Chapter 13: Personality Disorders Flashcards
A ________ _______ is a persistent pattern of emotions, cognitions, and behaviour that results in enduring emotional distress for the person affected and for others and may cause difficulties with work and relationships
personality disorder
Several studies have shown that people who are _________ have a worse outcome in treatment if they also have a personality disorder
depressed
When it comes to personality disorders, what is the issue that continues to be debated in the field ?
whether personality disorders are extreme versions of otherwise typical personality variations (dimensions) or ways of relating that are different from psychologically healthy behaviour
The distinction between problems of degree and problems of kind is usually described in terms of __________ and _________.
- dimensions
- categories
Categorical models are ________ but they are also too ______.
- convenient
- rigid
Some had proposed that the DSM-IV-TR personality disorders section be replaced or at least supplemented by a ___________ model in which individuals would not only be given categorical diagnoses but would also be rated on a series of personality dimensions
dimensional
What are three advantages of a dimensional model?
- retain more information about each individual
- more flexibility; permits both categorical and dimensional differentiations among individuals
- avoids random choice decisions involved in assigning a person to a diagnostic category
One of the more widely accepted models is called the “_____ _____” or the _____-______model
- Big Five
- Five Factor
What are the five factors in the five factor model?
- extraversion
- agreeableness
- openness
- conscientiousness
- neuroticism
List the 3 personality clusters.
- Cluster A: odd or eccentric
- Cluster B: dramatic, emotional, or erratic
- Cluster C: anxious or fearful
Which three personality disorders fall under cluster A?
- paranoid
- schizoid
- schizotypical
Which four personality disorders fall under cluster B?
- antisocial
- borderline
- histrionic
- narcissistic
Which three personality disorders fall under cluster C?
- Obsessive compulsive
- dependent
- avoidant
What sort of life changes do people with personality disorders experience?
- more suicide attempts
- more trouble at work
- being separated or divorced
- having problems with friends and relatives
- having problems with the law
- Clusters A and B diagnoses were associated with various physical diseases, such as cardiovascular diseases and arthritis
____% of the world population has a personality disorder. Personality disorders are more prevalent in ____-______ countries.
- 7.8%
- high income
TRUE or FALSE: a person could receive a diagnosis of one personality disorder at one point in time but years later no longer meet the criteria for that original problem and now have characteristics of a second (or third) personality disorder.
TRUE
Histrionic personality disorder is biased against _______ while antisocial personality disorder is biased against _____.
- females
- males
Individuals with borderline personality disorder die by suicide at a rate about ____ times higher than the general population, with most research suggesting that ____-____% of patients with this disorder have taken their own lives. However, their symptoms gradually improve if they reach their ___’s.
- 50
- 8 to 10%
- 30’s
Overall, who tends to be diagnosed with personality disorders more often, men or women?
men
A major concern with personality disorders is that:
people tend to be diagnosed with more than one
_________ __________ disorder involves pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent.
paranoid personality disorder
The defining characteristic of people with paranoid personality disorder is a ________ __________ ________
pervasive unjustified distrust
Individuals with paranoid personality disorder are very sensitive to _______ and have an excessive need for _______. Having this disorder increases the risk of _____ _____and _______ _______, and is related to having a _____ overall quality of life.
- criticism
- autonomy
- suicide attempts
- violent behaviour
- poor
How is paranoid personality disorder different from the paranoid type of schizophrenia and delusional disorder?
Their suspicions don’t reach delusional proportions and they don’t experience hallucinations
what are some potential causes for paranoid personality disorder? (CGRUMPS)
- genetics
- poor treatment/upbringing
- relatives with schizophrenia
- maladaptive schemas
- cultural factors
- severe cognitive disorders
Why is it hard to treat people with paranoid personality disorder?
- They’re mistrustful
- unlikely to seek professional help when they need it
- Have difficulty developing the trusting relationships necessary for successful therapy
When it comes to treating clients with paranoid personality disorder, what is the important first step?
Establishing a meaningful therapeutic alliance between the client and the therapist
TRUE or FALSE: to date there are multiple demonstrations that any form of treatment can significantly improve the lives of people with paranoid personality disorder
FALSE: to date there are no confirmed demonstrations that any form of treatment can significantly improve the lives of people with paranoid personality disorder
Paranoid personality disorder bears relationship to:
paranoid type of schizophrenia and delusional disorder
When it comes to treating paranoid personality disorder, therapists will use _______ _______ to change mistaken assumptions about others
cognitive therapy
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions is called ________ _________ disorder.
Schizoid personality disorder
Clinical description of schizoid personality disorder
- doesn’t enjoy nor have an interest in closeness with others, including romantic or sexual relationships
- appear cold, aloof, and detached
- don’t seem affected by praise or criticism
- social isolation, poor rapport, and constricted affect
____________ appears to be prevalent among people with schizoid personality disorder. What is one of the possible explanations as to why this is?
