Week 21 Flashcards

Question

How does the DSM-5 address the limitations of Anti-social personality disorder (ASPD) and psychopathy, and what is its new approach?

Answer 1

The DSM-5 maintains the diagnosis of ASPD but introduces a dimensional-trait approach to personality pathology. This approach aims to include a broader understanding of personality traits beyond antisocial behaviors, attempting to address previous criticisms that earlier editions didn’t adequately cover the emotional and interpersonal components of psychopathy.

Answer 2

The PCL-R is a 20-item tool used in correctional and forensic settings to diagnose psychopathy. It captures interpersonal-affective deficits and behavioral deviance, and is more aligned with McCord & McCord’s predatory-aggressive view of psychopathy, focusing on impulsive, aggressive behavior, and a lack of empathy, rather than Cleckley’s focus on emotional pathology.

Answer 3

The two subdimensions are: - Interpersonal-affective factor: Linked to narcissism, low empathy, proactive aggression, social assertiveness, and low fear. - Antisocial deviance factor: Associated with impulsiveness, sensation-seeking, alienation, mistrust, substance use, and reactive aggression.

Answer 4

The interpersonal-affective factor is related to narcissism, low empathy, proactive aggression, and adaptive traits (e.g., low distress and depression). The antisocial deviance factor is associated with maladaptive tendencies like impulsivity, antisocial behavior, and substance-related problems. While moderately correlated, they show contrasting relationships with external outcomes.

Answer 5

The PPI is a self-report measure used to assess psychopathy in noncriminal adults. It focuses on personality dispositions related to historic conceptions of psychopathy, with 154 items organized into eight facet scales. The PPI assesses both interpersonal-affective features and antisocial deviancy.

Answer 6

1. Fearless dominance (FD): Reflects social potency, stress immunity, and fearlessness. It is associated with positive psychological adjustment (e.g., lower anxiety, higher well-being). 2. Self-centered impulsivity (SCI): Reflects egocentricity, exploitiveness, hostile rebelliousness, and lack of planning. It correlates with antisocial behaviors, impulsivity, and aggression.

Answer 7

The two factors are uncorrelated and show distinct external correlates: PPI-FD (fearless dominance): Associated with positive adjustment (e.g., well-being, lower anxiety) and low empathy. PPI-SCI (self-centered impulsivity): Linked to maladaptive behaviors like impulsivity, aggression, substance abuse, and emotional distress.

Answer 8

PPI-FD is seen as a more adaptive expression of fearlessness (boldness), associated with higher well-being and less anxiety, while the interpersonal-affective factor of the PCL-R is considered a more pathological form of fearlessness, often associated with antagonistic traits.

Answer 9

The interpersonal-affective factor of the PCL-R (Psychopathy Checklist-Revised) refers to a set of traits related to how individuals interact with others emotionally and socially. This factor includes characteristics such as manipulativeness, lack of empathy, shallow emotions, and superficial charm. It highlights the emotional coldness and interpersonal deficits that psychopaths may exhibit. This factor focuses on the person’s ability to manipulate, deceive, or fail to connect emotionally with others, showing a lack of remorse or guilt for harmful behaviors.

Answer 10

"Callous-unemotional" traits refer to characteristics such as low empathy, lack of remorse or guilt, shallow affect, and lack of concern for school performance or other responsibilities. These traits are linked to more severe and persistent conduct problems.

Answer 11

The APSD assesses psychopathic tendencies in children (ages 6-13), focusing on two main factors: Callous-Unemotional (CU) traits (emotional insensitivity and disregard for others) and Impulsive/Conduct Problems (I/CP) (impulsivity, behavioral deviancy, and inflated self-importance).

Answer 12

Children with high CU traits tend to have average or above-average intelligence, low anxiety, low emotional reactivity, and engage in planned and reactive aggression. In contrast, children with high I/CP traits typically show below-average intelligence, high emotional reactivity, and reactive aggression.

Answer 13

Callous-unemotional traits moderate the expression of conduct disorder, leading to more persistent and severe behavioral issues, including high levels of premeditated aggression and more persistent violent behavior over time. The DSM-5 will include criteria for a distinct Callous-Unemotional (CU) variant of child conduct disorder, reflecting the importance of CU traits in predicting more severe conduct issues.

