Chapter 12: Personality Disorders Flashcards
Personality
Captures patterns of acting, thinking, and feeling that characterize a given individual and distinguish that person from others
Personality traits
Reflect aspects of our behaviour that are relatively consistent across time and situations
Neuroticism
Captures the degree to which an individual is prone to experiencing unpleasant emotions like anxiety, sadness, and fear
Extraversion
captures the extent of a person’s preference for social interactions vs solitary activity
Openness to experience
Captures how curious an individual is and how receptive they are to new ideas, approaches, and events
Conscientiousness
Taps propensity for organization, punctuality, and achievement motivation
Agreeableness
Reflects individual differences in people’s preferences for co-operation and social harmony
Five Factor Order (FFM)
OCEAN example
Dimensional Networks
Founded on the premise that personality traits are continuously distributed in populations and personality pathology reflects extreme variants of typical personality traits
Categorical approach
The diagnostic approach taken by the DSM, in which an individual is deemed either to have a disorder or not have a disorder
Polythetic Criterion set
An individual may be diagnosed with only a certain subset of symptoms without having to meet all criteria
PD unspecified Personality Disorder
-More commonly applied than any other PD Diagnosis, indicating that most of the people suffering personality pathology do not neatly fit into the categorical presentations outlined in the DSM
Limitation of the current categorical model is that polythetic criterion sets yield heterogenous groups
BPD (Bipolar personality disorder) diagnosis requires presence of any 5/9 possible symptoms
Personality disorders are maladaptive and enduring pattersn(s) of behaviour defined by 6 general criteria
Criteria A: Behavioural patterns must manifest in at least two of the following areas= cognition, emotions, interpersonal functioning, or impulse control
Criteria B: Such patterns must be rigid and consistent across a broad range of personal and social situations
Criteria C: Patterns should cause clinically significant distress in social, occupational, or other important areas of functioning
Criteria D: Symptoms must be stable and of lengthy duration, with onset in adolescence or earlier
Criterion E: Behavioural patterns cannot. be accounted for by another mental disorder
Criterion F: Patterns are not due to acute substance use (drugs or alcohol) or of another medical condition
Personality Disorders are organized in 3 clusters
Cluster A: Odd or eccentric features and includes paranoid, schizoid, and schizotypical PDs
Cluster B: Dramatic, emotional, or erratic features) includes antisocial, borderline, histrionic, and narcisstic PDs
Cluster C (anxious or fearful features) consists of avoidant, dependent, and obsessive compulsive PDs
Personality Disorders
-Paranoid personality disorder
-Schizoid personality disorder
-Schizotypal personality disorder
-Antisocial, etc
Paranoid personality
disorder is defined by a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
Schizoid personality disorder
is defined by a pattern of detachment from social relationships and a restricted range of emotional expression.
Schizotypal personality disorder
is a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.
Antisocial personality disorder
is a pattern of disregard for, and violation of, the rights of others.
Borderline personality disorder
is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.
Histrionic personality disorder
is a pattern of excessive emotionality and attention seeking.
Narcissistic personality disorder
is a pattern of grandiosity, need for admiration, and lack of empathy.
Avoidant personality disorder
is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
Dependent personality disorder
is a pattern of submissive and clinging behavior related to an excessive need to be taken care of.
Obsessive-compulsive personality disorder
is a pattern of preoccupation with orderliness, perfectionism, and control.
Personality change due to another medical condition
is a persistent personality disturbance that is judged to be due to the direct physiological effects of a medical condition (e.g., frontal lobe lesion).
Other specified personality disorder and unspecified personality disorder is a category provided for two situations:
(1) the individual’s personality pattern meets the general criteria for a personality disorder, and traits of several different personality disorders are present, but the criteria for any specific personality disorder are not met; or (2) the individual’s personality pattern meets the general criteria for a personality disorder, but the individual is considered to have a personality disorder that is not included in the DSM-5 classification (e.g., passive-aggressive personality disorder).
