Abnormal Final Personality Review

Question 1

Personality Disorders: general Defintion

Answer 1

Chronic pattern looking at aspects of person’s life, employment, and livelihood.
Persistent pattern of emotions, cognitions, and behaviours resulting in subjective distress

Question 2

Dimensions and Categories: What is the controversy here?

Answer 2

Degrees and kinds looking at how disorders are categorized as either having or not having, yet others argue they exist on a continuum of disorders

Question 3

Advantages of Dimensional model

Answer 3

Gain more information on individuals, flexible in permitting both kinds and degrees of disorders, and avoid arbitrary decisions in assigning diagnostic category.

Question 4

Continuum of disturbances in the self and Big Five

Answer 4

Looks at interpersonal functioning on a spectrum.
Measures the Big Five personality traits of Conscientiousness, Agreeableness, neuroticism, extraversion, and openness to new experiences.

Question 5

Personality across cultures (Hint: Turkey and China, Taiwan and Slovenia)

Answer 5

Turkey youth were higher in conscientiousness and extraversion compared to China while Taiwan and Slovenia were equal in their traits.

Question 6

Clusters of Disorders, there are three

Answer 6

Cluster A is odd/eccentric (paranoid, schizoid, and schizotypal), Cluster B is dramatic/emotional/erratic (antisocial, borderline, narcissistic, and histrionic), Cluster C is anxious/fearful (avoidant, dependent, and obsessive-compulsive).

Question 7

General prevalence in relation to anxiety and mood disorders.

2) what were the findings of Trull’s Study

Answer 7

• 2017-18 found 5.6% discharged from hospital had personality diagnosis, second lowest after anxiety (4.4%), mood is highest with 28.4%
  2) 7.4% have a personality disorder, 9.1% in Trull’s study, 2.1% in cluster A, 5.5% in B, and 2.3% in C. All linked to substance abuse.

Question 8

Cluster A & B are thought to be associated with what?

2) Worldwide variance of disorder in general.
3) Borderline and Suicide

Answer 8

Physical disease, suggest major life problems present.

2) Varied cross-culturally, 7.8% worldwide, 0 in China, Australia and other high income countries had higher prevalence. Lack research due to lack of outreach for help.
3) Borderline had 80% attempt suicide.

Question 9

Gender Differences in general

2) Personality Disorder Biases

Answer 9

Prevalent in men, 10.3% compared to women’s 8%. Women are higher in cluster C and borderline. May be genetic, sociocultural, bias in physicians.

2)Antisocial associated with males, study found 42% guessed correctly, females associated with histrionic more. May be biased against women, misdiagnosis possible. Likely not bias as it does not exist with other personality disorders.

Question 10

Comorbidity for schizotypal and paranoid
Schizotypal and schizoid
Cluster C Rates

Answer 10

Considerable overlap between personality disorders with schizotypal and paranoid highest at 37.3%,
Schizotypal and schizoid at 19.2%.
Lowest in Cluster C.

Question 11

Paranoid Disorder Clinical Description
Relation to Schizophrenia
What is their Quality of life like?

Answer 11

Mistrust in others interferes with social life, unjustified mistrust, unfounded suspicions, assume others are out to get them, overtly hostile.
Excess autonomy, sensitivity to criticism, more suicide attempts, violent behavior, poor Quality Of Life.
Relate to paranoid schizophrenia and delusional disorder, lack delusions and hallucinations.

Question 12

Causes of Paranoid Disorder

2) What kind of psychosocial groups are vulnerable?

Answer 12

Biological: Relatives with schizophrenia
Psychosocial: early mistreatment possibly, schemas may result in malevolent thoughts taught by parents, like everyone is out to get you (the child), stay on your toes.

2) Cultural: Groups like prisoners (think others talk behind their back), refugees (do not understand the language), elderly (hard of hearing, think youth are putting in a nursing home), and deaf (can not hear so do not know what others are saying) may susceptible.

