts about the loyalty or trustworthiness of friends or associates
  • Reluctance to confide in others because of suspicions
  • Tendency to read hidden meanings into the benign actions of others
  • Bears grudges for perceived wrongs
  • Angry reactions to perceived attacks on character or reputation
  • Unwarranted suspiciousness of partner fidelity
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10
Q

Schizoid PD: DSM-5 Criteria

A

Presence of 4 or more symptoms of interpersonal detachment & restricted emotion:
• Lack of desire for or enjoyment of close relationships
• Almost always prefers solitude to companionship
• Little interest in sex
• Few or no pleasurable activities
• Lack of friends
• Indifference to praise or criticism
• Flat affect, emotional detachment, or coldness

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11
Q

Schizotypal PD: DSM-5 Criteria

A

Presence of 5 or more of the following peculiar patterns:
• Ideas of reference (i.e., belief that ordinary events have particular meaning for them
personally)
• Odd beliefs or magical thinking, (i.e., belief in extrasensory perception)
• Unusual perceptions
• Odd thought and speech
• Suspiciousness or paranoia
• Inappropriate or restricted affect
• Odd or eccentric behavior or appearance
• Lack of close friends
• Social anxiety and interpersonal fears that do not diminish with familiarity

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12
Q

ETIOLOGY OF CLUSTER A PDS

A

highly heritable

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13
Q

causes of Schizotypal PD

A

• Early trauma & adversity
• Genetic vulnerability for schizotypal PD appears to be similar to that of
schizophrenia
• Relatives of those with schizophrenia are at increased risk for schizotypal PD
• Deficits in cognitive & neuropsychological functioning are similar (but milder) than
those in schizophrenia
• Enlarged ventricles & less temporal lobe gray matter (similar to those with
schizophrenia)

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14
Q

4 disorders in Cluster B

A
  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder
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15
Q

Antisocial Personality Disorder

A

• Aggressive, impulsive, callous
• Report history of truancy, running from home, lying, theft, arson,
deliberate destruction of property by early adolescence
• Law-breaking, physical aggression, defaulting on debts, being reckless,
little regard for truth, little remorse for actions which hurt others as adults
• ASPD is more common in men than women
• ¾ of those with ASPD meet diagnostic criteria for another disorder,
commonly substance use disorder
• ¾ of felons meet diagnostic criteria for ASPD

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16
Q

Antisocial Personality Disorder: DSM-5 Criteria

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A
  • Age at least 18
  • Evidence of conduct disorder before age 15

Pervasive pattern of disregard for the rights of others since the age of 15 as shown by at least 3 of the following:
• Repeated law breaking
• Deceitfulness, lying
• Impulsivity
• Irritability and aggressiveness
• Reckless disregard for own safety and that of others
• Irresponsibility as seen in unreliable employment or financial history
• Lack of remorse

17
Q

Antisocial Personality Disorder: Etiology

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A

• Genetic:
• - - Heritability of criminality (not necessarily of ASPD)
• - - Psychopathy MAY be more heritable???
• Structural:
• - - Defects in prefrontal cortex (planning, conscience, interpretation, understanding consequences)
• - - Underarousal Hypothesis:
• = = = = Exhibit deficient response to aversive emotional arousal
• = = = = Less anxiety when anticipating punishment and slower response to avoid punishment
• = = = = Failure to acquire conditioned reactions necessary for punishment avoidance, conscience development, etc.
=> limited learning from experience and minimal guilt or remorse for transgressions
• = = = = Low HPA and Hypoactive Amygdala
• Environmental:
• - - High levels of dysfunction and violence in family of origin leading to poor capacity for empathy and impulse
control.