- Homelessness
- they lack of close friendships and lack of dissatisfaction about not having a relationship with another person
List four possible causes for Schizoid personality disorder (CLAN)
- childhood shyness
- abuse
- neglect
- low density dopamine receptors
How is schizoid personality disorder treated?
with social skills training like role playing
It is rare for a person with _______ personality disorder to request treatment except in response to a crisis such as extreme depression or losing a job.
schizoid
___________ ___________ disorder involves a pervasive pattern of interpersonal deficits featuring acute discomfort with, and reduced capacity for, close relationships, as well as by cognitive or perceptual distortions and eccentricities of behaviour.
Schizotypal personality disorder
Schizotypal personality disorder is considered by some to be on the same ________ as schizophrenia but without some of the more debilitating symptoms, such as ________ and _______.
- spectrum
- hallucinations
- delusions
Clinical description of schizotypal personality disorder
- social deficits, psychotic like symptoms, cognitive impairments/paranoia
- Ideas of reference
- report unusual perceptual experiences
- hypersensitive to criticism as children
TRUE or FALSE: It’s common for individuals with schizotypal personality disorder go on to develop schizophrenia
FALSE: Only a small proportion of individuals with schizotypal personality disorder go on to develop schizophrenia
What are the three possible causes for schizotypal personality disorder?
- genetics, prevalence of disorders in relatives
- left hemisphere damage; brain abnormalities
- abnormalities in semantic association abilities (may be cause of magical ideation)
People with schizotypal personality disorder who request clinical help often seek assistance for ___________ or ___________.
anxiety or depression
The presence of schizotypal personality disorder significantly increases the risk for developing _______ _________ ________ even years later
major depressive disorder
How do practitioners treat schizotypal personality disorder?
- CBT
- treat depression
- antipsychotic medication
- community treatment
- social skills training
____________ ___________ disorder involves a pervasive pattern of disregard for and violation of the rights of others.
antisocial personality disorder
antisocial personality disorder is similar to the non DSM label _________, but with greater emphasis on overt behaviour rather than on personality traits.
psychopathy
What is the clinical description of antisocial personality disorder?
- aggressive, lying, cheating, no remorse
- substance abuse common
- unnatural death common for boys with this disorder
- Moral insanity, egopathy, sociopathy, and psychopathy
___-___% of male offenders are diagnosed with antisocial personality disorder.
50-80%
It is important to note the developmental nature of antisocial behaviours and traits. The DSM-5-TR provides a separate diagnosis for children who engage in behaviours that violate society’s norms called _____________ ___________.
conduct disorder
What are the two subtypes of conduct disorder?
- childhood-onset type (the onset of at least one criterion characteristic of CD before age ten)
- adolescent-onset type (the absence of any criteria characteristic of CD before age ten)
When it comes to antisocial personality disorder, the most important personality characteristic that distinguished the boys who showed a stable and persistent pattern of physical aggression, theft, and vandalism was a combination of high __________ and low __________.
- impulsivity
- empathy
The likelihood of developing antisocial personality disorder increases if the child has both _______ ________ and ______.
- conduct disorder
- ADHD
Genetic influences on antisocial personality disorder
- gene environment interaction (certain environmental influences are important only in the presence of certain genetic predispositions)
- chronic stress in family
- academic difficulty, peer problems, low family income, neglect and harsh discipline from parents
- underarousal of cortex, fearlessness
Neurobiological influences on antisocial personality disorders
- executive cognitive deficits in psychopaths
- Underarousal hypothesis (abnormally low levels of cortical arousal, causing fearlessness)
- fearlessness hypothesis (antisocial and risk taking behaviours due to having a higher threshold for experiencing fear)
- insufficiently developed cortices ( key role in the inhibition and control of impulses)
- Deficit MAOA due to defective gene producing it
Psychological and social dimensions of antisocial personality disorder
- failure to abandon an unattainable goal
- aversive interchange with parents
- parents’ inept monitoring of child’s activities
- inconsistent parental discipline at home
- Experience of physical abuse ( when certain individuals are severely traumatized by loved ones, over time they might learn to turn off their emotions as a way of coping)
When it comes to antisocial personality disorder, The most common treatment strategy for children involves _______ _______
parent training
When it comes to antisocial personality disorder, a __________ approach to treatment can help reduce delinquent behaviour on the part of juveniles who have committed criminal offences.
multifacted
Preschool programs that provide good ______ ______ and ______ ______ can help prevent antisocial personality disorder
- parenting skills
- family support
___________ ____________ disorder involves a pervasive pattern of instability of interpersonal relationships, self-image, affects, and control over impulses.
