Chapter 15 (Exam 2) Flashcards

Question

general info dramatic personality disorders (SECOND cluster of personality disorders )

Answer 1

- most commonly diagnosed out of the categories - behaviors are so dramatic, errational, and emotional that it is nearly impossible to have satisfying relationships - causes are not well understood - treatments range from ineffective to moderately effective

Answer 2

persistently DISREGARD and VIOLATE others' rights - highest scoring in psychopathy - MUST be 18 y/o to diagnose - likely to lie repeatedly, be reckless, and impulsive - little regard for others; can be cruel, sadistic, aggressive, and violent - higher rates of alcohol use disorder and history of conduct disorder - commonly diagnosed among serial killers - no known effective treatment; hardest to treat - clinicians believe there is a lack of moral conscious - more commonly diagnosed in men (3x more) - prevalence rate: 3.6%

Answer 3

psychodynamic- begins with an absence of parental love, leading to a lack of basic trust, individuals with this disorder are MORE LIKELY to have violence and abuse in their childhoods cog behavioral - behavior may be learned through modeling or unintentional reinforcement (often runs in families, esp males- most likely a result of modeling and genetics) - people with this disorder tend to hold attitudes that trivialize the importance of other people's needs

Answer 4

****BRAIN CIRCUIT: deficient functioning (poor connectivity?) in ***prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, and temporal cortex *** - lower levels of serotonin (impacting impulsivity and aggression) - lower levels of anxiety and arousal (more likely to take risks and seek thrills) - respond to warnings and expectations of stress with lower brain/body arousal, slow autonomic arousal, and slow EEG waves - more commonly diagnosed among first degree relatives diagnosed with this - concordance rates: identical- 67% fraternal- 31%

Answer 5

- treatments are typically ineffective - major obstacle= lack of conscience or desire to change (usually court mandated) - some cog behavioral therapists try to guide clients to think about moral issues and others' needs (hospitals and prisons try to create therapeutic communities- structured environments that teach responsibility towards others) - atypical antipsychotic drugs have been tried but they are ineffective

Answer 6

a term that describes a cluster of psychopathological traits that fall into these categories: 1. interpersonal traits 2. affective traits 3. antisocial traits 4. lifestyle traits - the psychopathy checklist-revised (PCL-R) is the most commonly used instrument to measure psychopathy

Answer 7

antisocial personality disorder - there is a lot of overlap between APD and psychopathy - not all aspects of psychopathy are captured by APD (e.g. interpersonal and affective traits) therefore... psychopaths will always meet crit for APD BUT people with APD do not always meet crit for psychopathy

Answer 8

people display great INSTABILITY, including major shifts in mood, an unstable self-image, and impulsivity - interpersonal relationships are also unstable - people with BPD are prone to bouts of anger (this can turn inward- many self harm and 70% attempt suicide) - more commonly diagnosed in females - prevalence rate: 5.9%

Answer 9

psychodynamic- lack of early acceptance or abuse/neglect by parents (aka object relations theory) biological- genetic predisposition; lower brain serotonin activity, irregular brain structure/circuit activity and anatomy sociocultural- more likely to occur in rapidly changing cultures

Answer 10

- GOLD STANDARD: dialectical behavioral therapy (DBT)- includes CBT, psychodynamic, and humanistic therapies - relational psychoanalytic therapy/transference-focused therapy- can be helpful when they focus on pt's central relationship disturbance, poor sense of self, and pervasive loneliness and empathy - psychotropic medications (antidepressants, mood stabilizers, antianxiety, and antipsychotic drugs have helped some calm from their emotional and aggressive storms) - some benefit from a combination of drug therapy and psychotherapy

Answer 11

EXTREMELY emotional and continually seek to be the center of attention - often engage in attention seeking behaviors and are always "on stage" (APPROVAL and PRAISE are their lifeblood) - vain, self-centered, demanding - some attempt suicide (often to manipulate others) - diagnosed more often in women in clinical settings BUT equally common in men and women when using structured assessments - prevalence rate: 1.8%

Answer 12

psychodynamic- experienced unhealthy relationships during childhood; cold, controlling parents left them feeling unloved and afraid of abandonment (they learned to behave dramatically, inventing crises that would require people to act protectively) cog behavioral- look at the lack of substance and the extreme suggestibility; propose that people with this disorder hold a general assumption that they are helpless to care for themselves so they seek out others who will meet their needs socio/multicultural- caused by society's norms and expectations; the vain, dramatic, and selfish behavior may be an exaggeration of femininity

Answer 13

cog behavioral- cognitive restructuring; therapist helps pt change the belief that they are helpless and try to help them develop better, more deliberate ways of thinking and problem solving psychodynamic/group therapy- help clients deal with their dependency - clinical case reports suggest that each approach can be useful but overall outcome studies show only modest response to treatment - drug therapy is less successful, unless it is used to relieve depression

Answer 14

GRANDIOSE, need ADMIRATION, feel NO EMPATHY for others - exaggerate their achievements and talents, often appearing as arrogant - constantly need people praising/admiring them - rarely interested in others; only connect with people if there is something to be gained - 6.2% of adults display NPD (50-75% are men) - teens exhibit this behavior as a part of development; it does not mean they have it

