CH 10 Personality Disorders Flashcards
DSM-5 Criteria
Paranoid Personality Disorder
A (1-7), B
A. Pervasive distrust/suspicion of others, motives are interpreted as malevolent, begining by early adulthood
1. Suspects (baseless) that others are exploiting/deceiving/harming them
2. Preoccupied with unjustified doubts about loyalty of friends/associates
3. Reluctant to confide in people (fear that info will be used against them)
4. Reads (false) hidden demeaning/threatening meanings
5. Persistently bears grudges
6. Perceives attacks on character/reputation that are not apparent to others
7. Recurrent suspicions about fidelity of sexual partner (baseless)
DSM-5 Criteria
Schizoid Personality Disorder
A. Pervasive pattern of detachment from social relationships & restricted range of emotion expression in interpersonal settings
1. Neither desires/enjoys close relationships
2. Almost always chooses to be solitary
3. Little if any sexual interest in others
4. Pleasure in few, if any, activities
5. Lacks close friends
6. Indifferent to praise/criticism of others
7. Cold, detached, flattened affectivity
DSM-5 Criteria
Schizotypal Personality Disorder
A. Pervasive pattern of social/interpersonal deficits marked by acute discomfort with/capacity for close relationships and cognitive/perceptual distortions/eccentric behavior
1. Ideas of reference
2. Odd beliefs/magical thinking influences behavior, inconsistent with cultural norms
3. Unusual perceptual experiences
4. Odd thinking & speech
5. Suspiciousness or paranoid ideation
6. Innappropriate or constricted affect
7. Behavior/appearance is peculiar
8. Lack of close friends
9. Excessive social anxiety that does not diminish with familiarity, associated with paranoid fears rather than negative self-judgements
DSM-5 Criteria
Histronic Personality Disorder
A pervasive pattern of excessive emotionality and attention seeking
1. Uncomfortable in situations in which they’re not the center of attention
2. Inappropriate sexually seductive behavior
3. Rapidly shifting & shallow expression of emotions
4. Uses appearance to draw attention to self
5. Excessively impressionistic, detail-lacking speech
6. Self-dramatization and exaggerated emotional expression
7. Easily influenced
8. Considers relationships more intimate than they are
More common in women
DSM-5 Criteria
Narcissistic Personality Disorder
Pervasive pattern of grandiosity, need for admiration, and lack of empathy
1. Grandiose self-importance
2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or love
3. Believes they are “special” or unique and can’t be understood by normal people
4. Requires excessive admiration
5. Entitled
6. Interpersonally exploitative
7. Lacks empathy
8. Often envious of others or believes others are envious of them
9. Arrogant, haughty behaviors
DSM-5 Criteria
Antisocial Personality Disorder
A. Pervasive pattern of disregard for and violation of the rights of others, since age 15
1. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
2. Deceitfulness
3. Impulsivity or failure to plan ahead
4. Irritability and aggression (physical fights or assaults)
5. Reckless disregard for safety of self and others
6. Consistent irresponsibility, indicated by repeated failure to sustain consistent work behavior or honor financial obligations
7. Lack of remorse
B. 18+
C. Evidence of conduct disorder with onset before age 15
D. Occurrence of antisocial behavior is not exclusively during schizophrenia or bipolar disorder
DSM-5 Criteria
Borderline Personality Disorder
Pervasive pattern opf instability of itnerpersonal relationships, self-image, affects, and marked impulsivity
1. Frantic efforts to avoid real or imagined abandonment
2. Pattern of unstable and intense relationships
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
4. Impulsivity in at least two areas that are potentially self-damaging
5. Recurring suicidal behavior/gestures/threats/self-mutilation
6. Affective instability due to a marked reactivity of mood
7. Chronic feelings of emptiness
8. Inappropriate, intense anger/difficulty controlling anger
9. Transient, stress-related paranoid ideation or sever dissociative symptoms
Why are personality disorders difficult to treat/research
- Must wait until age 18 to diagnose
- Can’t diagnose without extended treatment
They don’t see their symptoms as problematic
What differentiates the understanding of symptoms in personality disorders from other disorders
They perceive symptoms as part of themself (their personality)
What are general features of personality disorders?