Borderline personality disorder
________ personality disorder is one of the most common personality disorders observed in clinical settings.
Borderline
Clinical description of borderline personality disorder
- turbulent relationships, fear of abandonment, self mutilating behavours, no control over emotions
- often engage in suicidal or self mutilating behaviours
- Approximately 10% die by suicide
- comorbid with other disorders (mood disorders, eating disorder, substance abuse)
- impulsivity
why are men with borderline personality disorder susceptible to abusing their partner?
because they set excessively high standards for others and blame their partners when things go wrong
What are the causes of borderline personality disorder?
- genetics, related to mood disorder
- memory bias (for negative cognitions typical of this disorder)
- Childhood sexual abuse; similarities with PTSD
- early trauma and biological predisposition
- experienced rapid cultural changes
How do practitioners treat borderline personality disorder?
- antipsychotics and antidepressants
- Dialectual behaviour therapy (effective in reducing suicide attempts)
- Treatments similar to those with PTSD
- couples therapy for some
What are three subtypes of patients with borderline personality disorder?
- impulsive subtype (those with a history of impulsive, self-destructive, and treatment-threatening behaviours)
- identity disturbance subtype (those with a markedly and persistently unstable self-image or sense of self)
- affective cluster (those with marked mood swings and difficulty controlling anger)
Out of the three subtypes of borderline personality disorder, which subtype is not recommended to receive couples counseling as a form of treatment?
The impulsive subtype
___________ ___________ disorder involves a pervasive pattern of excessive emotionality and attention seeking.
histrionic personality disorder
Clinical description of histrionic personality disorder
- Dramatic, theatrical, self centred, vain, seeks constant reassurance, impulsive
- views situations in global black and white terms
- speech is often vague, lacking in detail
Evidence suggests that histrionic personality and _________ _________ co-occur more often than chance would account for.
antisocial personality
How are practitioners to treat histrionic personality disorder?
- improving problematic interpersonal relationships
- teaching appropriate ways of negotiating their wants and needs
______ ________ disorder involves a pervasive pattern of grandiosity in fantasy or behaviour, need for admiration, and lack of empathy.
Narcissistic personality disorder
Clinical description of Narcissistic personality disorder
- unreasonable sense of self importance, grandiosity
- no compassion for others, arrogant, envious
- because they often fail to live up to their own expectations, they are frequently depressed
What causes narcissistic personality disorder?
- failure of empathetic “mirroring” from parents
- child remains fixated at self-centered, grandiose stage of development
How do practitioners treat narcissistic personality disorder?
- CBT
- coping strategies (relaxation training, accepting criticism)
- empathizing
- treatment of depression
_________ _________ disorder involves a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism.
Avoidant personality disorder
Clinical description of avoidant personality disorder
- interpersonally anxious
- fears rejection
- pessimistic about their future
What causes avoidant personality disorder?
- Born with difficult temperament, parental rejection, uncritical love
- low self esteem, social alienation persisting into adulthood
- overreactive behavioural inhibition system
How do practitioners treat avoidant personality disorder?
- social skills training
- CBT; graduated exposure to feared situations
- Behavioural rehearsal; patients act out situations that cause anxiety
- systematic desensitization; relaxing in the Prescence of feared situations
- medical interventions for anxiety
________ ____________ disorder is characterized by a person’s pervasive and excessive need to be taken care of, a condition that leads to submissive and clinging behaviour and fears of separation.
dependent personality disorder
Clinical description of Dependent personality disorder
- interpersonally dependent, anxious
- submissive, timid, passive
- feelings of inadequacy, sensitive to criticism, needs reassurance
- clings to relationships
What causes dependent personality disorder?
- disruptions in early childhood leads to fears of abandonment
- High in sociotropic traits (excessive focus on interpersonal relationships and a strong need for social acceptance)
- low on individualistic achievment traits
How do practitioners treat dependent personality disorder?
- developing confidence
- ensuring patient does not over depend on therapist
___________ ________ ______ disorder involves a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.
obsessive-compulsive
personality disorder
clinical description of obsessive compulsive personality disorder
- poor interpersonal relationships due to general rigidity
- quest for perfectionism
obsessive compulsive personality disorder is caused by ________.
genetics
How do practitioners treat obsessive compulsive personality disorder?
- relaxation techniques
- CBT to reframe compulsive thoughts
What two personality disorders are still under study? Why is this?
- sadistic personality disorder (receiving pleasure by inflicting pain on others)
- passive aggressive personality disorder (people are defiant and refuse to cooperate with requests)
- not in the DSM 5 or DSM 5-TR because theres too many permutations, making it difficult to diagnose, and it’s difficult to use the information to come up with an effective treatment plan
