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chapter 15 Flashcards

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1
Q

Personality Disorders

A

Involve problems in thinking, affect, impulse control and interpersonal functioning
Persist for years and influence many domains of life
DSM-5 provides criteria for personality disorder in general as well as 10 specific personality disorders

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2
Q

The 10 personality disorders are classified into 3 clusters:

A

The 10 personality disorders are classified into 3 clusters:
Odd/Eccentric (cluster A)
Dramatic/Erratic (cluster B)
Anxious/Fearful (cluster c)

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3
Q

General Personality Disorder

A

An inflexible pattern of inner experience and Behavior that is distinct from CULTURAL EXPECTATIONS, and influences at least two of the following:

  • Cognition about the self and others
  • Affect
  • Interpersonal functioning
  • Impulse control

*The pattern
Causes significant distress or impairment
Is inflexible
Is pervasive across situations

*Onset by early adulthood and persistence for a long duration

Not explained by another mental disorder, by a substance, or by a medical condition

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4
Q

Personality Disorders: Prevalence

A

About 1 out of 10 people meet diagnostic criteria for a personality disorder

Important to consider whether patterns of Behavior are unusual for a person’s cultural background

Tend to co-occur with psychological disorders
Commonly encountered in treatment settings
40% of outpatients meet criteria for a personality disorder
Associated with more severe symptoms

Personality disorders are not stable over time
About half of people achieve remission 2 years later
99% remit when re-assessed after 16 years
People may still have some symptoms after remission
Many will relapse

Personality disorders are highly comorbid
More than 50% meet criteria for another personality disorder
High rates of over overlap in symptoms and concerns

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5
Q

Test-Retest Stability of Personality Disorders

A

-for depression (without personality disorder) low Test-Retest 6 months, 12 months and 24 months

slide 13

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6
Q

What are the two criticisms of the current DSM classification of PD’s?

A

-based on western values (maybe idk)

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7
Q

Common Risk Factors of personality disoders

A

Personality disorders tend to co-occur and share genetic vulnerability

Environmental factors
Early adversity
Childhood abuse or neglect
Aversive or unaffectionate parental style

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8
Q

Odd/Eccentric Cluster

A

Cluster A
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder

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9
Q

Paranoid Personality Disorder

A

Suspicious of others
Strangers, casual acquaintances, family members
Expectation for mistreatment or exploitation
Secretive and continually on the lookout for signs of trickery and abuse
Hostile and angry in response to perceived insults

Seen as difficult and critical
Social world filled with conflict, which perpetuates paranoia

(Cluster A)

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10
Q

DSM-5 Criteria:Paranoid Personality Disorder

A

Presence of 4 or more of the following signs of distrust and suspiciousness from early adulthood across many contexts:
Unjustified suspiciousness of being harmed, deceived, or exploited
Unwarranted doubts about the loyalty or trustworthiness of friends or associates
Reluctance to confide in others because of suspiciousness
The tendency to read hidden meanings into the benign actions of others
Bears grudges for perceived wrongs
Angry reactions to perceived attacks on character or reputation
Unwarranted suspiciousness of the partner’s fidelity

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11
Q

Schizoid Personality Disorder

A

Do not desire or enjoy social relationships
No close friends

Aloof and show no warm, tender feelings when interacting with others
Rarely experience strong emotions
No interest in sex
Enjoy few activities

Indifferent to praise or criticism

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12
Q

DSM-5 Criteria: Schizoid Personality Disorder

A

Presence of 4 or more of the following signs of aloofness and flat affect from early adulthood across many contexts:
Lack of desire for or enjoyment of close relationships
Almost always prefers solitude to companionship
Little interest in sex
Few or no pleasurable activities
Lack of friends
Indifference to praise or criticism
Flat affect, emotional detachment, or coldness

Presence of 5 or more of the following signs of unusual thinking, eccentric Behavior, and interpersonal deficits from early adulthood across many contexts:
Ideas of reference
Odd beliefs or magical thinking, e.g., belief in extrasensory perception
Unusual perceptions
Odd thought and speech
Suspiciousness or paranoia
Inappropriate or restricted affect
Odd or eccentric behavior or appearance
Lack of close friends
Social anxiety and interpersonal fears that do not diminish with familiarity

