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Psychological Disorders > Chapter 13: Personality Disorders > Flashcards

Chapter 13: Personality Disorders Flashcards

1
Q

Define personality trait.

A

enduring patterns of perceiving, relating to, and thinking about the environment and oneself

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2
Q

Define personality disorder.

A

is an enduring pattern of inner experience and behavior that deviates markedly from the norms and expectations of the individual’s culture, is pervasive and inflexible, and has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment

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3
Q

What are personality traits and how do they lead to personality disorders?

A

Personality traits are present from birth. Personality disorders while the traumas start young typically develop in adolescence to adulthood. Children cannot be diagnosed with personality Disorder even if they show symptoms. A former diagnosis is not possible till 18

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4
Q

List the defining features of personality disorders.

A
  1. distorted thinking patterns
  2. problematic emotional responses
  3. problems with impulse control
  4. interpersonal difficulties
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5
Q

Cluster A description

A
  1. odd or eccentric cluster.
  2. social awkwardness and social withdrawal.
  3. similar to those seen in schizophrenia; however, they tend to be not as extensive or impactful on daily functioning as seen in schizophrenia
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6
Q

Cluster A Disorders

A

paranoid, schizoid, and schizotypal personality disorders

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7
Q

Cluster B description

A
  1. dramatic, emotional, or erratic cluster
  2. problems with impulse control and emotional regulation
  3. nearly impossible for individuals to establish healthy relationships with others
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8
Q

Cluster C description

A
  1. anxious or fearful cluster
  2. overlap with symptoms from the anxiety and depressive disorders
  3. have the most treatment options of all the personality disorders
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9
Q

Cluster C Disorders

A

avoidant, dependent, and obsessive-compulsive personality disorders

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10
Q

Describe how paranoid personality disorder presents.

A
  1. marked distrust or suspicion of others
  2. Individuals interpret the actions of others as malicious intent towards themselves
  3. Compliments and criticisms are misinterpreted as negative
  4. hesitant to share any personal information
  5. Volatile
  6. Quick to mistrust, slow to trust
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11
Q

Describe how schizoid personality disorder presents.

A
  1. Solitary, lacking interest to socialize
  2. lack of friends or sex partners
  3. indifferent to criticisms or praises
  4. rarely show any feelings
  5. limited need for attention or acceptance
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12
Q

Describe how schizotypal personality disorder presents.

A
  1. Discomfort in interpersonal relationships
  2. odd cognitive or perceptual distortions and eccentric behaviors
  3. seek isolation
  4. The feature of “ideas of reference” or the belief that unrelated events pertain to them
  5. ideas of reference lead them to believe in mind control and the supernatural
  6. Similar to schizophrenia, with sometimes auditory hallucinations, and unusual speech patterns
  7. High social anxiety
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13
Q

Describe how antisocial personality disorder presents.

A
  1. disregard for, and violation of, the rights of others
  2. begins in late childhood or early adolescence and continues throughout adulthood
  3. If Diagnosed before 18, it is called conduct disorder.
  4. aggression toward people or animals, destruction of property, deceitfulness or theft, or serious violation of rules
  5. referred to as “psychopaths” or “sociopaths”
  6. fail to conform to social norms
  7. Deceive to gain profit or pleasure
  8. Impulsivity
  9. Hard to hold down jobs, not uncommonly in large debt
  10. extremely irritable and aggressive, repeatedly getting into fights
  11. marked disregard for their safety, as well as the safety of others
  12. lack of remorse for their actions
  13. rationalize their actions as the fault of the victim or minimize the consequences
  14. Selfish and lack a moral conscience
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14
Q

Describe how borderline personality disorder presents.

A
  1. pervasive pattern of instability
  2. impairment in personal relationships.
  3. terrified of real or imagined abandonment
  4. interpret abandonment as a reflection of their own behavior
  5. Similar to Bipolar they experience fluctuating moods.
  6. impulsive behaviors such as self-harm and suicidal behavior
  7. engage in more suicide attempts and completion of suicide
  8. Sexually promiscuous
  9. feelings of emptiness and painful feelings of aloneness
  10. hallucinations and delusions are present however, the patient realizes they are not real and unacceptable
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15
Q

Describe how histrionic personality disorder presents.

