Chapter 12 - Personality Disorders Flashcards
personality disorders
pattern of inner experience and behaviour that is not deemed appropriate considering individual’s cultural expectations
key features of diagnosis
- Pattern manifestation in 2+ areas (Cognition,emotion, interpersonal functioning or impulse control)
- Rigid and consistent pattern across many contexts
- Distress/ impairment
- Stability and long duration of symptoms
- Behaviour not caused by another mental illness
- Behaviour not caused by substance abuse
cluster A
odd and eccentric disorders - paranoid, schizoid, schizotypal
cluster B
dramatic, emotional, or erratic disorder - antisocial, borderline, histrionic, narcissistic
cluster C
anxious and fearful disorders - avoidant, dependent, and obsessive-compulsive
onset of PD
adolescence or early adulthood
Areas of pattern manifestation
Cognition
Emotion
Interpersonal Functioning
Impulse control
How should Personality Disorders be assessed
Through structured interviews
Diagnostic issues in PDs
Low reliability (time and people) Gender/ Cultural issues Co-morbidity/overlap Weak treatment efficacy Poorly understood etiology
Etiology Theories
Psychodynamic
Attachment Theory
Cognitive Behavioural
Biological
Psychodynamic Theories
parent-child relationships leads to
inadequate sense of self
Issues relating to other people
Attachment Theories
Poor parent-child attachment > Poor adult attachment > Interpersonal relationship problems
Cognitive Behavioural Theories
Rigid, inflexible schemas
Invalidating environment
Modelling inappropriate behaviours
Biological Theories
Genetics
Brain Functioning
Emotion Regulation
How many Criterion must be met for a Paranoid PD diagnosis
4+ criteria
Paranoid Personality Disorder more common in which gender
males
Paranoid Personality Disorder
Pervasive distrust and suspicion of others
Schizoid Personality Disorder
Pervasive disinterest in social relationships and restricted affect
How many criterion must be met for a schizoid PD diagnosis
4+ criteria
Schizoid PD and social skills
They don’t have social skills and are not interested in learning them
Schizotypal Personality Disorder
Pervasive pattern and social deficits, discomfort in interpersonal relationships, and perceptual distortion or eccentricities
Treatment of Schizotypal Disorder
Anti-Psychotics and Anti-Depressants
Schizotypal PD
Males
How to Cluster A PDs differ from schizophrenia
Schizophrenia is more severe
Schizotypal PD may be a mild form of schizophrenia
Can Cluster A PDs predict psychotic disorders
Cluster A PDs can be a precursor
When may Cluster A PDs appear
Childhood and Adolescents
Are Antisocial and Psychopathy the same disorder
No they are different
Not all people with antisocial are psychopaths
Which is more severe Antisocial PD or Psychopathy
Psychopathy is more severe
Is psychopathy a formal diagnosis
No, there is no formal diagnosis of psychopathy
Most psychopaths have Antisocial PD
true
Most Antisocial PD individuals are psychopaths
False
Only a small proportion have Antisocial PD individuals have psychopathy
Antisocial PD
Pervasive disregard for and violation of the rights of others
How many criterion must be met for a Antisocial PD
3+ criteria
Must have conduct disorder prior to the age of 15 to be diagnosised with Antisocial PD
true
reliability of Antisocial PD
high behavioural reliability
treatment of Antisocial PD
psychotherapy (aimed at symptoms and behaviour)
Meds (Manage threatening behaviour)
Factors for psychopathy
- Interpersonal and affective ( superficially charming, grandiose, pathological lying, lack of remorse)
- Antisocial behaviour and lifestyle (Easily bored, lack of realistic long-term goals, impulsive, irresponsible)
- Promiscuous (casual sexual relationships)
- Many short-term relationships
assessment of psychopathy
psychopathy checklsit
Can psychopathy predict future violence
yes
psychopaths can commit what kinds of violence
Cold blooded
Goal oriented
Sadistic and Gratuitous
Biological Theories of Psychopathy
hypoactive amygdala and genetics
Environmental theories of Psychopathy
abusive environment and disturbed living arrangements
Primary psychopaths
lack fear
secondary psychopaths
sensitivity to rewards
Treatment of Psychopathy
reatment- resistant
Contingency management
Intensive supervision
Preventive Detention
borderline PD
Pervasive instability in interpersonal relationships, self-image, and affect with marked impulsivity
How many criteria are needed for BPD
5+ riteria
Biological etiology
mild brain dysfunction
Childhood experiences causing BPD
Child abuse/neglect
Child sexual abuse
Attachment problems with parents
Modelling
Linehan’s Biosocial Theory
Linehan’s Biosocial Theory
BPD is a dysfunction of emotion regulation
Treatment for BPD
DBT
4 Modules over 12 months
BPD medication treatment
Anti-depressants
Anti-psychotics
Anti- Convulsants
What are anti-convulsants used for in BPD
Emotional instability
Impulsivity
Histrionic PD
Excessive emotionality and attention-seeking
How many symptoms are needed for a HPD diagnosis
5+ symptoms
Cultural consideration of HPD
Behaviour must be distressing or impairing functioning
Narcissistic PD
Pattern of grandiosity, need for admiration and lack of empathy
How many symptoms are needed for a NPD diagnosis
5+ symptoms
What is NPD associated with
Frequent internet and social media use
Cluster C PDs
Avoidant PD
Dependent PD
Obsessive-compulsive PD
Avoidant PD
Social Inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
comorbidity
co-occurrence in the sae person of two or more different disorders
overlap
similarity of symptoms in two or more different disorders
personality of paranoid personality disorder
humourless, eccentric, hostile, jealous, and preoccupied with power and control
difference in paranoid schizophrenia and paranoid personality
severity of paranoid beliefs - in paranoid personality they are non-bizzare
personality of schizoid personality disorder
loners, cold, indifferent towards others, no desire to have any sort of relationships or go out, don’t desire sexual relations
what do low doses of antipsychotic drugs release in schizotypal personality disorder
cognitive problems, social anxiety. antidepressant medication can also produce these effects
Antisocial PD diagnosis requires what 7 violation of rights of others
nonconformity, callousness, deceitfulness, irresponsibility, impulsivity, aggressiveness, and recklessness
polythetic approach
subset of symptoms or behaviours is required for a diagnosis, unlike most medical diagnosis
fearlessness hypothesis (Antisocial PD)
Antisocial PD individuals have a higher threshold for feeling fear than do the other people
dependent personality disorder
rely on someone else to make decisions - seek advice and direction from others
cognitive restructuring
basis for change along with skills training and behavioural practices
dialectical behaviour therapy
more for BPD, acceptance by the therapists of the patients demanding and manipulative behaviors