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13
Q

Schizotypal Personality Disorder

A

Eccentric thoughts and Behavior, interpersonal detachment, and suspiciousness
Some develop more severe psychotic symptoms over time, and a small proportion develop schizophrenia

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14
Q

Similarities with schizophrenia - Schizotypal Personality Disorder

A 
Similarities with schizophrenia 
Genetic vulnerability 
Deficits in cognitive and neuropsychological functioning
Enlarged ventricles
Less temporal lobe gray matter 
Neurotransmitter dysregulation
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15
Q

DSM Criteria: Schizotypal Personality Disorder

A

Presence of 5 or more of the following signs of unusual thinking, eccentric Behavior, and interpersonal deficits from early adulthood across many contexts:

  • Ideas of reference
  • Odd beliefs or magical thinking, e.g., belief in extrasensory perception
  • Unusual perceptions
  • Odd thought and speech
  • Suspiciousness or paranoia
  • Inappropriate or restricted affect
  • Odd or eccentric behavior or appearance
  • Lack of close friends
  • Social anxiety and interpersonal fears that do not diminish with familiarity
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16
Q

Dramatic/Erratic Cluster

A 
Cluster B
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
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17
Q

Antisocial Personality Disorder

A

Pervasive disregard for the rights of others
Aggressive, impulsive, and callous traits

Pattern of irresponsible Behaviors
Working inconsistently, breaking laws, being irritable and physically aggressive, defaulting on debts, being reckless and impulsive, neglecting to plan ahead

Little regard for truth and little remorse for misdeeds
5x more common in men
75% also meet criteria for another disorder
Substance use is very common

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18
Q

Psychopathy

A

Focuses on internal thoughts and feelings
Poverty of emotion
Negative emotions
Lacks shame, remorse and anxiety; does not learn from mistakes
Positive emotions
Merely an act used to manipulate others; superficially charming
Impulsivity
Behave irresponsibly for thrills

*Psychopathy Checklist – revised (Hare, 2003)

*Compared to Antisocial Personality Disorder:
Does not require symptoms before age 15
Includes more affective symptoms (e.g., lack of empathy)

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19
Q

DSM-5 Criteria:Antisocial Personality Disorder

A

Age at least 18

Evidence of conduct disorder before age 15
Pervasive pattern of disregard for the rights of others since the age of 15 as shown by at least three of the following:
Repeated law breaking
Deceitfulness, lying
Impulsivity
Irritability and aggressiveness

Reckless disregard for own safety and that of others
Irresponsibility as seen in unreliable employment or financial history
Lack of remorse

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20
Q

Etiology of Antisocial Personality Disorder

A

Problems with research
Differences in diagnosis (APD vs. psychopathy)
Conducted mostly with criminals
Interactions of genes and the social environment
Genetic, Behavioral, and family influences are very hard to disentangle
*Social environment
Poverty, exposure to violence
*Family environment interacts with genetics
-Polymorphism of the MAO-A gene predicts psychopathy among males who had experienced childhood physical or sexual abuse or maternal rejection

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21
Q

what disorder says- “I hate you, don’t leave me”

A

Borderline Personality Disorder

22
Q

DSM-5 Criteria:Borderline Personality Disorder

A

Presence of five or more of the following signs of instability in relationships, self-image, and impulsivity from early adulthood across many contexts:

  • Frantic efforts to avoid abandonment
  • Unstable interpersonal relationships in which others are either idealized or devalued
  • Unstable sense of self
  • Self-damaging, impulsive Behaviors in at least two areas, such as spending, sex, substance abuse, reckless driving, and binge eating
  • Recurrent suicidal Behavior, gestures, or self-injurious Behavior (e.g., cutting self)
  • Marked mood reactivity
  • Chronic feelings of emptiness
  • Recurrent bouts of intense or poorly controlled anger
  • During stress, a tendency to experience transient paranoid thoughts and dissociative symptoms
23
Q

Etiology BPD: Parenting Interacts with Child Vulnerability

A

Linehan’s Diathesis-Stress Theory
Diathesis of emotional dysregulation interacts with a family environment that is invalidating
Person’s feelings are discounted and disrespected
Emotional dysregulation and invalidation interact with each other in a dynamic fashion