Answer 15

psychodynamic- focus on cold, rejecting parents; life spent feeling unsatisfied, rejected, unworthy, and ashamed; object relations (occurs because of a series of traumatic empathic failures on part of caregivers; focus on grandiose self-presentation; self-sufficiency replaces warm relationship cog behavioral- propose that this develops when people are treated too positively early in life; overvalue self-worth sociocultural- observe a link between NPD and eras of narcissism in society

Answer 16

ONE OF THE MOST DIFFICULT PERSONALITY DISORDERS TO TREAT (no major treatment approaches have had much success; any perceived criticism in therapy= pt gives up) - pt usually seek treatment because of a secondary issue (e.g. depression or marital problems) - pt may manipulate therapists to support their sense of superiority (a love-hate relationship may evolve) psychodynamic- recognize and work through basic insecurities cog behavioral- focus on self-centered thinking and redirection

Answer 17

antisocial personality disorder AND narcissistic personality disorder

Answer 18

displays ANXIOUS and FEARFUL behavior - although symptoms are similar to anxiety and depressive disorders, there are no direct links (beside avoidant personality disorder and social anxiety disorder) - limited research - treatments are moderately helpful (considerably better than other personality disorder clusters)

Answer 19

CONSISTENT discomfort and RESTRAINT in social situations, overwhelming feelings of INADEQUACY, and extreme SENSITIVITY to negative evaluation - prevalence rate: 2.4% - slightly more common in women

Answer 20

avoidant personality disorder= fear of close social relationships social anxiety disorder= fear of social circumstances - some believe they should be combined

Answer 21

psychodynamic- focus on shame and insecurities traced back to childhood experiences cog behavioral- result of failure to develop effective social skills; harsh criticism and rejection in early childhood may lead people to assume their environment will always judge them negatively

Answer 22

- pt comes to therapy seeking acceptance and affection - a therapist MUST gain the pt's trust (beyond this, they treat this the same as social anxiety disorder and anxiety- with exposure and social skills training) - group therapy (esp in cog behavioral principles) help provide practice - antianxiety and antidepressant meds are sometimes useful

Answer 23

pervasive, EXCESSIVE need to be CARED FOR - clinging and obedient, fear separation from loved ones, distressed, lonely, sad, prone to self-dislike - reliance on others (the smallest decision can not be made) - CENTRAL FEATURE: difficulty with separation - prevalence rate: less than 0.6% - more common in women

Answer 24

psychodynamic- uses similar explanations for depression (FREUDIAN)- unresolved conflicts during oral stage (OBJECT RELATIONS)- early parental loss or rejection prevents healthy attachment and separation (OTHER)- overinvolvement or overprotection by caregivers cog behavioral (BEHAVIOR)- unintentional clinging and loyal behavior rewarded by dependent parents (COGNITIVE)- maladaptive attitudes; "inadequate and helpless to deal with the world"; "need to find someone to protect me"

Answer 25

psychodynamic- transference of dependency needs cog behavioral- challenge and change their assumptions of incompetence and helplessness and provide assertiveness training - antidepressant drug therapy has been helpful if pt experiences depression - group therapy provides pt with an opportunity to receive support from peers; group members may serve as models for one another

Answer 26

so preoccupied with ORDER, PERFECTION, and CONTROL that they lose all flexibility, openness, and efficiency - set unreasonably high standards for themselves and others; afraid to make decisions because they fear making mistakes - rigid and stubborn - trouble expressing affection; relationships may be stiff and superficial - equally diagnosed in men and women - prevalence rate: 7.9%

Answer 27

Freudian- overly harsh toilet training during anal stage; anal retentive and fixated cog behavioral- illogical thinking processes

Answer 28

people with OCPD typically do not believe there is anything wrong with them, so they are unlikely to seek treatment unless suffering from secondary condition (e.g. anxiety, depression) - respond well to psychodynamic or cognitive therapy - many report success with SSRIs

Answer 29

- personality disorders are hard to diagnose, easy to misdiagnose, and raise serious issues of reliability and validity

Answer 30

1. some diagnostic criteria cannot be observed directly (diagnoses rely heavily on impressions of the clinician; clinicians differ widely in their judgements about when a personality style should be called a disorder) 2. similarity of disorders within/between clusters creates classification difficulties (it is common that people with personality disorders typically meet criteria for several; indiv. must meet a certain number of criteria to receive a diagnosis, but no single feature is necessary for any diagnosis)

Answer 31

the classification system uses CATEGORIES instead of DIMENSIONS - the current approach assumes that: problematic personality traits are either present or absent, a personality disorder is either displayed or not, a person who suffers from a personality disorder is not troubled by personality traits outside of that disorder

Answer 32

people whose traits significantly impair their functioning should receive this diagnosis: PERSONALITY DISORDER- TRAIT SPECIFIED (PDTS) - when assigning the diagnosis, clinicians would identify and list problematic traits and rate the severity of impairment from 0-4 (0= little to none, 4= extreme impairment) - 5 groups of problematic traits would be eligible for this diagnosis

Answer 33

1. NEGATIVE AFFECTIVITY (unstable emotions, anxiousness, hostility) 2. DETACHMENT (social withdrawal, restricted emotional reactivity, intimacy avoidance) 3. ANTAGONISM (deceitfulness, hostility, grandiosity) 4. DISINHIBITION (impulsivity, risk taking, irresponsibility) 5. PSYCHOTICISM (unusual beliefs and experiences, eccentricity) - 25 specific traits are divided between the 5 groups - the traits must significantly impair functioning