Chapter 13 & 15 Flashcards

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1
Q

Intermittent explosive disorder (IED)

A

Recurrent verbal or physical aggressive outbursts that are far out of proportion. Not preplanned

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2
Q

Oppositional defiant disorder

A

Not extreme physical aggressiveness like conduct disorder but exhibits behavior like losing temper, arguing with adults, refusing to comply.

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3
Q

Conduct disorder DSM-5 criteria

A

Behavior that violates the rights of others or norms in three of the following in the last 12 months:

  1. Aggression towards people or animals
  2. Destruction of property
  3. Deceitfulness
  4. Serious violation of rules
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4
Q

2 types of conduct disorder

A
  1. Life-course-persistent, antisocial behavior continues into adulthood
  2. Adolescence-limited, normal adulthood
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5
Q

Conduct disorder prevalence

A

5-6%

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6
Q

Etiology Conduct Disorder (Genetic)

A

Children who are maltreated and have low MAOA activity are more likely to develop CD

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7
Q

Etiology of Conduct Disorder (Brain)

A

Reduced activation of the amygdala and PFC

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8
Q

Etiology Conduct Disorder (Psychological factors)

A

Deficiency in moral awareness. Social information processing has a hostile bias

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9
Q

Peer influences in Conduct Disorder

A

Peer rejection can predict aggressive behavior. Associating with other deviant peers increases delinquent behavior.

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10
Q

Treatment of Conduct Disorder

A
  1. Family check up: meet family, assess, and give feedback
  2. Parental Management Training: parents are taught to modify their responses to their children
  3. Multisystemic treatment: involves the family, the school, and sometimes the peer group
  4. Prevention programs
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11
Q

Three Personality Disorder clusters

A

Cluster A: odd/eccentric
Cluster B: dramatic/erratic
Cluster C: anxious/fearful

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12
Q

Cluster A Personality disorders

A
  1. Paranoid
  2. Schizoid
  3. Schizotypal
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13
Q

Cluster B Personality disorders

A
  1. Antisocial
  2. Borderline
  3. Histrionic
  4. Narcissistic
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14
Q

Cluster C Personality disorders

A
  1. Avoidant
  2. Dependent
  3. Obsessive Compulsive
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15
Q

DSM criteria for General PD

A

Inflexible pattern of behavior that is distinct form cultural expectations and influences two of the following:
1. Cognition about self and others
2. Affect
3. Interpersonal functioning
4. Impulse control
Pattern causes distress or impairment, is inflexible and is pervasive across situations

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16
Q

PD comorbidities

A
  1. Mood and anxiety with Cluster C
  2. Mood with Cluster B
  3. Substance use with Antisocial
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17
Q

Problems with DSM approach to PD

A
  1. The disorders aren’t as stable as the definition implies

2. Extremely high comorbidity rate among PD’s

18
Q

Alternative DSM-5 model for PD

A

Excludes schizoid, histrionic, dependent and paranoid personality disorder because they rarely occur or they usually co-occur with other PD’s

19
Q

Alternative DSM model of PD’s personality trait domains

A
  1. Negative affectivity
  2. Detachment
  3. Antagonism
  4. Disinhibition
  5. Psychoticism
20
Q

Risk factors for PD

A
  1. Shared genetic vulnerability among PD’s
  2. High heritability
  3. Childhood abuse or neglect
21
Q

DSM criteria for Paranoid PD

A

Presence of 4 of the following signs of distrust and suspiciousness:

  1. Unjustified suspiciousness of being harmed, deceived or exploited
  2. Unwarranted doubts about the loyalty of friends
  3. Reluctance to confide in other due to suspiciousness
  4. Tendency to read hidden meanings in benign actions of others
  5. Bear grudges for perceives wrongs
  6. Angry reactions to perceives attacks on character
  7. Unwarranted suspiciousness of partners infidelity
22
Q

DSM criteria for Schizoid PD

A

4 of the following signs of aloofness and flat affect:

  1. Lack of desire or enjoyment of close relationships
  2. Almost always prefers solitude to companionship
  3. Little interest in sex
  4. Few or no pleasurable activities
  5. Lack of friends
  6. Indifference to praise or criticism
  7. Flat affect
23
Q

DSM criteria for Schizotypal PD

A

5 of the following signs of unusual thinking, eccentric behavior, and interpersonal deficits:

  1. Ideas of reference
  2. Odd beliefs or magical thinking
  3. Unusual perceptions
  4. Odd thought and speech
  5. Suspiciousness or paranoia
  6. Inappropriate or restricted affect
  7. Odd or eccentric behavior or appearance
  8. Lack of close friends
  9. Social anxiety that does not diminish with familiarity
24
Q

