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Clinical Psychology > 10: Personality disorders > Flashcards

10: Personality disorders Flashcards

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1
Q

What does the following mean: personality disorders are axis 2 disorders Cluster A?

A
  • thought to be stable LT conditions

- hence xp throughout much of an individual’s life

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2
Q

Personality disorders are characterised by individuals undergoing an enduring pattern of inner xp + behaviour that differs noticeably from the expectations of the individual’s culture in at least 2 of what?

A
  • cognition
  • mood
  • interpersonal functioning
  • impulsive control
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3
Q

What makes diagnosis of personality disorders difficult?

A
  • high comorbidity with mood disorders

eg: Major depression, bipolar disorder

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4
Q

What are personality disorders?

A

clusters of traits that are stable over time

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5
Q

Why has the stability of personality disorders have come into question, challenging its definition (Loranger et al) esp when examining dependent + schizotypal personalities ?

A
  • fair proportion of people who suffer from substance misuse have symptoms of personality disorders = occurring disorders
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6
Q

Why is there is shift in the assessment + diagnosis of personality disorders to dimensional models vs categorical?

A
  • Allows personality to be assessed using various scales + psychometric test
    = allows more comprehensive description of patient functioning
  • found to be better at predicting
  • Dimensional scores more reliable across clinicians vs categorical diagnosis
  • PD not so distinct from normal so better to think they are of an extreme of a distribution vs categorically different from norm population
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7
Q

Which behaviour did Ulrich, Borkenau + Marneros (2001) find personality tests were better able to predict?

A

offending behaviour than categorical diagnosis of antisocial personality disorder

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8
Q

What did Heuman + Morey (1990) found about the reliability between categorical diagnosis and dimensional scores?

A

Dimensional scores = more reliable across clinicians vs categorical diagnosis

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9
Q

Define the sub-clinical category Schizotypy

A

group of personality traits found to leave individual susceptible to delusion-like beliefs

  • share a number of common characteristics with psychotic-based disorders = SZ
  • SZ + schizoid PD found under category
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10
Q

What 2 beahviours can be observed between SZ + people with schizotypy?

A
  1. executive functioning deficits specifically associated with negative schizotypy
    - score highly on psychometric measures of schizotypy
    - Wisconson card sorting task
  2. Abnormality in attention
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11
Q

Often schizotypy can be a prodromal phase to what to what (Yoon, Kang + Kwon, 2008)?

A

active phase of schizotypy personality disorder

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12
Q

How are schizotypes often characterised by an individual (Bentall, Claridge + Slade, 1989)?

A
  • being quirky but awkward in social interactions

- showing sings of “odd” behaviour + lanuage

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13
Q

What support is there that schizotypy is a multi-factor construct (Claridge et al, 1996)?

A

various methods have been used to assess schizotypy

  • using various approach + theory
    1. 3 factor construct of Schizotypt
    2. 4 factor construct of Schizotypy
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14
Q

Sz + Schizotypy personality disorder symptoms are clustered around what 3 factors?

A
  1. Positive
  2. Negative
  3. Disorganisation
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15
Q

What are the 4 factor construct of Schizotypy?

A
  1. Unusal xp (positive)
  2. Introversive anhedonia (negative)
  3. Cognitive disorganisation
  4. Impulsivity non-conformity
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16
Q

What is the difference between SZ vs Schizotypy?

A

SZ = episodic psychotic personality based disorder

Schizotypy PD = grounded in LT, fairly stable development of personality

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17
Q

To be diagnosed with SPD, 5 or more of what symptoms have to be present?

A
  1. ideas of reference (not delusions)
  2. odd beliefs/ magical thinking which influence behaviour that are not the nrom
  3. unusual perceptual xp, including bodily illisions
  4. odd thinking + speech
  5. being suspicious (of others)
  6. odd behaviour/ appearance
  7. lack of friends other than first degree relatives
  8. excessive social anxiety which doesn’t seem to subside even when familiar so more to do with paranoia
18
Q

What is Schizoid PD?

A
  • less intense form of SPD
    Characterised by…
  • pattern of reduced attachment from social relationships
  • accompanied by restricted range of emotions
19
Q

To be diagnosed with Schizoid PD, at least 4 of what symptoms have to be present?

A
  1. no desire/ enjoyment of close relationships
  2. almost always choosing solitary activities
  3. little interest in sexual xp
  4. little pleasure in few activities
  5. lacks close friends/ confidants
  6. indifferent to praise/ criticism
20
Q

What is the main difference between SPD vs Schizoid PD?

A
  • reason for withdrawal from social interaction
    SPD = fear of social interaction (paranoia/ suspicion)
    Schizoid PD = lack of desire for social interaction
21
Q

What are the 5 or more symptoms which need to be present + having a significant impact on their daily life for borderline PD to be diagnosed?

A
  1. erratic emotions accompanied by feelings of emptiness + anger
  2. Difficulty making + maintaining relationships
  3. unstable sense of identity - often driven by social influencers
  4. risk taking without considering potential consequences
  5. self-harming or thoughts of it
  6. fear of being rejected/ abandoned
  7. hallucinations/ delusions
22
Q

Who are most likely to be diagnosed with borderline PD?

