Week 3 Flashcards
Chapter 13 (373-379), chapter 15 (97 cards)
1
Q
What distinguishes Intermittent Explosive Disorder (IED) from Conduct Disorder?
A
IED involves impulsive, unplanned aggression, while Conduct Disorder involves more premeditated aggression.
2
Q
What behaviors are typical in Oppositional Defiant Disorder (ODD)?
A
Temper loss, arguing with adults, noncompliance, spitefulness, and deliberate annoyance of others.
3
Q
How is ODD different from ADHD?
A
ODD involves deliberate defiance, not attentional deficits or impulsivity
4
Q
What are the four main symptom categories of Conduct Disorder?
A
(1) Aggression to people/animals, (2) Property destruction, (3) Deceit/theft, (4) Rule violations.
5
Q
What diagnostic specifier highlights emotional traits in some cases of Conduct Disorder?
A
“Limited prosocial emotions” specifier—lack of remorse, empathy, and guilt.
6
Q
What is the estimated prevalence of Conduct Disorder?
A
About 5–6%.
7
Q
What are the two developmental types of Conduct Disorder proposed by Moffitt?
A
Life-course-persistent and adolescence-limited types.
8
Q
What characterizes the life-course-persistent type of Conduct Disorder?
A
Early onset (by age 3), persistent antisocial behavior into adulthood, more severe outcomes.
9
Q
What’s typical of the adolescence-limited type of conduct disorder?
A
Onset in adolescence with antisocial behavior usually tapering off in adulthood.
10
Q
Do all children with Conduct Disorder go on to have adult antisocial behavior?
A
No; about half may not meet full diagnostic criteria later, though most continue to have problems.
11
Q
What disorders commonly co-occur with Conduct Disorder?
A
ADHD, ODD, anxiety, depression, and substance use disorders.
12
Q
Which disorders tend to precede Conduct Disorder?
A
Specific phobias and social anxiety.
13
Q
How does heritability differ by type of behavior?
A
Aggressive behaviors are more heritable than rule-breaking behaviors.
14
Q
What role does neighborhood wealth play in genetic influence?
A
Genetic effects on rule-breaking are stronger in wealthier neighborhoods.
15
Q
How do callous and unemotional traits relate to heritability?
A
They are more highly heritable, especially in adverse environments.
16
Q
What did adoption studies show about parenting’s role?
A
Positive reinforcement by adoptive mothers can buffer genetic risk from biological parents.
17
Q
Which brain areas show deficits in children with Conduct Disorder?
A
Amygdala, ventral striatum, and prefrontal cortex.
18
Q
What emotional recognition difficulties do these children face?
A
Trouble recognizing fear, sadness, and happiness—but not anger.
19
Q
What social-cognitive bias is common in aggressive children?
A
Hostile attribution bias—interpreting ambiguous situations as hostile.
20
Q
How do callous traits affect moral development?
A
These children may lack guilt and moral awareness
21
Q
How does peer rejection relate to Conduct Disorder?
A
Peer rejection, even in 1st grade, can predict later aggression.
22
Q
What are two theories on peer influence?
A
Social selection (choosing deviant peers) and social influence (being influenced by peers)—both supported.
23
Q
What is the most effective approach to treating Conduct Disorder?
A
Multisystemic interventions involving family, peers, school, and community.
24
Q
How can early family intervention help by conduct disorder?
A
It can prevent the escalation of symptoms and reduce the severity of long-term outcomes.
25
What defines a personality disorder and what broad impacts can it have on a person's life?
A personality disorder is defined by enduring, inflexible, and maladaptive personality traits that impair identity and relationships across multiple life domains. These traits persist over time and often lead to difficulties in relationships, increased risk of victimization, and poorer physical health.
26
How does the DSM-5-TR classify personality disorders?
DSM-5-TR classifies personality disorders into three clusters:
Cluster A: Odd or eccentric behavior
Cluster B: Dramatic or erratic behavior
Cluster C: Anxious or fearful behavior
27
What are the general criteria for diagnosing a personality disorder according to DSM-5-TR?
Inflexible pattern of behavior and inner experience distinct from cultural expectations
Affects at least two of: cognition, affect, interpersonal functioning, impulse control
Causes significant distress or impairment
Pervasive across situations
Onset by early adulthood
Stable and persistent symptoms
Not due to another disorder, substance, or medical condition
28
What role does culture play in diagnosing personality disorders?