Question 13

Treatment for Paranoid Disorder
Problems
2) What one treatment has had some success?

Answer 13

Unlikely to seek help, triggered by mood disorder, sense of trust and rapport with therapist, no proof of significant improvement in lives.
2) Cognitive restructuring may be helpful.

Question 14

Schizoid Disorder Clinical Description
Bleuler’s Perspective on it
What do schizoid’s no longer desire?

Answer 14

Isolation from social relations, limited emotions and range thereof, cold, and indifference.
Bleuler saw it as the tendency to turn inward and away from the outside world
2) no desire for closeness, romance, sex, appear cold, aloof, indifferent.

Question 15

Developmental and Biological causes of Schizoid Disorder

Answer 15

Developmental: Childhood shyness may be precursor to adult onset.
Biological: Inherited as trait, biological dysfunction with early learning and problems communicating causing social deficits.

Question 16

Treatment for Schizoid Disorder

Answer 16

Rare to seek help, mood disorder triggers outreach (depression and Bipolar)
Social training teaches emotions and empathy, social network, limited outcome and cautious in effectiveness.

Question 17

Schizotypal Disorder Clinical Description
Relation to Schizophrenia
Relation to Religion

Answer 17

Social isolation, unusual behaviour, suspicious, odd beliefs,
Continuum of schizophrenia, no positive symptoms or cognitive impairments. Perceive illusions and presence of others when alone, but only a feeling and not hallucinating.
Beliefs in religion and spirituality, may cause misdiagnosis.

Question 18

Causes of Schizotypal Disorder
Relatives
Disease
Memory

Answer 18

Biological: Phenotype of schizophrenia, lack biological influences in prenatal, illness, and environmental stressors result in less severe diagnoses of schizotypal disorder.
Relatives with schizophrenia had more schizotypal compared to those without,
Influenza may increase likelihood of getting it
Cognition: The cognitive assessment found mild-moderate deficits in memory and learning= damage in left hemisphere.

Question 19

Treatment for Schizotypal Disorder
What causes an outreach?
What are they treated for?
What medication and psychosocial treatment?

Answer 19

Mood disorder triggers outreach, risk major depressive disorder.
Treated for major depressive disorder, interest as a precursor to schizophrenia.
Anti-psychotics, community treatment, and social skills reduce symptoms, prevent onset of later paranoia, may be promising.

Question 20

Antisocial Disorder
Prevalence in new male inmates
History of the disorder
Fatality Rates

Answer 20

Fail to comply with social norms, unacceptable actions, irresponsible, impulsive, and deceitful.
New male inmates had 44% global, 36% in Ontario, 54% in Atlantic, 40% in Prairies, and 64% in Pacific, Mesopotamia in 760 BCE.
twice as likely to die unnaturally, attributed to alcohol abuse and poor self-care. Debated to be psychopathy

Question 21

Conservative or liberal diagnoses for Antisocial disorder
Antisocial and Psychopathy: Similarities
Childhood & and IQ
Major difference

Answer 21

Liberal with 50-80% diagnosed in prisons/hospitals, 14 psychopaths
Deceitfulness, impulsivity, lack of remorse.
16% broke laws in childhood, at-risk children had lower IQs, IQ could protect from problems.
Psychopaths put less effort and do not improve in therapy.

Question 22

Childhood/Adolescent Conduct Disorder

Specifier

Answer 22

Present in a way similar to adults with psychopathy may feel remorse.
Callous-unemotional presentation distinguishes from normal children as they lack remorse and emotions are dampened
Conduct disorder likely predicts antisocial disorder and ADHD.

Question 23

Causes of Antisocial Disorder
Genetics, what does it say on adopted children?
Predictors in Family
Is it inevitable?