24
Q

Linehan’s Diathesis-Stress Theory of _____

A

BPD

biological diathesis=> emotional dysregulation of the child* => great demands on the family => invalidation by parents through punishing or ignoring the demands => emotional outburst by child to which the parents demand => dysregulation of the child*

  • not necessarily a bad parenting style
  • child learns the only way to get attention

-a parenting style can discourage this

slide 57

25
Q

Histrionic Personality Disorder

A

Overly dramatic and attention-seeking Behavior
Often use their physical appearance to draw attention to themselves
Self-centered, overly concerned with their physical attractiveness, and uncomfortable when not the center of attention
Inappropriately sexually provocative and seductive

Easily influenced by others

26
Q

DSM-5 Criteria: Histrionic Personality Disorder

A

Presence of five or more of the following signs of excessive emotionality and attention seeking from early adulthood across many contexts:
-Strong need to be the center of attention
-Inappropriate sexually seductive Behavior
Rapidly shifting and shallow expression of emotions
-Use of physical appearance to draw attention to self
-Speech that is excessively impressionistic and lacking in detail
-Exaggerated, theatrical emotional expression
-Overly suggestible
-Misreads relationships as more intimate than they are

27
Q

Narcissistic Personality Disorder

A

Grandiose view of self
Preoccupied with fantasies of great success

Self-centered
Demands constant attention
Lacks empathy
Feelings of arrogance, envy, entitlement
View themselves as superior to others

Primary goal of interaction with others is to bolster their own self-esteem
Value being admired more than gaining closeness
Tendency to seek out high status partners

Highly likely to be vindictive and aggressive when faced with a competitive threat or a put-down

28
Q

DSM-5 Criteria: Narcissistic Personality Disorder

A

Presence of five or more of the following signs of grandiosity, need for admiration, and lack of empathy from early adulthood across many contexts:
Grandiose view of one’s importance
Preoccupation with one’s success, brilliance, beauty
Belief that one is special and can be understood only by other high-status people
Extreme need for admiration
Strong sense of entitlement
Tendency to exploit others
Lack of empathy
Envious of others
Arrogant Behavior or attitudes

29
Q

Etiology of Narcissistic Personality Disorder

A

Parenting

Fragile Self-Esteem

30
Q

Etiology of Narcissistic Personality Disorder: Fragile Self-Esteem

A

Inflated self-worth and denigration of others defend against feelings of shame
Sensitivity to negative social interactions
Associated with higher levels of neuroticism and depression

31
Q

Etiology of Narcissistic Personality Disorder

A

Parenting
Overly indulgent parents foster children’s belief that they are special
Parental tendencies to see their children as highly superior to others predicts children’s narcissistic traits

32
Q

Anxious/Fearful Cluster

A

Cluster C
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive Compulsive Personality Disorder

Prone to worry and distress

33
Q

Avoidant Personality Disorder

A

Fearful of criticism, rejection, and disapproval
Avoids social situations do to fear of negative feedback
Restrained and inhibited in social situations
Feelings of inadequacy, inferiority
Beliefs of incompetence and inferiority
Avoids taking risks or trying new activities
High comorbidity with social anxiety disorder
Similar genetic vulnerability

34
Q

Dependent Personality Disorder

A

Excessive reliance on others
Intense need to be taken care of
Discomfort with being alone
Subordinate needs to ensure protective relationships are not threaten
Urgently seek new relationship when one ends
View themselves as weak
Turn to others for support and decision making
Likely to develop depression after interpersonal losses

35
Q

DSM-5 Criteria:Dependent Personality Disorder

A

An excessive need to be taken care of, as shown by the presence of at least five of the following from early adulthood across many contexts:
Difficulty making decisions without excessive advice and reassurance from others
Need for others to take responsibility for most major areas of life
Difficulty disagreeing with others for fear of losing their support
Difficulty doing things on own or starting projects because of lack of self-confidence
Doing unpleasant things as a way to obtain the approval and support of others
Feelings of helplessness when alone because of fears of being unable to care for self
Urgently seeking new relationship when one ends
Preoccupation with fears of having to take care of self

36
Q

Obsessive-Compulsive Personality Disorder

A

A perfectionist
Preoccupied with rules, details, schedules, and organization
Often to the extreme of being unable to finish projects
Serious, rigid, formal, and inflexible
Overly focused on work
Little time for leisure, family, and friends
Reluctant to make decisions or delegate

