test 4 Flashcards
(22 cards)
- What does it mean that BPD has been referred to as a disorder of “stable instability”? In what ways are individuals with BPD “unstable”?
there is instability of mood inappropriate or intense anger, rapidly changing negative emotions - often in response to interpersonal stress.
instability of self image,
instab;e interpersonal relationships
destructive impulsivity
stern and knight, where does the term borderline come from
stern says it reflects his view that it did not fit the existing classification system
knight said that it was not just the border of neurosis but the border of neurosis and psychosis
women and borderline
apa said 75% but we think this is bias boy who shows up, conclusion that there is no Dif
what do lineman and gunderson consider to be the core features of bpd
linehan - affective instability. dysthymic baseline mood - emotional instability is secondary that results from instability in the self structure
gunderson: fear and intolerance of aloneness are central
linehans biosocial theory
bpd results when biological or temperamental vulnerabilities interact with failures in the child’s social environment - causing or excacterbating emotion regulation problems.
more specifically high levels of sensitivity to negative emotions, high emotional reactivity, a slow return to baseline after becoming emotionally aroused are precursors
With a good support asystem the vulnerable child may be fine.
the key environmental feature is an invalidating family environment.
what types of negative life events characterize the youth of those with bpd, what is the main problem with almost all of the studies that look at this
trauma and early adversity, problems with attachment in close relationship
one problem is that they are retrospective reporting which is bias
Know the different forms of executive neurocognition and know the associated findings that link deficits in these area to BPD.
Executive neurocognition is being able to delay or terminate a given response cognitive or motor for the purpose of achieving another goal that is less immediate.
When we make a conscious deliberate effort to control our attention or motor behavior - interference control
Stroop task
Cognitive inhibition: the ability to suppress information from working memory
Directed forgetting task. Remember words follopwed by an r forget the words followed by an f. After the task the subjects are required to recall all the words presented to them
Behavioral inhibition: go no go task
‘Motivational or affective inhibition: emotional stroop - this requires the purposeful interruption of a tendency or a behavior that results from a particular motivational-emotional state. Passive avoidance task learning what is rewarded and punished.
Inhibitory deficits are involved in inattention, impulsivity, and problems with affect regulation. The clinical presentation of BPD therefore makes it reasonable to expect that people with this disorder would sho impairments on neurocognitive tasks requiring inhibition. Reaserch shows this
which six of cleckley have the strongest influence
superficial charm and good “intelligence”
lack of remorse or shame
inadequately motivated antisocial behavior
poor judgement and failure to learn by experinece
pathological egocentricity and incapacity for love
unresponsiveness in general interpersonal relations
personality
regularities and consistencies in behavior, thinking, perceiving, and feeling. stable across situation and time, integrated and cohesive, requires some sort of beginning in childhood
what are the four criterion of general personality disorder
an enduring pattern of inner experience and behavior 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.
the enduring pattern is inflexible and pervasive
the enduring pattern leads to clinically significant distress of impairment
the pattern is stable and of long duration and can be tracked back to adolescents or early childhood
cluster a
odd eccentric: paranoid, schizotypal, schizoid
behaviors are similar to schizophrenia: flat affect, odd thought or speech patterns
they differ on their grasp on reality
paranoid pd
paranoia in one aspect or situation
schizotypal pd
symptoms of schizophrenia not sever enough to warrant a diagnosis
mild perceptual and cognitive distortions, odd beliefs, unusual perceptual experiences,
odd/ eccentric behaviors: odd speech patterns
Discomfort with and deficits in interpersonal relations: wants close relationships but often avoids them
schizoid
flat affect, detached and indifferent
cluster b
dramatic emotional
histrionic, antisocial, narcissistic, borderline
manipulative and potentially uncaring, emotional dysregulation, inappropriately sexual
histrionic pd
exaggerated emotionality that lacks depth, emotions are shallow and shift rapidly, discomfort when not center of attention (constantly seeks reassurance, approval and prais), inappropriately sexual and seductive behavior - extreme focus on appearance
Cognitive behavior models of Histrionic PD
Core beliefs:
Self: if I can’t entertain people they will abandon me, other: if other people don’t respond to me they are rotten
Learning history: selective interpersonal reinforcement by family and peer relationships leads to excessive attention seeking behaviors
Antisocial PD
Disregard for and violation of the rights of others, Failure to conform to social norms with respect to lawful behavior, Deceitfulness, Impulsivity or failure to plan ahead, Irritability and aggressiveness, Reckless disregard for the safety of others, Consistent irresponsibility, Lack of remorse for behaviors
more genetic than environmental
passie or neglectful parenting or overluharsh
learning deficits
can’t be bored, chronic levels of low arousal
cluster c
anxious-fearful: extreme concern of criticism and abandonment that leads to impaired relationships
avoidant pd, dependent pd, ocdpd
Avoidant personality disorder:
severe social anxiety disorder
Feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Avoidance of activities of daily living (like work) involving people for fear of criticism or rejection. Low self-esteem and social isolation
Dependent personality disorder:
low self efficacy
Feel helpless, dependent, submissive, reassurance seeking, and have difficulty making independent decisions. Avoidance of adult activities and tolerance of abuse and maltreatment
Power differentials are great, but within their limits - at the heart of abusive relationships is an unfair power differential
Obsessive compulsive personality disorder
a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, this is control disorder, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety context as indicated by four or more of the following
