Chapter 12 - Personality Disorders Flashcards
What is a personality disorder?
Enduring pattern of inner experience and behaviour that deviates markedly from expectations of individual’s culture
What are characteristics of personality disorder?
Rigid and inflexible
Highly inappropriate behaviour to others
Restricted range of traits compared to others
Causes distress to others
What are the 3 DSM-5 clusters of personality disorders?
Custer A: Odd and eccentric
Cluster B: Dramatic, emotional, erratic
Cluster C: Anxious and fearful
What are the disorders under Cluster A?
Paranoid, schizoid, schizotypal
What are the disorders of Cluster B?
Antisocial, borderline, histrionic, narcissistic
What are the disorders of Cluster C?
Avoidant, dependent, obsessive-compulsive
What is the lifetime prevalence of personality disorders?
6.7%
Cluster ____ seek treatment most, followed by cluster ____, then cluster ____.
B; C; A
For personality disorders, functioning is often __________.
Egosyntonic
In diagnosing personality disorders, ______ reliability is typically good, but _____ reliability is weak.
Interrater; test-retest
What are the biases for diagnosing personality disorder?
Gender and cultural
What are the gender biases of diagnosing personality disorders?
Clinician bias
Bias in DSM criteria
Systemic bias
What is comorbidity?
Co-occurrence of 2+ different diagnoses
What is diagnostic overlap?
Similarity of symptoms in 2+ different disorders
What is the psychodynamic view of the development of personality disorders?
Disturbances in parent-child relationship
Separation-individuation
Inadequate sense of self
What is attachment theory of PD?
When bond to parents poor, child lacks inter-relational confidence
What is the cognitive-behavioural perspective of PD?
Disordered schemas developed early in life
New events distort to maintain validity of schemas
What are the biological factors of PD?
Genetics, dysfunction of prefrontal cortex
Cluster A has ______ links with ______ and ______.
Genetic; schizophrenia; mood disorders
Cluster B has ______ factors and _____ problems.
Biological; attachment
Cluster C has limited investigation of _______.
Causal factors
What is paranoid personality disorder?
Suspiciousness concerning motives of other people
People with paranoid personality disorder have problems in _________, with a need for ________, _________ and ________ nature.
Relationships; control; jealous; suspicious
PPD has a genetic link with _________.
Schizophrenia
The difference between PPD and schizophrenia is…
Severity of paranoid beliefs
Schizophrenia delusions, PPD within realm of possibility
What is schizoid personality disorder?
Completely uninterested in intimate involvement with others
People with schizoid personality disorder lack ____________, prefer ________, and avoid _________.
Emotional responsiveness; being alone; social relations
Schizoid personality disorder mirrors negative symptoms of ______ but may be more related to ______.
Schizophrenia; asocial disorders
What is schizotypal personality disorder?
Extremely superstitious and odd beliefs/behaviours
Schizotypal personality disorder DOES NOT meet criteria for ____________.
Delusional/hallucinatory psychotic experiences
What are the differences between schizophrenia, schizotypal PD, and schizoid PD?
Schizophrenia: psychotic symptoms (hallucinations/delusions)
Schizotypal: odd beliefs/behaviours
Schizoid: absolute disinterest/indifference to others
What is the difference between antisocial PD and psychopathy?
Antisocial PD: observable behaviours, disregard/violation of others
Psychopathy: “users” of others, antisocial/violent behaviours
Only small portion of ________ are _______, but most _______ individuals are also _______.
ASPD; psychopathic
Psychopathic; ASPD
What are the 3 etiologies of ASPD?
Genetics, social/family factors, psychological factors
How do social/family factors affect ASPD?
Inconsistent responding/punishing from parents
What is the fearlessness hypothesis of ASPD?
Higher thresholds for feelings fear, so fear not as strong
Based on Schmauk’s study, ASPD patients responded well to ________ punishments, but not ________ or ________ punishments.
Tangible; social; physical
Symptoms of ASPD often _________ over time and likely __________ by _________.
Remit; disappear; 4th decade of life
ASPD treatment response is generally ________.
Poor
Treatment for ASPD should be aimed at…
Symptom reduction and behaviour management
Psychopathy is strongly linked to ______ and ______.
Aggression; violence
What is selective impulsivity theory of psychopathy?
Will act impulsively only if consequences worth the risk
In forensic populations, approximately _____ inmates psychopaths
15-25%
What are the 5 brain parts for abnormality of psychopathy?
Prefrontal cortex
Hippocampus
Angular gyrus
Basal ganglia
Amygdala
What are the 2 neurotransmitters associated with psychopathy and what happens to them?
Low serotonin activity and high dopamine activity
Environmental factor of psychopathy is…
Emotional deprivation (abuse, neglect)
What is fundamental psychopathy?
Result of biological predisposition hindering ability to experience emotions
What is secondary psychopathy?
Result of negative environmental experiences
Precursors to psychopathy emerge in childhood, such as…
Callous and unemotional traits
What is borderline personality disorder?
Pervasive pattern of instability of interpersonal relationships, self-image, and marked impulsivity
What are the 9 DSM-5 criterion for BPD?
Unstable interpersonal relationships
Avoid abandonment
Problems with sense of self
Impulsive
Suicidal/self-harming
Affective instability
Emptiness
Anger
Paranoid ideation/severe dissociative behaviours
The 5 dysregulations associated with BPD are…
Emotional, interpersonal, self, behavioural, cognitive
What are the 4 etiologies of BPD?
Childhood experiences
Attachment problems
Biological factors
Genetics
What are the biological factors of BPD?
Reduced grey matter in prefrontal cortex and hippocampus
What are the 2 factors of biosocial theory?
Emotional vulnerability, invalidating environment
What is the treatment for BPD?
DBT (build life worth living)
What is histrionic personality disorder?
“Life of the party”, attention-seeking behaviours
What is narcissistic personality disorder?
Grandiose and consider selves to have unique/outstanding abilities
What characterizes narcissistic personality disorder?
“Me, me, me”, cannot handle criticism, exploit others
What is avoidant personality disorder?
Pervasive pattern of avoiding interpersonal contacts
What is the parental rejection theory of avoidant PD?
Lack self-confidence and avoid others for fear of further rejection
What is dependent personality disorder?
Afraid to rely on self to make decisions, seek reassurance from others and submissive role
Female relative to those with DPD are likely to have _________ while male relatives to those with DPD are likely to have _______.
Panic disorder; depression
What is obsessive-compulsive personality disorder?
Inflexibility and desire for perfection
How does OCPD differ from OCD?
OCPD absence of obsessional thoughts and compulsive behaviours
What are barriers to treatments for PDs?
Patients not see problem
Difficulty maintaining therapeutic relationships
Treatment context
What is object relations therapy?
Correct aspects of self resulting from unfortunate early experiences, importance of therapeutic relationship
What are the cognitive-behavioural approaches to treatment for PDs?
Beck’s CBT, DBT
Pharmacological interventions work best for _______ personality disorder.
Borderline
