Week 9 Lecture 9 - Personality Disorders - Jo Fielding (DN) Flashcards Preview

z. z. PSY3032 Lectures - Abnormal Psychology > Week 9 Lecture 9 - Personality Disorders - Jo Fielding (DN) > Flashcards

Flashcards in Week 9 Lecture 9 - Personality Disorders - Jo Fielding (DN) Deck (82)
Loading flashcards...
1

What is personality?

  • Qualities, traits  of character/behaviour
    • peculiar to a specific person
  • Enduring patterns of perceiving, relating to, & thinking about the environment & oneself that are exhibited in a wide range of social & personal contexts.

2

When is personality disordered?

Enduring pattern of behaviour & inner experience

deviates from expectations of a person’s culture in at least 2 of the following areas:

  • cognition
  • affectivity
  • interpersonal functioning
  • impulse control

3

How do personality disorders differ from many of the other disorders we have studied in this unit?

  • Chronic
  • tend to originate in childhood
  • persist throughout the lifespan
  • invade every aspect of persons life

 

4:00

4

How does DSM-5 classify Personality Disorders?

Cluster A: odd or eccentric behaviours

  • Paranoid
  • Schizoid
  • Schizotypal

 

Cluster B: emotional, erratic or dramatic behaviours

  • Borderline
  • Histrionic
  • Narcissistic
  • Antisocial

 

Cluster C: fear, anxiety

  • Avoidant
  • Dependent
  • Obsessive-Compulsive

5

What was one of the reasons for promotion of an alternative model in DSM-5?

Comorbidity of personality disorders

 

 

14:05

6

What is the DSM-5 criteria for Cluster A: Paranoid

Pervasive distrust & suspiciousness of others, motives interpreted as malevolent.

Indicated by 4 (or more) of the following:

  • 1. Suspiciousness of being exploited, harmed, deceived
  • 2. Doubts about loyalty /trustworthiness of others
  • 3. Reluctance to confide in others because - suspiciousness
  • 4. Reads hidden meanings into innocuous actions of others
  • 5. Bears grudges for perceived wrongs
  • 6. Angry reactions to perceived attacks on character/reputation
  • 7. Unwarranted suspiciousness of fidelity of partner

7

Which other Personality Disorders are comborbid with Paranoid Personality Disorder?

Schizotypal, borderline, avoidant all have similar diagnostic criteria

it is the underlying bit that distinguishes them

8

How does Cluster A: Paranoid Personality Disorder differ from Schizophrenia?

  • no hallucinations
  • only a general impairment in work & social 
  • dont have cognitive disorganised seen in Schizophrenia

12:30

9

What factors have been implicated in the aetiology of Cluster A: Paranoid Personality Disorder

we dont know a lot about cause
  • Genetic -
    • common if family member with schizophrenia
  • Psychological
    • difficult to get info out of them
    • childhood (faulty perceptions as they see the world as malevolent)
    • difficult to entangle fact from fiction
  • Cultural
    • misinterpreting others views/opinions of them

10

Why is treatment difficult for Cluster A: Paranoid Personality Disorder

  • Trust
    • hard to develop
    • unlikely to seek help unless crisis
    • may seek help for comorbid conditions (depression) not for the personality disorder itself
  • Therapists not optimistic about treatment
    • difficult to keep them around long enough to effect positive change

 

17:00

11

What is the DSM-5 criteria for Cluster A: Schizoid Personality Disorder

Pervasive pattern of detachment from social relationships, & a restricted range of expressions of emotion in interpersonal settings.

Indicated by 4 (or more) of following:

  • 1. Lack of desire/enjoyment close relationships
  • 2. Almost always chooses solitary activities
  • 3. Little interest in sex
  • 4. Few / no pleasurable activities
  • 5. Lack of friends
  • 6. Indifferent to praise / criticism from others
  • 7. Flat affect, emotional detachment

 

18:10

12

What factors have been considered in the Aetiology of Cluster A: Schizoid Personality Disorder?

  • childhood experiences
  • parents with autism may have child who develops Schizoid
    • possible biological basis 

 

more frequently diagnosed in males

 

21:00

13

Which personality types have similar diagnostic criteria to Schizoid Personality Disorder, so are often comorbid?

Schizotypal Personality Disorder

Avoidant Personality Disorder

Paranoid Personality Disorder

 

21:10

14

What are some likely precursors to Schizoid Personality Disorder?

Childhood shyness

Abuse

Parents of kids with Autism may develop Schizoid PD

 

21:30

15

What is likely to prompt someone with Schizoid PD to seek treatment?

What would treatment/therapy usually involve?

How effective is treatment?

Normally a crisis - or another individual distressed by them

  • e.g., job loss, extremem depression
  • Not likely to just go and seek help for the PD

Treatment approaches:

  • teaching them to empathise with others
  • social skills training
  • Role play: learning to identify & engage with social networks

Effectiveness

not alot of evidence as it is hard to get individuals to 

22:00

16

What is the DSM-5 criteria for Cluster A: Schizotypal Personality Disorder

Pervasive pattern of social & interpersonal deficits – acute discomfort with, & reduced capacity for close relationships as well as by cognitive, or perceptual distortions & eccentricities.