Answer 23

Genetics: Adopted children with criminal mothers likely to be arrested, convicted, or are in orphanages longer points to gene-environment interaction.
Predicted by parents exposing a child to stress with marriage, legal, other psychiatric disorder
Not inevitable as they interact with factors like academic difficulty, socialization, income, neglect, and discipline.

Question 24

Cognitive causes for Antisocial Disorder

Answer 24

Discrepancies in executive function and attention abilities and abilities to maintain plan and inhibit irrelevant information.

Question 25

Underarousal Theory
Cortical Hormones
Theta Waves: What are they?

Answer 25

Cortical hormone levels in psychopaths are low, has inverted U-shaped relation in regards to arousal and performance, points to cortical arousal being cause of disorder.
May come from low-frequency theta waves supposed to disappear in adulthood, cerebral cortex is likely to be in primitive stage of development as they inhibit, control impulses and are not developed enough.

Question 26

Fearlessness Theory
Which sex?
What else results in aggression? Is it generalizable?

Answer 26

A higher threshold is needed for fear, frightening imagery has little effect on the psychopath
May be linked to the Y chromosome as found in men only.
Combines with stressors to result in aggression, stays in one family but not generalizable to everyone as other factors contribute.

Question 27

Psychological Causes of Antisocial
Developmental
Sociological
Stress

Answer 27

Psychopaths in risk tasks were found to be less affected by no reward, likely less deterred by signs of goals no longer achievable.
The family had an impact on the child’s aggression, coercive family process combined with less supervision, genetics, inept monitoring to maintain aggression.
Low socialization increased the risk of nonviolent criminality in females like conduct disorder.
Stress is the final factor, combat may predict as was the case for Vietnam veterans, childhood trauma as well, and physical abuse.

Question 28

Integrative Model for Antisocial Disorder

Answer 28

Label of “criminal” points to a genetic vulnerability combined with both antisocial vulnerabilities and personality traits resulting in under arousal or fearlessness.
Family stress due to divorce causes the child to push away good role models and attract other antisocial children.

Question 29

Treating Antisocial Disorder
Problems
Treatment
Factors

Answer 29

Very manipulative in therapy results in a pessimistic prognosis, few documented success stories, encouraged to find at risk children to prevent
CBT may reduce violence 5-years post-treatment. Parent training is common to recognize problems and use reinforcers to reduce problems.
Factors like SES, dysfunction in family, stress, history in the family, and conduct disorder.

Question 30

Preventing Antisocial Disorder
Childhood
Are there any definitive predictors?

Answer 30

Preschool combines parenting skills with supports for families suffering economic and social disadvantages
Cannot identify which children are higher risk, likely best approach due to lack of disorder in adulthood.

Question 31

Borderline Disorder Clinical Description
Prevalence in Clinical setting
How many die of suicide
What is the remission rate/how many are "cured"
How do they rationalize their self-abuse
Comorbidity with mood disorders and eating disorders (percentages)
The average age range of improvement
Likelihood of abuse by spouse

Answer 31

Tumultuous lives, mood, and relationships are unstable. Combine with poor self-image, feel empty and risk suicide.

Most common in a clinical setting, self-mutilating behaviours

10% die due to suicide

75% achieve remission 6 years after the first treatment.

Abuse of self rationalized to be tension reducing
80% have major depression, 10% bipolar II, eating disorder like bulimia in 25% and 20% for anorexia.

Improve in 30-40s with some difficulties

Abuse of spouse are high borderline characteristics,
40% of men abuse spouses.

Question 32

Causes of Borderline Disorder
Familial
Cognition and memory
Developmental
What kind of suicide attempts?
How many report sexual abuse? How many reported neglect and prior to what age?
Similarities to PTSD
Other factors
Is Abuse a definitive predictor of borderline disorder?
How is the environment-gene correlation Model present here?

Answer 32

Familial: major indicator, those with a mood disorder and an identical twin had higher concordance rates in twin compared to a fraternal twin

Cognitive factors: Inability to forget words associated with a borderline disorder like hurt, cut, tumultuous.