A
  1. pervasive and excessive emotionality and attention-seeking
  2. uncomfortable in social settings unless they are the center of attention
  3. dramatic
  4. Charming
  5. dress and engage in sexually seductive or provocative ways
  6. easily suggestible
  7. Consider casual acquaintanceships intimately.
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16
Q

Describe how narcissistic personality disorder presents.

A

Trump, its fucking Trump

  1. display a pattern of grandiosity
  2. overvalues their abilities and accomplishments
  3. boastful and pretentious
  4. fantasized to enhance their success or power
  5. Believe they are special and interact with those of high status
  6. need excessive admiration from others
  7. Self-esteem is fragile
  8. constantly seek out compliments and expect favorable treatment
  9. lack of empathy
  10. exploit others and unable to understand the feelings of others
  11. Are envious of others and want others to be envious of themselves
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17
Q

Describe how avoidant personality disorder presents.

A
  1. pervasive pattern of social inhibition due to feelings of inadequacy and increased sensitivity to negative evaluations
  2. fear of being rejected drives their reluctance to engage in social situations
  3. Have a hard time maintaining employment due to fear of rejection
  4. Have few friends despite a want to have them
  5. actively avoid social situations for fear of being ridiculed or disliked
  6. Exaggerate consequences of social snafoos
  7. Have a very hard time forming intimate relationships
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18
Q

Differences between Social Anxiety Disorder and Avoidant Personality Disorder

A

With Social Anxiety disorder, the negative self-concept is not as pervasive. It comes and goes even in that disorder.

With Avoidant Personality Disorder, these behaviors the negative self-concept is more stable as an enduring personality trait.

Thing one is a mood that comes and goes, and the other is a constant trait

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19
Q

Describe how dependent personality disorder presents.

A

Beaten wife syndrome in a way
1. pervasive and excessive need to be taken care of by others
2. submissive and clinging behaviors
3. Fear of abandonment
4. Dependent on the other person to make decisions
5. Give others complete power over their life
6. Rarely stick up for themselves
7. Don’t know what to do when alone
8. Lack self-confidence, efficacy and responsibility
9. Will do desperate things to get reassurance and approval

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20
Q

Describe how obsessive-compulsive personality disorder presents

A
  1. preoccupation with orderliness, perfectionism, and ability to control situations
  2. lose flexibility, openness, and efficiency in everyday life
  3. preoccupation with details, rules, lists, order, organization, or schedules overshadows the larger picture of the task or activity.
  4. Perfectionism on task often prevents the task from being completed
  5. Spends so much time on perfectionism that they lose leisure time or time for social relationships
  6. Do not seek help form others
  7. rigid and stubborn, particularly with their morals, ethics, and values
  8. Live significantly below their financial means to prepare for coming catastrophe
  9. Believe others should have their high standards
  10. OCPD lacks the definitive obsessions and compulsions of OCD. OCD sufferes often fail to have the personality traits for a OCPD diagnosis
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21
Q

Describe the epidemiology of Cluster A personality disorders.

A

Cluster A: 2-5%

paranoid personality disorder: 2.3%, More common in men but it I contested and believed women are more common

schizoid personality disorder: 4.9% No gender difference

schizotypal personality disorder: 3.3%. More common in men

22
Q

Describe the epidemiology of Cluster B personality disorders.

A

Antisocial: 0.6% Three times more common in men

Borderline: 1.4% More common in women in clinical samples but no gender difference in community samples

Histrionic: 0% (National Epidemiologic survey reported 1.8%) More prevalent amongst females in clinical settings but is contested that there is no gender difference

Narcissistic: 0% (National Epidemiologic survey reported 6.2%) Men more often than women

23
Q

Describe the epidemiology of Cluster C personality disorders.