Clinicians must consider whether behavior patterns are unusual relative to the person’s cultural background, as cultural norms influence traits like self-promotion and emotional expression, affecting the evaluation of disorders such as narcissistic and cluster C personality disorders.
29
Why is the use of structured interviews important in diagnosing personality disorders?
Structured interviews improve diagnostic reliability and accuracy, while unstructured interviews often miss up to half of personality disorder diagnoses and are less predictive of long-term outcomes.
30
What are the key features of Cluster A personality disorders, and which are included in the Alternative DSM-5-TR Model?
Paranoid: Distrust and suspiciousness (No)
Schizoid: Detachment and restricted emotions (No)
Schizotypal: Cognitive distortions, eccentric behavior, lack of close relationships (Yes)
31
What are the key features of Cluster B personality disorders, and which are included in the Alternative DSM-5-TR Model?
Antisocial: Disregard for others’ rights (Yes)
Borderline: Instability in relationships, self-image, affect, impulsivity (Yes)
Histrionic: Excessive emotionality and attention seeking (No)
Narcissistic: Grandiosity, need for admiration, lack of empathy (Yes)
32
What are the key features of Cluster C personality disorders, and which are included in the Alternative DSM-5-TR Model?
Avoidant: Social inhibition, feelings of inadequacy, hypersensitivity (Yes)
Dependent: Excessive need to be cared for, submissiveness, fear of separation (No)
Obsessive-Compulsive: Preoccupation with order, perfection, control (Yes)
33
What does research suggest about the stability of personality disorder diagnoses over time?
About half of those diagnosed with a personality disorder no longer meet criteria for the same disorder after 2 years, and 99% with severe cases do not meet criteria after 16 years, indicating these disorders may not be as stable as DSM-5-TR suggests.
34
Despite remission, why can an initial personality disorder diagnosis still be important?
Because milder symptoms often persist after remission, and an initial diagnosis can predict lower functioning even 15 years later.
35
What is a major issue related to comorbidity in DSM-5-TR personality disorder classifications?
More than half of people diagnosed with one personality disorder meet criteria for another, partly because some disorders share similar symptoms like social withdrawal.
36
Why are the diagnostic thresholds for personality disorders considered problematic?
The number of symptoms required is arbitrary; many with subthreshold symptoms still have significant problems, and symptom severity varies widely, suggesting a dimensional approach may be more helpful than strict yes/no criteria.
37
Why was the alternative DSM-5-TR model for personality disorders proposed?
Because the traditional DSM-5-TR model showed poor stability over time, high comorbidity, and arbitrary diagnostic thresholds.
38
How many and which personality disorders are included in the alternative DSM-5-TR model?
Six disorders are included; schizoid, histrionic, dependent, and paranoid personality disorders are excluded due to rarity or high overlap.
39
What is the basis for diagnosing personality disorders in the alternative DSM-5-TR model?
Diagnoses are based on persistent impairments in personality functioning and extreme scores on five personality trait domains and 25 specific facets.
40
What are some strengths of the dimensional personality trait approach in the alternative DSM-5-TR model?
It provides more stable ratings over time, richer detail, links to other psychological disorders, predicts important life outcomes, and is viewed as more useful by clinicians
41
What are the five personality trait domains in the alternative DSM-5-TR model?
1. Negative Affectivity
2. Detachment
3. Antagonism
4. Disinhibition
5. Psychoticism
42
What facets are included in the Negative Affectivity domain?
Anxiousness, Emotional lability, Hostility, Perseveration, Separation insecurity, Submissiveness.
43
What facets are included in the Detachment domain?
Anhedonia, Depressivity, Intimacy avoidance, Suspiciousness, Withdrawal, Restricted affectivity.
44
What facets belong to the Antagonism and Disinhibition domains?
Antagonism: Attention seeking, Callousness, Deceitfulness, Grandiosity, Manipulativeness.
Disinhibition: Distractibility, Impulsivity, Irresponsibility, (Lack of) rigid perfectionism, Risk taking.
45
What facets are in the Psychoticism domain?
Eccentricity, Cognitive perceptual dysregulation, Unusual beliefs and experiences.
46
What evidence supports genetic vulnerability in personality disorders?
Many personality disorders share genetic risk; people at high genetic risk for one disorder are often at high risk for others. Heritability estimates are moderately high.
47
How does childhood adversity relate to personality disorders?