Personality change due to another medical condition
Captures persistent personality disturbance that results directly from a medical condition (eg traumatic brain injury) or known organic cause
Base rates
A statistic used to describe the percentage of a population that demonstrates some given characteristic
Etiology Factors
Factors that influence or promote the development of a disease
DSM is “etiologically agnostic”
meaning that the manual largely describes pathological presentations without sufficiently addressing risk and vulnerability factors
Much research is based on
Research conducted with relatively restricted groups
PDs are culturally relative
Means that the functions and acceptability of various behaviours that vary by culture, rather than being universal truths; as such, an individual’s beliefs and activities should be understood in terms of their own age
Demographic factors can bias PD diagnosis:
member of marginalized groups, racialized groups, or BIPOC communities are both under and over diagnosed
Suspiciousness is a key
Feature of paranoid PD
Cluster A: Odd and Eccentric Disorders
Includes paranoid, schizoid, and schizotypal personality disorder
-The DSM presents each as a distinct condition, yet all involve unusual and eccentric patterns of thinking and behaviour that often lead to social problems
Ecological Momentary Assessment (EMA)
A research method where participants are surveyed multiple times during a short window (single day) for a sustained period (eg weeks) during their daily life
Paranoid PD features are strongly associated with
Cognitive difficulties
Schizoid traits
Associated with blunted affect and lack of caring relationships
Schizotypal traits
Are most associated with poor social functioning
Schizotypal and paranoid PD are associated with
Negative affect, paranoid symptoms, and psychotic like experiences
Schizotypal PD
is the only disorder categorized as both a PD and schizophrenia spectrum disorder in the DSM
Paranoid personality disorder
Translates to “out of one’s mind”
Initially paranoid is a person
Exhibiting suspiciousness, hostility, and systemized delusions
Systemized delusions
Are logical and coherent, yet based on false grounds (beliefs that are highly improbable but not impossible)
PPD
Characterized by patterns of pervasive mistrust, suspiciousness, resentment of others
They are hypersensitive to interpersonal cues, assume innocuous stimuli- have a special meaning for them (self referential thinking) and are inclined to interpret others’ motivations as spiteful or malevolent
-hypervigilance, where persons with paranoid ideation are inclined to attribute negative events to outside sources—specifically to other people
Suspiciousness factor
(1) global suspicion of harm, exploitation, or deception from others without sufficient basis; (2) preoccupation with unjustified doubts of loyalty or trustworthiness of friends or associates; (3) reluctance to confide in others due to unwarranted fear that disclosed information will be used against them; and (4) perceiving benign remarks or events as carrying hidden threats or demeaning meaning.
Hostility factor captured
(1) persistently bearing grudges; (2) perceiving attacks on one’s character or reputation that are not apparent to others, and being quick to counterattack or react aggressively; and (3) recurrent unjustified suspicions of infidelity from a romantic or sexual partner.
Deficits in cognitive-affective information processing
may constitute one pathway to PPD development
Children maltreatment is associated with hostile attribution
meaning maltreated children may be more to erroneously interpret neutral interpersonal cues as hostile, and respond aggressively
Youth with PPD
more likely to initiate fight, less cooperative, and less likely to be leaders
Key feature of many psychiatric conditions
Paranoia
Delusional disorder with a specified persecutory type
Is characterized by systemized delusions that involve themes of others cheating, conspiring against, or having harmful or malicious intent toward the affected individual
Schizotypal personality disorder
Experience of paranoia
PTSD and paranoia
Each involves hyper vigilance and pervasive feelings of being under threat
Many people with PPD are reluctant
to present for treatment due to symptoms of mistrust
Schizoid personality disorder divided into three categories
schizoid personality disorder, schizotypal personality disorder, and avoidant personality disorder
Schizotypal PD
took on symptoms related to eccentricity,
Avoidant PD
those associated with avoidance and sensitivity.
Social Isolation
remained a core feature of both schizoid and avoidant PD
Schizoid PD and isolation
to be driven by disinterest in interpersonal relationships
Social Withdrawal in avoidant PD
hypothesized to result from fear of rejection or negative evaluation.
Schizoid PD
defined by detachment, withdrawal from social relationships, and a restricted range of emotional expression in social settings
At least four of the seven symptoms are required for diagnosis
1) no desire or enjoyment of close relationships, including family; (2) indifference to praise or criticism from others; (3) little to no interest in having sexual experiences with others; (4) almost always choosing solitary activities; (5) lack of close friends/confidants other than first-degree relatives; (6) displaying emotional coldness, detachment, or flat affect; and (7) taking pleasure in few, if any, activities
Schizoid PD
having reduced sensitivity to pleasure from bodily, sensory, or interpersonal experiences, and claims affected individuals prefer mechanical or abstract tasks (e.g., computer or mathematical games
-may appear socially inept and aloof
-difficulty picking up interpersonal cues, rarely reciprocating social gestures (e.g., facial expressions or nods), and displaying a constricted range of emotional expressions