A

Avoidant: 5.2% More common in women

Dependent: 0.6% More common in women

OCPD: 2.4% Equal in women and men

24
Q

What is the difference in prevalence rates across the three clusters? Are there any trends among gender?

A

Cluster A 2-5% schizotypal being more common in men and there being no difference in schizoid and conflicting evidence for paranoid

Cluster B 0-1.4% antisocial and narcissistic are more common in men with borderline and histrionic being more common in women, in general.

Cluster C 0.6-5.2% women being more likely to be diagnosed with avoidant and dependent personality disorders and OCPD appearing to be equally prevalent in women and men.

25
Q

Identify the most commonly occurring personality disorder. Which is the least common?

A

Most common is Avoidant maybe narcissistic is the one survey is right, least is Antisocial

26
Q

With what other disorders are personality disorders comorbid?

A

Mood Disorders, anxiety disorders and Substance abuse disorders

27
Q

What are the comorbidities with Mood and Personality disorders

A
  1. MDD lowest in Cluster A, higher rate in Cluster B, and the highest rate in Cluster C.
  2. Bipolar most common in Cluster B and OCPD but the results are not clear
  3. OCPD has the highest comorbidity rate of all personality disorders
28
Q

What are the Comorbidities with Anxiety and Personality Disorders

A
  1. Borderline and Schizotypal have high comorbidities with anxiety disorders
  2. Narcissists are likely to be diagnosed with GAD and Panic Disorder
  3. Schizoid and Avoidant had high rates of GAD
  4. Avoidant had high social phobia
29
Q

What are the Comorbidities with Substance Abuse and Personality Disorders

A

Substance Abuse common in Antisocial, borderline and schizotypal but substance abuse is the least common comorbidity

30
Q

What is Schizotypal Comorbid with outside of Mood, anxiety and substance abuse disorders?

A

Schizotypal personality disorder is also comorbid with brief psychotic disorder, schizophreniform disorder, delusional disorder, and schizophrenia

31
Q

What is borderline Comorbid with Mood, anxiety and substance abuse disorders?

A

borderline is additionally comorbid with eating disorders, PTSD, and ADHD

32
Q

Describe the biological causes of personality disorders.

A
  1. Biological evidence of personality disorders is limited but three have some markers
  2. Schizotypal like Schizophrenia have high dopamine and enlarged ventricles
  3. Antisocial and Borderline disorders both have low Serotonin, depreciated functioning in the frontal lobe and overly reactive amygdala
33
Q

Psychodynamic cause of Personality Disorders

A

Places strong emphasis on negative childhood experiences, neglect, parental rejection and fears of abandonment. Lacking love as a child can manifest in lack of trust as an adult. Sometimes overcompensating or underemphasizing

34
Q

CBT cause of Personality disorders

A
  1. Emphasis on early childhood experiences
  2. Develops dysfunctional attitude toward others
  3. Combo of genetic dispositions and negative life experiences
35
Q

Dichotomous thinking

A

In CBT, all-or-nothing thinking. Perfectionism and rigidity. Present in OCPD

36
Q

Discounting the Positive

A

In avoidant Personality disorder. Misattributions toward being overly mocked and ridiculed during childhood expect only criticism as an adult

37
Q

Behaviorist cause of Personality Disorders

A
  1. Modeling: Maladaptive behaviors learned from imitating role models
  2. Reinforcement: Parents unknowingly reward aggressive behaviors by capitulating to their demands or preventing the escalation of behaviors. Also overindulging can lead to a grandiose sense of self
  3. Lack of social skills
38
Q

Describe the social causes of personality disorders.