Early trauma of sexual and physical kind.
Women with minor and major suicide attempts or parasuicidal.
76% reported sexual abuse and serious suicide attempts with 91-92% neglected prior to age of 18. Childhood trauma exists as well with a predisposing temperament and personality.
2-3 times more likely to be abused compared to men. similar to PTSD with difficulty in regulating mood, only specific to women.
Symptoms found in rapid cultural changes, identity changes, emptiness, fears of abandonment, and low anxiety.
20-40% have no history of abuse, so insufficient on own to produce disorder.
A Stressor from the environment may trigger unstable behaviors if the person lacks biological traits protecting against stressors they may be volatile.

Question 33

Treating borderline Disorder
Problem
Medications and Therapy
What factor is often not considered by the therapist?

Answer 33

Complicated by substance abuse

Tricyclic antidepressants, lithium, and antipsychotics helped. CBT is limited in research but DBT helped cope with stressors triggering suicidal behaviours and maladaptive behaviours.

Need to trust what treatments work for the individual though and not what should work, DBT helps relieve suicide attempts, drop-outs, and hospitalization results in less suicidal ideations, aggression, and better adjustment to social life.

Question 34

Treating subtypes of Borderline Disorder
What are the three subtypes?
Which type of treatment may be beneficial? Is it beneficial to all of them?

Answer 34

1. Impulsive subtype (impulsive, self-destructive, and treatment-threatening behaviours)
2. Identity disturbance subtype (persistent unstable self-image or sense fo self)
3. Affective subtype (marked mood swings and difficulty controlling anger)
   Couples therapy is beneficial but only to identity disturbance and affective subtype.

Question 35

Histrionic Disorder

Which gender is diagnosed more?

Answer 35

Overt drama, exaggerated emotions, vain, self-centered, uncomfortable when not in spotlight, seduce physically and behaviourally, concerned with looks, want reassurance, approval and upset when unattended. difficulties with delayed gratification, lack details in speech and is vague.

Women are diagnosed more than men, nature is questioned and features are thought to be stereotype of women, Sprock found evidence supporting this.

Question 36

Cause of Histrionic Disorder Clinical Description
History
What other personality disorder does it share similarities with?

Answer 36

Greeks believed the uterus moved through the body and in men related to the antisocial disorder.
2/3 met criteria for antisocial as well so maybe sex-typed alternative of the same underlying condition.

Question 37

Treating Histrionic Disorder

Answer 37

Little research, modified attention behaviors, focus on social relations by preventing manipulation of emotional crises, charm, sex, seducing, or complaining.

Question 38

Narcissistic Disorder
History
Clinical Description
What do they expect?
What happens when successful people confront them?

Answer 38

Based on Narcissus who spent days admiring the reflection
Freud believed it showed an exaggerated sense of self-importance and preoccupied with attention.
Lack sensitivity, and compassion, not comfortable unless admired, grandiosity creates negative attributes, expect special attention like best table in the restaurant. Manipulate others with little empathy, when confronted by successful people become envious and arrogant become depressed.

Question 39

Causes of Narcissistic Disorder
Developmental
Evolutionary
Sociological
What trait does it share with psychopaths of the Big Five Theory?
What happened in 1946-64

Answer 39

Developmental: Infancy is self-centred and demanding as part of survival
Socialization teaches altruistic behaviours but results in a failure of such socialization, fixated in the self-centred grandiose stage.
Endless search for ideal person, increases in Western societies due to social changes, emphasis on short-term hedonism, individualism, competitiveness, and success.
Shared disagreeableness in Big Five, with psychopaths, and saw a boom in 1946-64, result of increased public interest.

Question 40

Treating Narcissistic Disorder
Problems
Treatment

Answer 40

Limited success rates focus on grandiosity, hypersensitivity to criticism, and lack of empathy.
Replace fantasies with a focus on attainable experiences.
Relaxation training useful in facing and accepting criticism
Understanding the feelings of others is another goal, vulnerable to severe depressive episodes, treatment for depression makes it impossible to draw conclusions.

