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...

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.


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


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




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


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

Comorbidity of personality disorders





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


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


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



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


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




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




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




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

Schizotypal Personality Disorder

Avoidant Personality Disorder

Paranoid Personality Disorder




What are some likely precursors to Schizoid Personality Disorder?

Childhood shyness


Parents of kids with Autism may develop Schizoid PD




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


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



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


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)




What are ideas of reference?

belief that things relate to them



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 


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



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



What neurobiological similarity exists between Schizotypal PD & Schizophrenia?

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




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

because there is no full blown psychosis in the personality disorders




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


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



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

Borderline Personality Disorder

9.3% of clinical settings




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


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

Emotional instability




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%)



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


  • 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



  • 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