- Chronic interpersonal difficulties
- Problems with sense of self
- Difficulty functioning adequately in society
What diagnoses are included under
Cluster A
- Paranoid
- Schizoid
- Schizotypal
What diagnoses are included under
Cluster B
- Histrionic
- Narcissistic
- Antisocial
- Borderline
What diagnoses are included under
Cluster C
- Avoidant
- Dependant
- Obsessive-compulsive OCPD
What are the defining characteristics of
Cluster A
Odd or eccentric beliefs and behavior
What are the defining characteristics of
Cluster B
Dramatic behavior and emotionality
What are the defining characteristics of
Cluster C
Anxiety and fearfulness
Underlying Factors of Personality Disorders
Psychological
- Attachment in infancy (psychodynamic
- Learning-based: habit patterns & maladaptive cognitive styles
Underlying Factors of Personality Disorders
Sociocultural
Rates differ cross-culturally and over time
Characteristics of
Paranoid Personality Disorder
- High neuroticism
- Low agreeableness (high antagonism)
Heritability of
Schizoid Personality Disorder
50%
Characteristics of
Schizoid Personality Disorder
- Low openness
- Low Achievement
Prevalence and characteristics of
Schizotypal Personality Disorder
- More common in men
- Linked with schizophrenia
Prevalence and characteristics of
Histrionic Personality Disorder
- More common in women
- High comorbidity with Cluster B and other PDs
Prevalence and characteristics of
Narcissistic Personality Disorder
- More common in men
- High sexual coersiveness
- High social media use
When are personality disorders diagnosed?
(What is the minimum age)
18+
Children should not be diagnosed with personality disorders.
What is one question you can ask to find out if someone has BPD or Bipolar disorder?
Can you go days without sleeping/feeling tired?
Yes - Bipolar
No - BPD
How did Borderline Personality Disorder get its name?
“Border between neurosis and psychosis”
Describe the heritability of BPD
Moderate
4x more likely with bio relatives who have BPD
Risk factors for
BPD
- Moderate heritability
- Childhood abuse
- Childhood adversity
- Genetic vulnerability
Risk factors for
Antisocial Personality Disorder
- Low SES
- Urban upbringing
- Low parental supervision
- Child abuse
- Low Monoamine Oxidase A (MAOA) gene activity
- Link with depression (monoamine hypothesis)
Prevelance of
Avoidant Personality Disorder
2-3% of the population
Differentiate between
Social Anxiety and Avoidant Personality Disorder
Social Anxiety:
* Onset at some point throughout life (eg. moving to college)
* Close relationships are relatively normal
* Less Severe
Avoidant PD:
* Lifelong pattern of behavior and feelings
* Extreme severity
* Deep feeling of inadequacy
* Withdrawn from close relationships
Common comorbid disorders for
Dependent Personality Disorder
- Depression
- Anxiety
- BPD
- Histrionic PD
- EDs
- Somatic
Common comorbid disorders for
OCPD
- Mood
- Panic
- Anorexia
Prevelance of
OCPD
- 20% with OCD have OCPD
- 2%
- More common in men
Prevelance of
Dependant Disorder
More common in women
Define
Ego syntonic
Behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego
Treatment for
BPD
List different methods
- Dialectical Behavior Therapy
- Individual and Group
- Interpersonal effectiveness, emotion regulation, distress tolerance, mindfulness, coaching calls, team support
- Transference-Focused Psychotherapy
- SSRIs (not compelling)
Treatment for
Other PDs
List different methods/which ones are easily treatable
- Cognitive Therapy
- Antipsychotics or antidepressants for Schizotypal PD
- Cluster C is easiest to treat
- CBT and Antidepressants for Avoidant PD