Answer 14

Model formulated to reconcile alternative historic conceptions of psychopathy and differing methods for assessing it. Conceives of psychopathy as encompassing three symptomatic components: boldness, involving social efficacy, emotional resiliency, and venturesomeness; meanness, entailing lack of empathy/emotional-sensitivity and exploitative behavior toward others; and disinhibition, entailing deficient behavioral restraint and lack of control over urges/emotional reactions.

Answer 15

The three constructs in the Triarchic model are: Disinhibition - impulsiveness, weak behavioral restraint, hostility, mistrust, and emotional regulation difficulties. Meanness - lack of empathy, contempt toward others, predatory behavior, and empowerment through cruelty. Boldness - dominance, social assurance, emotional resiliency, and venturesomeness.

Answer 16

Cleckley’s conception emphasizes boldness and disinhibition, while criminal conceptions (e.g., PCL-R, APSD) focus more on meanness and disinhibition. The Triarchic model posits that individuals high in boldness or meanness in addition to disinhibition would warrant a diagnosis of psychopathy.

Answer 17

The TriPM is an inventory designed to measure the three constructs of the Triarchic model: Disinhibition, Meanness, and Boldness. It contains 58 items divided into subscales for each construct and has demonstrated promising convergent and discriminant validity. The TriPM includes: 1. Disinhibition (20 items) – assesses impulsivity and emotional dysregulation, sourced from the Externalizing Spectrum Inventory. 2. Meanness (19 items) – assesses lack of empathy and cruel tendencies, also sourced from the Externalizing Spectrum Inventory. 3. Boldness (19 items) – assesses fearless social, emotional, and activity preferences, developed based on the Fearless Dominance (FD) factor from the PPI.

Answer 18

The TriPM is important for its focus on the multidimensional aspects of psychopathy. It has shown promising validity in distinguishing the components of psychopathy, and the inventory is freely available online with translations in multiple languages. Ongoing research continues to validate its effectiveness in assessing psychopathy.

Answer 19

1. Core deficits in emotional sensitivity or responsiveness 2. Basic impairments in cognitive-attentional processing

Answer 20

Individuals with high levels of psychopathy often show a lack of normal enhancement in the startle blink reflex when exposed to aversive stimuli (e.g., disturbing images), indicating reduced defensive (fear) reactivity.

Answer 21

Reduced amplitude of brain response during cognitive tasks (e.g., after incorrect responses) suggests reduced cortical-attentional processing and impaired action monitoring, which may relate to the disinhibition component of psychopathy.

Answer 22

Functional neuroimaging studies show reduced amygdala reactivity to interpersonal distress cues (e.g., fearful human faces) in individuals with high levels of psychopathy, suggesting a deficit in processing emotional signals related to empathy.

Answer 23

The Triarchic model helps integrate findings by linking specific neurobiological deficits to different components of psychopathy: Boldness (linked to the lack of startle enhancement). Disinhibition (related to reduced brain potential responses in cognitive tasks). Meanness (connected to reduced amygdala response to affective cues).

Answer 24

Reduced subcortical response to affective cues (like fearful faces) has been tied to the callous-unemotional (CU) traits factor in child/adolescent psychopathy, which may indicate deficits in empathy or affiliative capacity linked to the meanness component of psychopathy.

Answer 25

The "dark triad" consists of three personality traits: Machiavellianism, psychopathy, and narcissism.

Answer 26

The Triarchic model suggests that the boldness component of psychopathy reflects emotional stability, social poise, and a tendency to enjoy novelty and adventure, which contrasts with the view that psychopathy is inherently deviant.

Answer 27

The Triarchic model differentiates between psychopathy subcomponents: Boldness is negatively correlated with anxiety. Disinhibition and Meanness show little to no correlation with anxiety. This suggests that low anxiety is central to the bold-disinhibited variant of psychopathy, but not necessarily to other forms.

Answer 28

While aggression is central to some criminal conceptions of psychopathy, the Triarchic model acknowledges that aggression may not be a defining feature for all psychopathic subtypes. Aggression tends to be linked to disinhibition and meanness components.