DSM criteria for Antisocial PD

A

At least 18, conduct disorder before 15, Pattern of disregard for the rights of other shown by 3 of the following:

  1. Repeated law breaking
  2. Deceitfulness
  3. Impulsivity
  4. Irritability
  5. Reckless disregard for safety of self and others
  6. Irresponsibility
  7. Lack of remorse
25
Q

Differences between Antisocial PD and Psychopathy

A
  1. Criteria for Psychopathy includes more affective symptoms

2. APD requires symptoms to be developed before age 15

26
Q

Etiology for Psychopathy and Antisocial PD

A
  1. Parenting qualities
  2. Poverty and exposure to violence
  3. MAO-A gene
  4. Unable to learn from experience
  5. Deficits in experience of fear and threat
27
Q

DSM criteria for Borderline PD

A

5 of the following signs of instability in relationships, self image, and impulsivity:

  1. Frantic efforts to avoid abandonments
  2. Unstable interpersonal relationships in which others are idealized or devalued
  3. Unstable sense of self
  4. Self damaging impulsive behaviors
  5. Recurrent suicidal behavior
  6. Marked mood reactivity
  7. Chronic feelings of emptiness
  8. Recurrent bouts of intense anger
  9. During stress, a tendency to experience paranoid thoughts or dissociative symptoms
28
Q

Etiology of Borderline PD

A
  1. Childhood abuse and poor parenting styles
  2. Difficult parental relationships
  3. Diminished connectivity of brain regions involved in emotion experience and regulatory control
29
Q

DSM criteria for Histrionic PD

A

5 of the following signs of excessive emotionality and attention seeking:

  1. Strong need to be center of attention
  2. Inappropriate sexually seductive behavior
  3. Rapidly shifting shallow experience of emotion
  4. Use of physical appearance to draw attention
  5. Speech that is excessively impressionistic and lacking in detail
  6. Exaggerated, theatrical emotional expression
  7. Overly suggestible
  8. Misread relationships as more intimate than they are
30
Q

DSM criteria for Narcissistic PD

A

5 of the following signs of grandiosity, need for admiration, and lack of empathy:

  1. Grandiose view of one’s importance
  2. Preoccupation with one’s success
  3. Belief that one is special
  4. Extreme need for admiration
  5. Strong sense of entitlement
  6. Tendency to exploit others
  7. Lack of empathy
  8. Envious of others
  9. Arrogant behavior
31
Q

Etiology of Narcissistic PD

A
  1. Parents promote children’s beliefs that they are special
  2. Experience shame more frequently than others
  3. Fragile self-esteem
  4. Sensitive to negative social interactions
32
Q

DSM criteria for Avoidant PD

A

Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism shown by 4 of the following:

  1. Avoidance of occupational activities
  2. Unwilling to get involved with people unless certain of being liked
  3. Restrained in intimate relationships
  4. Preoccupation with being rejected
  5. Inhibited in new interpersonal situations
  6. Views self as socially inept or inferior
  7. Unusually reluctant to try new activities
33
Q

DSM criteria for Dependent PD

A

Excessive need to be taken care of as shown by 5 of the following:

  1. Difficulty making decisions without excessive advice
  2. Need for others to take responsibility for most major areas of life
  3. Difficulty disagreeing with other for fear of losing support
  4. Difficulty doing things on own due to lack of confidence
  5. Doing unpleasant things to obtain approval of others
  6. Feelings of helplessness when alone because of fear to take care of oneself
  7. Urgently seeking a new relationship when one ends
  8. Preoccupation with fears of having to take care of oneself
34
Q

DSM criteria for Obsessive-Compulsive PD

A

Intense need for order, perfection, and control as shown by four of the following:

  1. Preoccupation with rules, details, and organization
  2. Extreme perfectionism interferes with task completion
  3. Excessive devotion to work to exclusion of leisure and friendships
  4. Inflexibility about morals and values
  5. Difficulty discarding worthless items
  6. Reluctance to delegate
  7. Miserliness
  8. Rigidity and stubbornness
35
Q

General treatments for PD’s

A
  1. Psychotherapy
    • DBT
    • Schema therapy
    • Mentalization therapy
    • Transference focused psychotherapy
  2. Antidepressants
36
Q

Treatment for Schizotypal and Avoidant PD

A
  1. Antipsychotic drugs
  2. Antidepressant medication
  3. CBT
37
Q

3 P’s of Personality Disorders

A
  1. Pervasive
  2. Persistent
  3. Pathological
38
Q

Prevalence PD’s

A

9-13%

39
Q

General etiology of PD’s

A
  1. Conditioning
  2. Emotion regulation
  3. Beck cognitive model
  4. Maladaptive schema’s
  5. Mentalization
  6. Object relations (splitting)
40
Q

Dialectical Behavioral Therapy

A

Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.
Good for crisis