18
Q

Antisocial Personality Disorder: Etiology

Study These Flashcards
A

• G x E: diathesis-stress model
• G factors
• - - Polymorphism of MAO-A gene
• E factors
• - - Physical abuse, high negativity, low warmth, parental inconsistency
• - - Poverty and exposure to violence (even without genetic vulnerability)
• Fearlessness in psychopathy
• - - Iykken (1957): ‘psychopaths’ fail to learn from punishment because they are fearless
• - - Lorber (2004): a ‘psychopath’s’ skin-conductance is less reactive when confronted with
aversive stimuli

19
Q

Borderline Personality Disorder

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A
  • Impulsivity and instability in relationships and mood
  • Overly sensitive to small signs of emotions in others
  • Often no coherent sense of self
  • Recurrent suicidality very common
  • Often comorbid with PTSD, mood disorders, substance use, eating disorders
20
Q

Borderline Personality Disorder: DSM-5 Criteria

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A

Presence of 5 or more of the following signs of instability in relationships, self-image, and
impulsivity from early adulthood across many contexts:
• Frantic efforts to avoid abandonment
• Unstable interpersonal relationships in which others are either idealized or devalued
• Unstable sense of self
• Self-damaging, impulsive behaviors in at least two areas, such as spending, sex,
substance abuse, reckless driving, and binge eating
• Recurrent suicidal behavior, gestures, or self-injurious behavior (e.g., cutting self)
• Marked mood reactivity
• Chronic feelings of emptiness
• Recurrent bouts of intense or poorly controlled anger
• During stress, a tendency to experience transient paranoid thoughts and dissociative
symptoms

21
Q

Borderline Personality Disorder: Etiology

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A
  • Genetic and neurobiological
    • -Genes account for 60% or more of the variance in the development of BPD
      • First-degree relatives of patients with BPD have high rates of disorders related to impulsivity
      • Serotonin and amygdala abnormalities
      • Low levels of activity and structural changes in prefrontal cortex (specifically, the anterior cingulate cortex)
  • Social factors
      • Childhood abuse
      • Linehan’s Diathesis-Stress Theory
  • = = = = Difficulty controlling emotions (diathesis) and raised in family environments where feelings are disrespected and devalued
  • = = = = Parents only pay attention to the kid when there is an emotional outburst, which further reinforces the behavior
22
Q

Borderline Personality Disorder: Treatment

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A

• Very hard to treat
• Antidepressants and mood stabilizers to quell mood symptoms and impulsivity if
need be
• Dialectical behavioral therapy (DBT)
• - - Combines client-centered empathy and acceptance with cognitive-behavioral problem solving, emotion-regulation techniques, and social skills training
• - - Mentalization-based therapy that focuses on thinking about their own and others’ feelings
• - - Schema-focused cognitive therapy identifies maladaptive assumptions that underlie cognitions

23
Q

Histrionic Personality Disorder

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A
  • Histrionic means dramatic or theatrical
  • Speech that is excessively impressionistic and lacks detail
  • Use appearance features to draw attention to themselves
  • Self-centered
  • Highly comorbid with depression, BPD, and medical problems
24
Q

Histrionic Personality Disorder: DSM-5 Criteria

Study These Flashcards
A

Presence of 5 or more of the following signs of excessive emotionality and attention
seeking from early adulthood across many contexts:
• Strong need to be the center of attention
• Inappropriate sexually seductive behavior
• Rapidly shifting and shallow expression of emotions
• Use of physical appearance to draw attention to self
• Speech that is excessively impressionistic and lacking in detail
• Exaggerated, theatrical emotional expression
• Overly suggestible
• Misreads relationships as more intimate than they are