Answer 29

Antisocial behavior is seen as arising from a mix of dispositional boldness, meanness, and disinhibition. The Triarchic model emphasizes that criminal behavior should be understood in terms of underlying motivations, spontaneity, and premeditation, rather than as a defining feature of psychopathy.

Answer 30

The Triarchic model proposes that psychopathy can take the form of: Bold-disinhibited: High in boldness and disinhibition. Mean-disinhibited: High in meanness and disinhibition. It suggests that labels like primary vs. secondary are less useful than understanding how different combinations of the three components define variants of psychopathy.

Answer 31

The Triarchic model posits that gender differences in psychopathy may arise due to different average levels of boldness, meanness, and disinhibition between men and women. Women may express psychopathy differently, and gender might influence the external behavior of psychopathic tendencies.

Answer 32

Yes, successful psychopaths may exhibit high boldness without significant disinhibition, making them effective leaders or individuals in positions requiring courage. The Triarchic model suggests that high boldness without high disinhibition may lead to success in leadership roles and crisis management.

Answer 33

Research on former U.S. presidents has shown that higher boldness (measured by the PPI-FD factor) correlates with higher ratings of leadership, persuasiveness, and crisis management, while higher meanness or disinhibition (SCI factor) is linked to negative outcomes like abuse of power.

Answer 34

Antisocial personality disorder

Answer 35

as a conduct disorder.

Answer 36

anxiety levels

Answer 37

Psychoanalysis, developed by Sigmund Freud, is an intensive, long-term therapy focusing on unconscious conflicts and early childhood experiences. Psychodynamic therapy is a shorter-term approach derived from psychoanalysis, focusing more on current issues and less on long-term exploration. Freud's ideas laid the foundation for both, with psychoanalysis being more comprehensive and psychodynamic therapy being a modern adaptation.

Answer 38

Freud initially proposed that mental health issues arise from repressed sexual urges (1895), later expanding his theory to suggest that psychiatric problems result from tension between the id (pleasure-driven unconscious urges), the superego (morality and societal judgment), and the ego (mediator). Psychoanalytic therapy aims to bring unconscious conflicts into conscious awareness to relieve stress. Although psychoanalysis is still practiced, it has largely been replaced by psychodynamic therapy, which is shorter, more focused on the client's social context, and aims to relieve distress rather than change the person.

Answer 39

In psychodynamic therapy, a process in which the patient reports all thoughts that come to mind without censorship, and these thoughts are interpreted by the therapist.

Answer 40

1. Free Association: The patient shares all thoughts freely without censoring them. This technique helps the therapist identify patterns or underlying meanings in the patient's thoughts. 2. Exploring Childhood Memories: Childhood experiences, particularly with caregivers, are believed to influence later psychological issues. These are often explored through free association. 3. Dream Analysis: Dreams contain both manifest (literal) and latent (symbolic) content. The therapist helps interpret the latent content to understand unconscious concerns (e.g., dreams of teeth falling out may symbolize fears about physical appearance). 4. Transference and Countertransference: The therapist interprets transference (the patient’s displacement of feelings onto the therapist, like anger toward a parent) and must be aware of countertransference (the therapist’s own emotions displaced onto the patient). These techniques aim to help patients uncover unconscious conflicts and understand the underlying causes of their psychological distress.

Answer 41

Advantages: - Historical Significance: Psychoanalysis was the first formal treatment for mental illness, paving the way for modern therapeutic approaches. - Deep Exploration: Some patients find the detailed, long-term process of psychoanalysis rewarding and beneficial for understanding their unconscious conflicts. Disadvantages: - Lack of Empirical Support: There is limited and inconsistent research evidence supporting the effectiveness of psychoanalysis, with some studies showing no reliable improvement in mental health outcomes. - Not Suitable for All: Psychoanalysis is not appropriate for patients with severe psychopathology or intellectual disabilities. - Cost and Time: It is often expensive due to the long duration of treatment, which may last for years.

Answer 42

Humanistic or person-centered therapy (PCT) is a therapeutic approach developed in the mid-20th century, based on the belief that mental health problems arise from a mismatch between a person's behavior and their true personal identity. The goal of PCT is to create an environment where patients can explore and discover their self-worth, gain a better understanding of their identity, and adjust their behavior to align more closely with their authentic self.