Indicated by 5 (or more) of the following:

  • 1. Ideas of reference
  • 2. Peculiar beliefs / magical thinking
  • 3. Unusual perceptions
  • 4. Peculiar patterns thought or speech
  • 5. Suspiciousness / paranoia
  • 6. Inappropriate / restricted affect
  • 7. Odd / eccentric behaviour / appearance
  • 8. Lack of close friends
  • 9. Anxiety about other people

17

How does Cluster A: Schizotypal Personality Disorder compare/differ to Schizophrenia?

  • Schizotypal exists on a continuum with schizophrenia

However Schizotypal

  • no hallucinations & delusions (more of a sense rather than actually seeing/hearing)
  • psychotic-like - but can test reality (have some insight)

 

25:45

18

What are ideas of reference?

belief that things relate to them

 

19

How do the unusual perceptions in Schizotypal PD differ from those in Schizophrenia?

 

Schizotypal - more like a sense that someone is there

Schizophrenia - will actually see or hear 

20

What factors have been implicated in the aetiology of Cluster A: Schizotypal Personality Disorder

Is there a gender difference in aetiology?

  • Genetic contribution possible
    • twin studies show increased prevalence in relatives with Schizophrenia
      • (as with other 2 Cluster A disorders (Paranoid & Schizoid)
    • may be a phenotype of the schizophrenia genotype
      • evidence its a precursor for schizophrenia
  • Neurobiological
    • brain changes
    • increased ventricles, decreased grey matter in temporal lobes
    • similar to schizophrenia
  • Environmental contributions
    • Childhood mistreatment
      • more typically in men
    • PTSD
      • more typically in women

27:00

21

Which other Personality Disorders are comborbid with Cluster A: Schizotypal Personality Disorder?

Which other non-PD disorder also commonly co-exists?

Most likely to be comorbid

  • Paranoid Personality Disorder (cluster A)
  • Avoidant Personality Disorder (cluster C)
  • (Symptoms overlap)

Depressive disorder also common in people with Schizotypal PD

26:30

22

What neurobiological similarity exists between Schizotypal PD & Schizophrenia?

  • similar brain changes
    • enlarged ventricles
    • reduced grey matter in temporal lobe

 

27:20

23

Why does Jo refer to the symptoms of Personality Disorders as 'Psychotic-like'

because there is no full blown psychosis in the personality disorders

 

28:50

24

Psychotic-like symptoms are characterised as either positive or negative

Which of the Cluster A Personality Disorders have positive symptoms &/or which have negative symptoms?

Cluster A:

  • Positive (e.g. Ideas of reference, magical thinking, perceptual disturbances)
    • Paranoid & Schizotypal
  • Negative (e.g. Social isolation, poor rapport, constricted affect)
    • Paranoid & Schizoid

25

Which of the Cluster A Personality Disorders was proposed to be dropped in DSM-5 (although did not eventuate)?

  • Paranoid & Schizoid (the first two) were proposed to be dropped (due to such overlapping symptoms)
  • just leaving Schizotypal (the third of the Cluster A PD's)
  • this may happen in future DSM revisions

 

26

What is one of the most common Personality Disorders found in clinical settings?

Borderline Personality Disorder

9.3% of clinical settings

 

33:15

27

What is the DSM-5 criteria for Cluster B: Borderline Personality Disorder

Pervasive pattern of instability of interpersonal relationships, self-image, & affects, & marked impulsivity.

Indicated by 5 (or more) of the following:

  • 1. Frantic efforts to avoid abandonment
  • 2. Unstable interpersonal relationships –others idealised / devalued
  • 3. Unstable sense of self
  • 4. Self-damaging, impulsive behaviours
  • 5. Recurrent suicidal behaviour, gestures, self-injury
  • 6. Affective instability
  • 7. Chronic feelings of emptiness
  • 8. Recurrent bouts of intense / poorly controlled anger
  • 9. During stress, experience transient paranoid thoughts / dissociative symptoms

28

What is the best predictor of suicide in individuals with Borderline Personality Disorder?

Emotional instability

 

33:15

29

Which other non-Personality Disorders are comborbid with Borderline Personality Disorder?

Which Cluster of Personality Disorders are likely to co-exist with Borderline PD?

Is there a gender difference in Borderline PD?

Non-PD Comorbidities

  • PTSD
  • Major depression
  • Bipolar disorder
  • Bulimia
  • Substance use disorderer

 

PD Comorbidity

  • Cluster A (Odd, eccentric)

 

Gender difference

  • more common in females (75%)

33:30

30

What factors have been considered in the Aetiology of Cluster B: Borderline Personality Disorder?

Genes

  • genes account for 60% variance in development of BPD
  • Twin studies - higher concordance in monozygotic twins

 

Serotonergic system dysfunction

  • linked to instability, suicide & impulsivity

 

Neuroimaging studies

  • look at limbic network involvement (involved in emotion regulation)
    • increased activity in amygdala
    • decreased activity in PFC
      • PFC normally downregulates an excitable amygdala

 

Environmental

  • early childhood trauma
    • sexual & physical abuse
      • significantly more likely to develop BPD, especially girls
    • not causative as there are people with BPD without abuse
      • thus complex relationship
      • though abuse seems to make one vulnerable (predisposed)
  • Temperament
  • Neurological impairment

 

42:00