25
Narcissistic Personality Disorder
• Grandiose view of themselves, preoccupied with fantasies of greatness • Very self-centered, requires almost constant attention • Difficulty with interpersonal relationships • - -Lacks empathy • - -Uses others for personal gain rather than interpersonal warmth or connection • - -Feelings of entitlement • Overconfident to hide underlying vulnerability to criticism • Can be comorbid with BPD
26
Narcissistic Personality Disorder: DSM-5 Criteria
Presence of five or more of the following signs of grandiosity, need for admiration, and lack of empathy from early adulthood across many contexts: • Grandiose view of one’s importance • Preoccupation with one’s success, brilliance, beauty • Belief that one is special and can be understood only by other high-status people • Extreme need for admiration • Strong sense of entitlement • Tendency to exploit others • Lack of empathy • Envious of others • Arrogant behavior or attitude
27
Narcissistic Personality Disorder: Etiology
* Parenting * - - Overindulgence, foster children’s belief that they are special * Self-psychology model * - - Qualities of self-importance and greatness mask very fragile self-esteem * - - Evidence to suggest that these people experience shame more frequently than others * Social cognitive model * - - These people have fragile self esteem so they use others to bolster their self esteem * - - Personal interactions are a way to bolster self esteem rather than gain warmth or closeness * - - Brag a lot a put people down who did better than them
28
CLUSTER C – 3 Personality Disorders
* Avoidant Personality Disorder * Dependent Personality Disorder * Obsessive-Compulsive Personality Disorder
29
Avoidant Personality Disorder
- Inferiority - Social Withdrawal - Shyness - Avoidance - Embarrassment - Low self-esteem
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Dependent Personality Disorder
- Indecision - Clinginess - Passivity - Requiring reassurance - Fear of aloneness
31
Obsessive-Compulsive Personality Disorder
- Needs rules and organization - Perfectionistic - Excessively moral - Constantly productive - Rigid
32
Avoidant Personality Disorder: DSM-5 Criteria
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism as shown by 4 or more of the following from early adulthood across many contexts: • Avoidance of occupational activities that involve significant interpersonal contact, because of fears of criticism or disapproval • Unwilling to get involved with people unless certain of being liked • Restrained in intimate relationships because of the fear of being shamed or ridiculed • Preoccupation with being criticized or rejected • Inhibited in new interpersonal situations because of feelings of inadequacy • Views self as socially inept, unappealing or inferior • Unusually reluctant to try new activities because they may prove embarrassing
33
Avoidant Personality Disorder: Etiology
Little known about the etiology of this disorder • Perhaps from being taught, through modeling, to fear people and situations that others would regard as harmless • Likely similar etiology to SAD
34
Avoidant Personality Disorder: Treatment
Similar to treatment for SAD | • Antidepressant medications along with CBT
35
Dependent Personality Disorder: DSM-5 Criteria
An excessive need to be taken care of, as shown by the presence of at least 5 of the following from early adulthood across many contexts: • Difficulty making decisions without excessive advice and reassurance from others • Need for others to take responsibility for most major areas of life • Difficulty disagreeing with others for fear of losing their support • Difficulty doing things on own or starting projects because of lack of self-confidence • Doing unpleasant things as a way to obtain the approval and support of others • Feelings of helplessness when alone because of fears of being unable to care for self • Urgently seeking new relationship when one ends • Preoccupation with fears of having to take care of self
36
Dependent Personality Disorder: Etiology
``` Etiology is not known • Overprotective parenting • Reinforces child’s need for dependency • Authoritarian parenting • Limit opportunities for child to develop feelings of self-efficacy ```
37
Obsessive-Compulsive Personality Disorder: DSM-5 Criteria
Intense need for order, perfection, and control, as shown by the presence of at least 4 of the following from early adulthood across many contexts: • Preoccupation with rules, details, and organization to the extent that the point of an activity is lost • Extreme perfectionism interferes with task completion • Excessive devotion to work to the exclusion of leisure and friendships • Inflexibility about morals and values • Difficulty discarding worthless items • Reluctance to delegate unless others conform to one’s standards • Miserliness • Rigidity and stubbornness
38
Obsessive-Compulsive Personality Disorder
Distinct from OCD since OCPD does not include the obsessions and compulsions that define OCD • Usually co-occurs with OCD • Etiology is unknown • Possible overlapping genetic vulnerability with OCD
39
GENERAL TREATMENT OF PD
* Many people with PDs enter treatment for a condition other than their PD * 52% of clients recover from personality disorders within about 15 months of treatment * Psychodynamic: aim to alter the patient’s present-day views of the childhood problems assumed to underlie the PD * Cognitive (mostly attributed to Beck): analyzed in terms of negative cognitive beliefs that could help explain the pattern of symptoms

Abnormal Psych (2 decks)

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