Answer 43

Person-centered therapy (PCT) was developed by Carl Rogers, during the rise of humanistic theory and the human potential movement. PCT is based on the belief that humans have an innate drive to realize and express their capabilities. Rogers emphasized that people have the potential to change and improve, and therapists should create an environment that fosters self-understanding. In PCT, the therapist and patient should have a genuine, equal relationship, where the therapist is nonjudgmental and empathetic. The patient experiences vulnerability, which motivates change, alongside the therapist’s supportive presence.

Answer 44

In person-centered therapy (PCT), the therapist takes a passive, non-directive role, focusing on guiding the patient toward self-discovery rather than directly changing their thoughts or behaviors. The therapist creates a safe, encouraging environment for the patient to explore their own issues, primarily through asking questions without judgment or interpretation. A key technique is providing unconditional positive regard, where the therapist expresses warmth and empathy without condemning or criticizing the patient. This creates an atmosphere free of approval or disapproval, helping the patient appreciate their own value and align their behavior with their true identity.

Answer 45

Advantages: PCT is highly acceptable to patients and fosters a supportive, empathetic environment. Disadvantages: A main disadvantage is the mixed findings on its effectiveness. The therapy uses general techniques that are not tailored to specific mental health issues, which may not work for everyone. Further research is needed to better understand its overall utility.

Answer 46

The primary goal of CBT is to alleviate psychological symptoms by changing the underlying cognitions and behaviors that contribute to mental disorders. This involves identifying maladaptive thoughts and behaviors and replacing them with more adaptive ones.

Answer 47

Unlike psychoanalysis and person-centered therapy, CBT is focused on the present and uses specific, goal-oriented interventions to address current symptoms. It emphasizes changing maladaptive thoughts and behaviors, often involving homework assignments and structured sessions, whereas psychoanalysis and person-centered therapy are more exploratory and relational.

Answer 48

Exposure therapy in CBT is used to help patients confront and fully engage with anxiety-provoking situations rather than avoiding them. This gradual exposure helps reduce fear through extinction learning, allowing patients to "unlearn" irrational fears and replace avoidance behaviors with more adaptive responses.

Answer 49

Advantages: - CBT is cost-effective and brief, making it accessible for many people. - It has strong empirical support, proving its effectiveness for various mental disorders. - It is flexible and can be adapted for different populations. Disadvantages: - Requires significant effort from patients, as they actively participate in treatment, often involving homework assignments. - May not be suitable for patients who struggle with the required level of effort or who prefer a more passive approach to therapy.

Answer 50

The cognitive model suggests that emotions and behaviors are influenced by one's automatic thoughts and beliefs about events. During CBT, patients explore the sequence of events (A), their beliefs (B), and the consequences (C), and work to evaluate and adjust their beliefs through reasoning and experiments.

Answer 51

A form of psychotherapy grounded in mindfulness theory and practice, often involving meditation, yoga, body scan, and other features of mindfulness exercises.

Answer 52

Techniques: - Mindfulness-Based Stress Reduction (MBSR) uses meditation, yoga, and attention to physical experiences to reduce stress. - Mindfulness-Based Cognitive Therapy (MBCT) focuses on observing thoughts objectively without judgment, helping prevent relapse in depression. - Dialectical Behavior Therapy (DBT) combines mindfulness with cognitive-behavioral techniques and skills training to help patients cope with maladaptive behaviors. - Acceptance and Commitment Therapy (ACT) encourages observing thoughts from a detached perspective without trying to change them, recognizing which thoughts are beneficial or harmful. Advantages: - Mindfulness therapies are accessible and familiar due to their use of popular practices like yoga and meditation. - They have been found effective for treating mood and anxiety disorders, showing moderate symptom improvement in various studies. Disadvantages: - Despite growing evidence, there is still no consensus on the overall efficacy of MBT. - The benefits may vary depending on the individual and their specific disorder.

Answer 53

Online and Mobile-Delivered Therapies - Use of smartphones and internet-based modules to deliver therapies like CBT. - Allows for flexible scheduling and more frequent therapist contact, especially for patients with limited access to traditional treatment. Cognitive Bias Modification - Uses video games or mobile apps to change problematic thought processes, such as training alcohol abusers to avoid alcohol-related stimuli. - Aims to modify subconscious thoughts to reduce urges and improve behavior. CBT-Enhancing Pharmaceutical Agents - Drugs like d-cycloserine, which enhance learning processes during therapy, improving outcomes for conditions like anxiety disorders. - These drugs may facilitate better integration of therapeutic techniques and improve treatment effectiveness.