A
  1. Family Dysfunction: poverty, unemployment, family separation, and witnessing domestic violence
  2. Childhood Maltreatment: developed during the first four to six years of a child’s life. Effected by the emotional environment the child is raised in. neglect or physical, emotional, or sexual abuse, is at-risk for an underdeveloped or absent sense of self. Mainly lacking discipline, affection and autonomy
  3. Attachment: anxious, ambivalent, and disorganized attachment are at an increased risk of developing various disorders. More specifically, those with an anxious attachment are at-risk for developing internalizing disorders, ambivalent are at-risk for developing externalizing disorders, and disorganized are at-risk for dissociative symptoms and personality-related disorders
39
Q

What personality disorders are most explained by the biological model?

A

Schizotypal, Antisocial and Borderline

40
Q

What cognitive distortions are most discussed with respect to personality disorders?

A

Dichotomous thinking and Discounting the Positive

41
Q

Discuss the roll of attachment and how theorists have used it to explain the development of personality disorders.

A

anxious attachment are at-risk for developing internalizing disorders,

ambivalent are at-risk for developing externalizing disorders, and

disorganized are at-risk for dissociative symptoms and personality-related disorders

42
Q

Cluster A treatment Options

A
  1. Often do not seek treatment because they don’t believe they need help or trust a therapist to help them.
  2. Treatment is slow and has a high dropout rate
  3. CBT techniques to help identify and change negative thought patterns do have positive effects
  4. Schizoid patients use CBT to experience positive emotions and have better social experiences
  5. Schizotypal patients use CBT to evaluate unusual thoughts
  6. Develop social skills
43
Q

Treatment Options for Antisocial Personality Disorder

A

Pretty limited as those with antisocial personality disorder don’t believe they need help and are often forced to get help. CBT tries to address lack of morality and try to get patients to think about the need of others.

44
Q

Borederline Treatment Options

A

DBT (Dialectical Behavioral therapy). Which shows that drop out rates are low and suicide ideation is low when going through this therapy

45
Q

The four main goals of DBT(Dialectical Behavioral therapy) are

A
  1. Reduce suicidal behavior
  2. Reduce therapy-interfering behavior
  3. Improve quality of life
  4. Reduce post traumatic stress symptoms
46
Q

The treatment components of DBT (Dialectical Behavioral therapy) are

A
  1. Skills training: Generally performed in a group therapy setting, individuals engage in mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation
  2. Enhancing Motivation: applying skills learned in the previous component to specific challenges and events in their everyday life
  3. Telephone and in-vivo coaching: 24/7 case management for the client from a DBT team
  4. Case Management: allowing the patient to become their own “case manager” and effectively use the learned DBT techniques to problem-solve ongoing issues. Therapist intervenes minimally
  5. Consultation Team. Since BPT needs constant attention, the therapists that treat it often need help themselves
47
Q

Treatment Options for histrionic Personality disorder

A
  1. Likely to seek out treatment but this is problematic for this feeds their need for attention
  2. Will employ seductiveness in the therapy setting
  3. CBT helps to identify dependency and become more self reliant
  4. CBT also helps change helpless beliefs and improve problem solving skills
48
Q

Treatment Options for Narcissistic Personality Disorder

A
  1. Amongst the most difficult to treat
  2. Typically, they seek out treatment for their secondary problems like depression
  3. CBT addresses grandiose thinking and tries to teach empathy with others
49
Q

Treatment options for Cluster C

A
  1. All in their way tend to seek out treatment
  2. CBT techniques similar to social anxiety disorder are applied
  3. With OCPD specifically tackling Dichotomous thinking, perfectionism, and chronic worry
  4. Exposure and social skills training help
  5. Meds have minimal help
  6. With Dependent, they become dependent on the therapist thus CBT focusing on autonomy and independence have shown some promise but its limited and inconclusive.
  7. For dependent some argue family or couples therapy would be ore effective since the relationship is the prime issue.
50
Q

Given the difference in personality characteristics between the three clusters, how are the suggested treatment options different between cluster A, B, and C?

A

Cluster A is hard to treat because they don’t seek out treatment or are distrustful
Cluster B treatment is only successful with Borderline thanks to DBT but the others are very difficult to treat
Cluster C treatment has success with OCPD and Avoidant but not successful with Dependent

Psychological Disorders (10 decks)

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