A
  • 75% diagnosis = females :O

- prevalence = 1/2%

23
Q

Why is there such a high rate of suicide (10%) among those diagnosed with borderline disorder?

A
  • negative emotions xp = negative thoughts
24
Q

What makes borderline PD hard to diagnose + treat?

A

high co-morbidity

- depression, anxiety, eating disorder, substance misuse

25
Q

Who is Craig?

A
  • went to doctor to sneakily ask for some codeine
  • doctor found history of morphine addiction + impulsivity + irregular work
  • didn’t give any drugs
  • afterwards he returned for a legitimate reason and said he knows the doctor is not stupid and would believe him
26
Q

How is the the term Antisocial PD described by clinicians?

A
  • a pervasive pattern of disregard for, + violation of, the rights of others
  • begins in childhood/ early adolescence
  • continues into adulthood
27
Q

What are the core characteristics of antisocial PD?

A
  • impulsivity
  • disregard for other people’s safety = reckless
  • consistent irresponsibility
  • lack of remorse for others
    repeatedly. ..
  • performing illegal acts
  • lying/ conning others for profit/ pleasure
28
Q

What label are offenders given if they have mental illness, PD, learning difficulties or drug dependency?

A

mentally disordered offender

29
Q

According to Lynam + Gudonis (2005), what are the five dimensions of personality would people with antisocial PD score low on?

A 
Costa + McCrae (1995) 5-factor model of personality
Low...
- neuroticism
- extroversion
- openness
- agreeableness
- conscientiousness
30
Q

A low score in the 5 factor model of personality (Costa + McCree) as suggested by Lynam + Gudonis for people with antisocial PD entails what type of behaviours?

A
  1. L neuroticism = emotional blandness - lacking appropriate concern for health/ social adjustment
  2. L extroversion = introversion - socially isolated, may xp flattened affect
  3. L openness = difficulty adapting to social/ personal change, little tolerance for opinions + high conformity
  4. L agreeableness = cynical + paranoia thinking, exploitative + manipulative
  5. L conscientiousness = underachiever, lack of self-discipline, aimless
31
Q

Define the term ‘psychopathy’

A
  • person demonstrates an apparent cluster of psychological, interpersonal + neurological features
    Hare 1993, they are…
  • social predators who charm + manipulate
    -ruthlessly plough through life
  • completely lacking consciousness + empathy
  • selfishly take + do what they want
  • violate social norm with no guilt
32
Q

What are the 3 categories of psychopathy devised by Hare?

A
  1. Primary psychopath
    - true psychopaths = actually have emotional, bio + cognitive differences
  2. Secondary psychopaths
    - behave as they do due to severe emotional problems/ inner conflict
  3. Dyssocial psychopaths
    - behaviour learnt from subcultures - gangs/ families
33
Q

Why are secondary + dyssocial psychopaths portrayed as incorrently as psychopaths in the media?

A
  • high recidivism rates
  • those with psychopathic disorder = 7x more likely to commit serious crime on discharge vs those with mental illness (Bartol + Bartol, 2011)
34
Q

What cluster does borderline PD belong to, A or B?

A

Cluster B

35
Q

What is the PCL-R?

A

Psychopathic check list - revised (Hare)
- measures 20 items based on typical characteristics
- rated based on interviews + file information
EG, superficial charm, lack or remorse, impulsivity, juvenile delinquency

36
Q

What is the prevalence of psychopathy in prison?

A

high

  • around 13% in UK scored high
  • 73% males in special unit
37
Q

What is the difference between antisocial PD vs Psychopaths, which is often overlooked in the legal sector?

A

psychopaths = often associated with criminal/ antisocial behaviour + can be classified as having anti-social PD
- much more precise + in-depth
Anti-social PD = much more diverse

38
Q

What are the guidelines + overall goals for treatment made by Roth + Fonagy (1998) for the treatment of borderline PD?

A
  1. Psychotherapy more effective for less severe cases
  2. Patients under age of 30 = greater risk of suicide = prevention rather than cure important target therapy
  3. those with good social support, chronic depression, psychologically minded + low impulsivity = most benefit from ‘talking therapy’
  4. commitment + enthusiasm of therapist important
39
Q

What treatments are there for borderline PD?

A
  1. cognitive therapy
    - identification + modification of cognitions + underlying schemata
  2. Emotional awareness therapy
    - work through a hierarchy of emotional awareness, starting with bodily sensations
  3. Pharmacological treatment
40
Q

What did Soloff et al find about the pharmacological treatment for borderline PD?

A
  • inconsistent
  • major tranquillisers (Haloperidol) reduce broad spectrum of symptoms
  • some have heightened suicide threats/ agression
41
Q

What treatment is there for antisocial PD?

A

Family + peer intervention (Borduin, 1999)

  • give them skills to cope with family life
  • reduce stress levels at home environment
  • peer-intervention to encourage pro-social interaction
42
Q

What are the treatments for psychopathy?

A

Therapeutic communities

- often used in forensic settings where there is a high percentage of offenders w/ PD

Clinical Psychology (17 decks)

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