Question 41

Avoidant Disorder Clinical Description

Are they different from apathetic individuals?

Answer 41

Relations are desired but anxiety leads to avoid any association due to fear of rejection.
Low self-esteem coupled with fear of rejection limits friends and depend on those comfortable with
Different from apathetic individuals resulting in flat interpersonal life
Pessimistic about future.

Question 42

Causes of Avoidant Disorder
Developmental
Cognition

Answer 42

Developmental: Difficult temperament in birth/personality, parents reject child, not enough uncritical love, low-self esteem, and social alienations. Parents rejected the child, engendered guilt, affection, consistent report of neglect, isolation, rejection and conflict with others.
Cognition: Sensitive to how others treat them, memories differ from reality, part of social anxiety spectrum, behavioural inhibition is linked to avoidant response in unfamiliar situations.

Question 43

Name four Treatments for Avoidant Disorder

Answer 43

1) Behavioral interventions for anxiety and social skills with some success
2) Social skills training within support group useful in helping people with disorder become assertive.
3) CBT helped graduated exposure to situations as central component, anxiety-causing could be rejection or fear of, criticism, and anxiety of appearance.
4) Systematic desensitization may help by relaxing in anxiety-provoking situations.
5) Behavioural rehearsal with acting out anxiety-provoking situations improved fear.

Question 44

Dependent Disorder Clinical Description

Answer 44

• motivated by anxiety
• agree with others when opinions differ and are rejected
• want to obtain and maintain supportive relations which nurture behavioral characteristics like submission
• timid and passive
• sensitive to criticism and need reassurance
• cling to relations
• cultures and philosophies may depend on submission as desired states.

Question 45

Causes of dependent Disorder

Cognition

Answer 45

Cognition: Need others for survival, live independently but early death of parent or neglect cause people to grow up fearing abandonment.
Genetics and physiological factors suggest underlying influences are misunderstood as is any gene-environment correlation.
Sociotropy is a personality orientation where investment is created for positive social interactions.
In groups tested on dependency found 4 subtypes of 1) autonomous, 2) sociotropic, 3) individualistic achievement and 4) low-scoring groups.
Sociotropy is a predictor of dependent disorder.

Question 46

Treating Dependent Disorder

Problems

Answer 46

Little research, ideal patients are submissive to therapists, negate major goal in making independent and responsible
Gradual progression in confidence to make decisions independently, the goal is to make patient is not dependent on therapist.

Question 47

Obsessive-Compulsive Disorder (OCD) Clinical Description

Similarities with serial killers, sex offenders, pedophpiles, and gifted children.

Answer 47

Fixated on doing things the right way

• persistence and dedication prevents from doing anything
• work oriented,
• little time for leisure
• poor interpersonal relations
• Psychological profiles of serial killers are OCD, fit definition of someone with severe mental illness but control by manipulating victims, control all aspects of crime fits OCD and childhood trauma.
• May be in sex offenders as well, pedophiles due to brain functioning similarly to those with OCD,
• OCD found in gifted children as well.

Question 48

OCD:
Causes
Treatment

Answer 48

Causes: Genetic contribution with predisposition to structure
Developmental: lack of parental reinforcement to aid with child’s conformity and neatness,
Cognitive Factors: Lack of Orderliness, afraid anything done is inadequate, procrastinate/ruminate about issues and minor details.
Treatment: relaxation or cognitive reappraisal techniques help to reframe thoughts, perfectionism is important to them.
CBT was found effective in treating OCD as well.

Question 49

Other Personality Disorder

Answer 49

Sadistic Disorder with pleasure derived by causing pain to others.
Passive-Aggressive disorder has defiance and refusal in cooperating with requests and undermine authority figures.