Compared to OCD:
Does not have the obsessions/compulsions of OCD
Symptoms often co-occur and share genetic vulnerability

37
Q

how many symptoms are needed for Obsessive-Compulsive Personality Disorder

A

four

38
Q

Treatment of Personality Disorders (PD)(1 of 2)

A

Often enter treatment for a condition other than PD

Presence of PD predicts slower improvement in psychotherapy

Psychotherapy is the treatment of choice
Evidence that personality traits do change
Often supplemented with medications
Psychodynamic theory
Childhood problems are at the root of PD
Cognitive theory
Negative cognitive beliefs are at the root of PD
Help person become more aware of beliefs and challenge maladaptive cognitions

39
Q

Treatment of Schizotypal PD and Avoidant PD

A

Schizotypal PD
Antipsychotic and antidepressant medications
Helpful for reducing unusual thinking

40
Q

who created the treatment for BPD

A

Dialectical Behavior Therapy

or

Psychodynamic therapy
Transference based therapy
Helps client consider parallels between response to therapist and experiences in other relationships
Mentalization therapy
Helps client to be more reflective about feelings, and those of other people, so as to not automatically act without thinking when emotions or interpersonal stressors occur

41
Q

Treatment of Borderline PD: Dialectical Behavior Therapy

A

Combines client-centered empathy and acceptance with cognitive Behavioral problem solving, emotion-regulation techniques, and social skills training

Dialectics
Constant tension between any phenomenon and its opposite, which is resolved by creating a new phenomenon

Group and individual therapy sessions

Four stages:
Addressing dangerously impulsive Behaviors (e.g., suicidal actions)
Modulating extreme emotionality and coaching the client to tolerate emotional distress
Improving relationships and self-esteem
Promoting connectedness and happiness

42
Q

T/F
Personality Disorders: Prevalence
When using structured interviews, inter-rater reliability is adequate to good for most diagnoses

A

TRUE

When using structured interviews, inter-rater reliability is adequate to good for most diagnoses

43
Q

How is cluster A of personality disorders different from schizophrenia?

A

Different from schizophrenia:
Bizarre thinking and functional impairments are less severe
Hallucinations are not present
Full-blown delusions are not present

44
Q

Characteristics of cluster B

A 
Characterized by symptoms that range from: 
Rule-breaking Behavior
Exaggerated emotional displays
Highly inconsistent Behavior
Inflated self-esteem
45
Q

Antisocial Personality Disorder and gender

A

5x more common in men

46
Q

T/F Personality disorders are stable over time

A

FALSE

Personality disorders are not stable over time

47
Q

Avoidant PD treatment

A 
Avoidant PD
Same treatments as social anxiety disorder
Antidepressant medications
CBT
Challenge negative beliefs
Social skills training
Exposure to feared situations
48
Q
  1. A concern about the DSM-5’s classification system for personality disorders is that
    a) about half of the people who meet criteria for one personality disorder also meet criteria for
    another personality disorder.
    b) some of the disorders are rare in community settings, and even in most clinical settings.
    c) many people who seem to have a serious personality problem don’t fit any of the personality
    disorder diagnoses.
    d) all of the above.
A

d) all of the above.

49
Q
  1. Compared to normal personality styles, personality disorders are more
    a) bizarre and out of control.
    b) dangerous and immoral.
    c) inborn and physiological.
    d) pervasive and inflexible.
A

d) pervasive and inflexible.

50
Q
  1. Unusual and eccentric thoughts and behavior (psychoticism), interpersonal detachment, and
    suspiciousness are characteristics of the DSM-5’s __________ personality disorder.
    a) schizotypal
    b) narcissistic
    c) avoidant
    d) borderline
A

a) schizotypal

51
Q
  1. According to the DSM-5, those diagnosed with schizotypal personality disorder
    a) have social deficits.
    b) are anxious in social situations.
    c) feel like outcasts or outsiders.
    d) all of these answers are correct.
A

d) all of these answers are correct.

52
Q
  1. Compared to individuals who are not psychopaths, the skin conductance of psychopaths is
    __________ when they are confronted with an intense or aversive stimulus.
    a) less reactive
    b) more reactive
    c) equally reactive
    d) more reactive only in those who are criminals
A

a) less reactive

Abnormal Psychology (13 decks)

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