Chapter 13 Flashcards
What are Personality Disorders?
Distinct group of disorders that are:
(1) long-standing
(2) pervasive
(3) have inflexible patterns of behaviour
What are the three life tasks
(1) Intrapersonal: Form coherent representations of self and others
(2) Interpersonal: Develop capacity for intimacy
(3) Social Group: Engage in pro-social and cooperative behaviours
What are the Personality Disorder Assessments?
(1) Clinical interviews: (challenge) many personality disorders are ego syntonic, person lacks insight
(2) MMPI: Good prediction of paranoid, schizotypal, narcissistic, and anti-social personality disorder symptoms
(3) MCMI-IV: Provides subscale measures of 15 clinical personality scales + 3 severe personality pathology scales
What constitutes cluster A?
Odd/Eccentric cluster. Includes: Paranoid, Schizoid, Schizotypal
Characteristics of “Paranoid”
Suspicious of others
Tend to blame others
Can be very jealous
Prevalence & Comorbidity of “Paranoid”
Prevalence:
1-2%
More frequent in men
Comorbidity:
Schizotypal, BPD & APD
Characteristics of “Schizoid”
No desire/ enjoyment for social relationships
Appear dull
No interest in sex
Indifferent to praise/ criticism
What is Schizoid Personality Disorder?
Symptoms precede psychotic illness
Link w/ autism
Prevalence & Comorbidity of “Schizoid”
Prevalence:
Less than 1%
More common in men
Comorbidity:
Schizotypal, avoidant, PPD
What is the Etiology of “Schizoid”
High Introversion, low on openness & achievement striving
Characteristics of “Schizotypal”
odd beliefs/ speech
Recurrent illusions
Ideas of reference (suspiciousness, eccentric, paranoid ideation)
Prevalence & Comorbidity of “Schizotypal”
Prevalence
3%
More common in men
Comorbidity
Bordeline, avoidant, and paranoid personality disorders
What constitutes Cluster B?
Dramatic, Erratic. Includes: Narcissistic Antisocial, Borderline, and Histrionic
Characteristics of “Borderline”
Attitudes & feelings towards others vary dramatically
Emotions are erratic, can shift
Argumentative, irritable, sarcastic, easily offended
Prevalence & Comorbidity of “Borderline”
Prevalence:
1-2%
More common in women
Cormorbidity:
mood disorder, substance abuse, PTSD, eating disorders, Culster A
Etiology of “Borderline”
Strong genetic component in twin studies
Negative experiences in childhood
Object-relation theory
What are the main dimensions of BPD
(1) Affect Instability:
* Inappropriate anger, drastic mood shifts
* reactive mood
* feelings of emptiness
(2) Dysfunctional relationships:
* Unstable and intense relationships
* Efforts to avoid abandonment
(3) Impulsivity
* Impulsive self-damaging behaviours
* Attempts at self-mutilation or suicide
What are the treatments for BPD?
(1) Dialectical Behaviour Therapy (DBT):
Encourage patient to accept negative affect without engaging in self-destructive or maladaptive behaviours
(2) transference-focused Psychotherapy:
Strengthening weak egos w/ particular focus on splitting
(3) Medication:
SSRIs, antipsychotic, mood stabilizers
Characteristic of “Histrionic”
Overly dramatic & attention-seeking w/ physical appearance
Prevalence & Comorbidity of “Histrionic”
Prevalence:
2-3%
More common among women
Comorbidity:
depression antisocial, narcissism, DPD
Etiology of “Histrionic”
(1) Cognitive Theory: Maladaptive schemas revolving around the need for attention to validate self-worth.
(2) Psychoanalytic Theory: seductiveness encouraged by parental upbringing
Characteristics of “Antisocial”
Conduct disorder before 15 y/o
Patterns of anti-social behaviour in adulthood (irresponsible, inconsistent work, break laws, physically aggressive)
Prevalence & Comorbidity of “Antisocial”
Prevalence:
1-4%
Comorbidity:
Substance Use
Etiology of “Antisocial”
Genetic Correlation
Higher MZ compared w/ DZ twins
Environmental influences
What is Psychopathy?
(1) Poverty of emotions (positive & negative)
(2) Lack of remorse
(3) No sense of shame
(4) Superficial charming
(5) Manipulate others for personal gain
What are some biological associations with psychopathy? Are there any treatments?
Generally linked w/ reduced amygdala & decreased prefrontal activity
CBT as treatment
What is the link between APD (Antisocial Personality Disorder) and psychopathy?
All psychopaths have APD but not vice-versa
Characteristics of “Narcissistic”
Preoccupation w/ being admired (power, success). Lack empathy
Prevalence & Comorbidity of “Narcissistic”
Prevalence:
less than 1%
Cormorbidity:
BPD
Etiology of “Narcissistic”
Product of our times ‘ values
Kohut*
What does KOHUT (1978) propose concerning Narcissism related personalities?
(1) Mirror-hungry personalities: crave self-objects whose confirming and admiring responses will increase their feelings of self-worth
(2) Ideal-hungry personalities: worthwhile as long as they can relate to people they can admire
(3) Alter-ego personalities: worthwhile only if they have a relationship with a self-object who looks like them and has similar opinions and values
(4) Merger-hungry personalities: individuals who experience others as their own self
(5) Contact-shunning personalities: intense longing to merge with self/objects; such individuals are highly sensitive to rejection, to avoid this pain, they avoid social contact
What are the components of NPD (Narcissistic Personality Disorder)?
Assess Narcissitic grandiosity:
(1) Entitlement Rage
(2) Exploitiveness
(3) Grandiose Fantasy
(4) Self-entitlement
Assess Narcissitic vulnerability:
(1) Contingent self-esteem
(2) Hiding the self
(3) Devaluing
What does Cluster C consist of?
Anxious/ Fearful. Includes: Dependent, Avoidant, Obsessive Compulsive
Characteristics of “Avoidant”
Sensitive to possibility of criticism, rejection, disapproval
Feeling of inadequacy
Reluctant to enter relationships
Prevalence & Comorbidity of “Avoidant”
Prevalence:
2%
Cormibidity:
Dependent personality, depression, generalized social phobia
Etiology of “Avoidant”
Modest genetic influence
Introversion & Neuroticism are elevated
Characteristics of “Dependent”
Intense need to be taken care of
Lack self-reliance
Uncomfortable when alone
Subordinate own needs
Prevalence & Comorbidity of “Dependent”
Prevalence:
less than 1%
Comorbidity:
Bipolar, depression, anxiety disorders, bulimia
Etiology of “Dependent”
(1) 30-60% attributed to genetics
(2) Neuroticism & Agreeableness have genetic component
(3) Environment: authoritarian & overprotective parents
Characteristics of “Obsessive Compulsive”
Perfectionistic approach to life
Preoccupied w/ details
Serious, rigid, formal, inflexible
Comorbidity of “Obsessive Compulsive”
OCD, panic disorder, depression, avoidant personality disorder
Etiology of “Obsessive Compulsive”
high conscientiousness & assertiveness, low compliance
Psychoanalytic Theory: OCPD due to fixation at anal stage (Freud)
How does OCD differ from OCPD?
OCD is about recurrent and persistent thoughts while OCPD is about a sense of orderliness, perfection, and a sense of control