Childhood abuse, neglect, and aversive or unaffectionate parenting styles significantly increase the risk of developing several personality disorders.
48
What did twin studies reveal about the relationship between childhood abuse and borderline personality disorder (BPD)?
Twins discordant for abuse showed similar BPD symptoms, suggesting genetic vulnerability may play a larger role than abuse itself.
49
Why might there be high rates of abuse among people with personality disorders if abuse isn’t the main cause?
Parental traits like impulsivity and emotionality may increase risks for both abuse and personality disorders, showing a complex interplay of factors.
50
What is the overall understanding of genetic and environmental influences on personality disorders?
Personality disorders result from complex interactions between genetic vulnerability and early adversity; abuse has damaging effects but may not directly cause personality disorders.
51
What are the core features of Schizotypal Personality Disorder?
Eccentric thoughts/behavior, interpersonal detachment, suspiciousness, odd beliefs (e.g., magical thinking), ideas of reference, unusual perceptions, flat affect, and social anxiety.
52
How is Schizotypal Personality Disorder related to schizophrenia?
Symptoms and cognitive deficits are milder but similar; about one-third of schizotypal cases develop schizophrenia; genetic vulnerabilities overlap.
53
What brain abnormalities are associated with Schizotypal Personality Disorder?
Enlarged ventricles, reduced temporal lobe gray matter, and neurotransmitter dysregulation similar to schizophrenia but less severe.
54
What is the core feature of Antisocial Personality Disorder (APD)?
A pervasive pattern of disregard for others’ rights, including impulsivity, aggression, irresponsibility, and lack of remorse.
55
How does psychopathy differ from APD?
Psychopathy includes superficial charm, lack of shame and remorse, fearlessness (boldness), meanness, and disinhibition; psychopathy is not a DSM diagnosis.
56
What are the three core traits of psychopathy in the triarchic model?
Boldness (fearlessness), meanness (aggression/lack of remorse), and disinhibition (impulsivity).
57
What are key symptoms of Paranoid Personality Disorder?
Distrust, suspiciousness of harm/deceit, doubts about loyalty, reluctance to confide, reading hidden meanings, grudges, and suspiciousness of partner’s fidelity.
58
What characterizes Schizoid Personality Disorder?
Social aloofness, lack of desire for close relationships, preference for solitude, emotional detachment, and indifference to praise or criticism.
59
What are the main symptoms of Histrionic Personality Disorder?
Excessive emotionality, attention seeking, inappropriate sexually seductive behavior, rapidly shifting emotions, theatrical expression, and suggestibility.
60
What defines Dependent Personality Disorder?
Excessive need to be cared for, difficulty making decisions independently, fear of being alone, urgent seeking of new relationships, and submissiveness.
61
What are common behaviors in APD according to DSM-5?
Illegal behaviors, deceitfulness, impulsivity, irritability/aggression, reckless disregard for safety, irresponsibility, and lack of remorse.
62
How common is APD in men and prison populations?
Men are 5 times more likely than women to have APD; over half of prison inmates meet criteria for APD.
63
What are the three main differences between Antisocial Personality Disorder (APD) and psychopathy according to the PCL-R?
1) Psychopathy includes affective symptoms like shallow affect and lack of empathy;
2) APD requires symptoms before age 15, psychopathy does not;
3) APD is a categorical diagnosis, psychopathy is measured dimensionally.
64
How do genetic and social factors interact in the development of APD?
Genetic vulnerability overlaps with substance use disorders, but social environment—such as parenting quality, poverty, and exposure to violence—plays a major role in whether APD symptoms develop.
65
What does adoption research reveal about the development of APD?
Genetically influenced antisocial behavior can evoke harsh parenting, which in turn worsens antisocial tendencies; social factors like harsh discipline and poverty predict APD even after controlling for genetic risk.
66
According to the triarchic model, what three traits underlie psychopathy and which psychological processes do they relate to?
Boldness (threat sensitivity), Meanness (lack of empathy), and Disinhibition (poor executive control).
67
How does threat sensitivity relate to psychopathy and learning from punishment?
People high in boldness show reduced physiological and neural responses to threats, leading to poor classical conditioning and difficulty learning from punishment.
68
What evidence supports the link between psychopathy (especially meanness) and lack of empathy?
Psychopaths struggle to recognize fear in others, show less amygdala and ventromedial prefrontal cortex activity when processing others’ pain, indicating diminished emotional responsiveness.