Answer 54

Psychiatric Medications are commonly used to treat mental disorders such as schizophrenia, bipolar disorder, depression, and anxiety disorders. Accessibility: Medications can be prescribed by general medical practitioners, unlike psychotherapies, which require trained psychologists. Effectiveness: Psychiatric drugs are often as effective as therapies like CBT, but the best choice depends on the specific disorder, the individual, and factors like comorbidity. Challenges: Despite their widespread use, the mechanisms of many psychiatric drugs in the brain are still not fully understood, and further research is needed to refine both pharmacological and behavioral treatments.

Answer 55

Describes a state of having more than one psychological or physical disorder at a given time.

Answer 56

Integrative or Eclectic Psychotherapy: Involves combining techniques from various therapeutic approaches to best address the patient's needs. Example: A therapist might use DBT's distress tolerance skills for short-term issues, CBT's cognitive reappraisal for long-standing problems, and MBCT's mindfulness meditation to reduce overall stress. Prevalence: Between 13% and 42% of therapists identify their approach as integrative or eclectic (Norcross & Goldfried, 2005).

Answer 57

Although various therapies have been shown to work for specific individuals, cognitive behavioral therapy is currently the treatment most widely supported by empirical research. Still, practices like psychodynamic therapies, person-centered therapy, mindfulness-based treatments, and acceptance and commitment therapy have also shown success.

Answer 58

COGNITIVE BEHAVIORAL

Answer 59

FREE ASSOCIATION

Answer 60

D) PCT is based on nonspecific treatment factors, without considering specific treatment factors to directly target a given mental problem..

Answer 61

C) Thoughts, actions, and emotions interact and contribute to psychopathology..

Answer 62

RESTRUCTURING

Answer 63

Dialectical behaviour therapy

Answer 64

borderline

Answer 65

those related to validity, reliability, generalizability, and ethics

Answer 66

What: pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity. Causes: generally considered the result of an interaction of genetic dispositon to negative affectivity interacting with a malevolent, abusive, and/or invalidating family environment Treatment: typically dialectival behavioural therapy (DBT) - a form of cognitive-behaviour therapy - draws on principles from Zen Buddhism, dialectical philosophy, and behavioural science - four components: individual therapy, group skills training, telephone coaching, anda therapist consultation team - typically lasts one year

Answer 67

Stages are defined by how severe a person's behaviours are. Stage 1: - person is miserable, behaviour is out of control - goal is to move from being out of control to acheiving behavioural control Stage 2: - person feels they are living a life of quiet desperation (life threatening behaviour is under control but they continue to suffer) - goal is to help the person move from quiet desperation to full emotional experiencing Stage 3: - challenge is to learn to live: to define life goals, build self-respect and find peace and happiness - goal is for the person to lead a life of ordinary happiness and unhappiness Stage 4: - goal is to find a deeper meaning through a spiritual existence

Answer 68

As a deep-rooted emotional pathology concealed by an outward appearance of good mental health. In contrast with other psychiatric patients, psychopathic individuals present as confident, sociable, and well adjusted. However, their underlying disorder reveals itself over time through their actions and attitudes. - did not characterize psychopathic patients as inherently cruel, violent, or dangerous. Whereas McCord and McCord (1964): describe the condition in more generally pathologic terms, highlighting "guiltlessness" (lack of remorse) and "lovelessness"

Answer 69

antisocial personality disorder (ASPD) - defined by specific symptoms of behavioral deviancy in childhood (e.g., fighting, lying, stealing, truancy) continuing into adulthood (manifested as repeated rule-breaking, impulsiveness, irresponsibility, aggressiveness, etc)

Answer 70

Triarchic model: three seperable symptomatic components - disinhibition, boldness, and meanness - the building blocks for differing conceptions of psychopathy Cleckley: emphasis on boldness and disinhibition Criminally oriented concepts: emphasis on meanness and disinhibition