69
What are the core features of Borderline Personality Disorder (BPD)?
High impulsivity, emotional instability, unstable relationships, fears of abandonment, chronic emptiness, and recurrent self-harm or suicidal behavior.
70
How do people with BPD typically experience emotions and relationships?
They have rapid mood swings, hypersensitivity to rejection, unstable self-image, intense anger, and distress in romantic relationships.
71
What neurobiological factors are linked to BPD?
Dysfunction in brain regions related to emotion regulation (prefrontal cortex, anterior cingulate) and emotion response (amygdala, hippocampus), plus diminished connectivity between these areas.
72
What does Linehan’s biosocial theory say about the development of BPD?
BPD develops from a biological vulnerability to emotional dysregulation combined with an invalidating family environment that punishes or ignores emotional expression, creating a cycle of dysregulation and invalidation.
73
What are the core features of Narcissistic Personality Disorder?
Grandiosity, fantasies of success, lack of empathy, arrogance, envy, entitlement, and expectation of special treatment.
74
How do people with NPD typically view their successes?
They attribute successes to their own abilities rather than chance.
75
What is the primary goal in interpersonal relationships for people with NPD?
To bolster their own self-esteem and gain admiration, often valuing admiration over closeness.
76
How do people with NPD react to threats to their self-esteem?
They tend to be vindictive and aggressive, often denigrating others who outperform them.
77
What is a key cause or contributing factor in the development of NPD according to parenting theories?
Overindulgent parenting that promotes a sense of being "special" and tolerates narcissistic behaviors.
78
What does Heinz Kohut’s model suggest about NPD and self-esteem?
People with NPD have fragile self-esteem masked by grandiosity and strive to bolster self-worth through others' respect.
79
How does social rejection affect people with narcissistic traits neurologically?
They show increased activation in brain regions associated with social pain, indicating sensitivity to rejection.
80
What is the defining fear in Avoidant Personality Disorder?
Fear of criticism, rejection, disapproval, and embarrassment
81
How do people with APD behave in social situations?
They are restrained, timid, avoid risks, and avoid interpersonal interactions to protect themselves from negative feedback.
82
How is APD related to social anxiety disorder?
They have overlapping diagnostic criteria and genetic vulnerabilities.
83
What are the main characteristics of Obsessive-Compulsive Personality Disorder?
Perfectionism, preoccupation with rules/details, rigidity, excessive planning, work orientation over pleasure, and inflexibility.
84
How do people with OCPD differ from those with OCD?
OCPD involves personality traits without the obsessions and compulsions that define OCD.
85
What cognitive traits are shared between OCPD and OCD?
Cognitive inflexibility and difficulty tolerating uncertainty.
86
What is the primary treatment approach for personality disorders?
Psychotherapy is the treatment of choice.
87
Why should clinicians assess for personality disorders even when patients seek help for other issues?
Because personality disorders predict slower improvement in psychotherapy and may affect treatment outcomes.
88
Can personality traits change in therapy?
Yes, studies show psychotherapy can significantly change traits like neuroticism, often within 6 weeks.
89
What are common supplements to psychotherapy in treating personality disorders?
Medications such as antidepressants and antipsychotics for accompanying symptoms like depression, anxiety, or cognitive issues.
90
What does psychodynamic therapy for personality disorders focus on?
Exploring early childhood experiences and how they influence current behaviors and beliefs.
91
What is the focus of cognitive therapy for personality disorders?
Identifying and challenging maladaptive beliefs and cognitive distortions.
92
Give an example of a maladaptive cognition for avoidant personality disorder.
"If people get to know the real me, they will reject me."
93
What techniques are used in CBT for avoidant personality disorder?
Behavioral strategies and exposure therapy to address social fears.
94
What makes treating borderline personality disorder (BPD) particularly challenging?
Intense interpersonal difficulties, trust issues, emotional instability, and high suicide risk.
95
What are two well-supported therapies for BPD?
Dialectical Behavior Therapy (DBT) and Mentalization-Based Therapy (MBT).
96
What is the focus of Mentalization-Based Therapy (MBT)?
Teaching clients to reflect on their own and others' mental states to avoid impulsive reactions.
97
What are the four stages of Dialectical Behavior Therapy (DBT)?
1. Addressing suicidal behaviors
2. Regulating emotions and distress tolerance
3. Improving relationships and self-esteem
4. Promoting connectedness and life satisfaction
