Chapter 15 - Personality Disorders Flashcards
When does a personality become pathological?
-Personality: general pattern of characteristics and behaviors
-Personality disorder: inflexible and pervasive (unable to adapt/change in scenarios); extreme levels of traits; associated with distress and/or impairment
–not a lot of research on most PDs except Antisocial and Borderline PD & no evidence-based treatment for many PDs
What are the 3 categories of PDs?
A: Odd or eccentric behavior
B: Dramatic, emotional, erratic behavior
C: anxious, fearful behavior
What are the disorders in Cluster A?
3 disorders:
-Paranoid PD;
-Schizoid PD;
-Schizotypal PD
*prevalence of each PD in this cluster ~3-5%
What are the key characteristics of Paranoid PD?
-Persistent distrust and suspiciousness of others
-Expect to be mistreated or exploited by others
-Hypersensitive, cautious, vigilant
What are the causes, prevalence, gender differences, & treatments for Paranoid PD?
-Gender Differences: Men > women
-Prevalence: ~3%
-Causes: psychodynamic theory (rigid use of projection); cognitive theory (developed an untrusting mental schema)
-No evidence-based treatment identified
What are the DSM-5 Criteria for Schizoid PD?
A: A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, present in a variety of contexts, indicated by ≥4:
1. Neither desires nor enjoys close relationships
2. Almost always choose solitary activities
3. Has no interest in sex
4. Takes pleasure in few activities
5. Lacks close friends or confidants
6. Indifferent to praise or criticism of others
7. Shows emotional coldness, detachment or flattened affectivity
B: Does not occur exclusively during the course of schizophrenia, another psychotic disorder, bipolar/depressive disorder with psychotic features, autism spectrum disorder
What are the causes, prevalence, gender differences, & treatments for Schizoid PD?
-Gender Differences: Men > women
-Prevalence: ~3-5%
-Causes: genetically associated with schizophrenia; cold and emotionally impoverished childhood
-No evidence-based treatment identified
What are the key characteristics of Schizotypal PD?
-A pervasive pattern of cognitive or perceptual distortions and
eccentricities of behavior and interpersonal deficits
-Odd thinking (e.g., magical thinking) & odd speech
-Unusual perceptual experience (feeling like someone’s there; derealization/depersonalization)
What are the causes, prevalence, gender differences, & treatments for Schizotypal PD?
-Gender Differences: Men > women
-Prevalence: Up to 4%
-Causes: genetic link to schizophrenia
-No evidence-based treatment identified
What is the link between Cluster A PDs and Schizophrenia?
-cluster A PDs are similar to less severe variants of schizophrenia
-Schizotypal PD has a strong relationship to schizophrenia (it has the same brain abnormalities)
-higher rates of cluster A PDs for family members of individuals with schizophrenia
-despite similarities with schizophrenia, we don’t prescribe antipsychotics for PDs
What are the disorders in Cluster B?
4 disorders:
-Antisocial
-Borderline
-Narcissistic
-Histrionic
*more commonly diagnosed than other clusters
What are the key characteristics of Antisocial PD?
-A pervasive pattern of disregard for and violation of the rights of others: irresponsible behaviour, break laws, disregard for safety of others; deceitful; aggressive; lack of remorse
-Conduct disorder present before age 15 (i.e., truancy, running away from home, theft, arson) but APD is diagnosed in adulthood
What are the gender differences, prevalence, and other terms for Antisocial PD?
-Gender Differences: Men > women
-Prevalence: ~3%
-Psychopaths or ‘sociopaths’: refer to same subgroup, sociopath is an outdated term (all psychopaths have APD, but not all people with APD have psychopathy)
What is Robert Hare’s model for Psychopathy?
FACTOR 1: Superficial charm; Grandiose sense of self-worth; Lack of empathy and remorse; Shallow affect; Manipulative
FACTOR 2: Failure to conform; Impulsivity; Irresponsibility; Aggression; Deceitful/lying; Disregard for others
*Psychopathy encompasses both factors whereas Antisocial PD predominantly involves Factor 2
What are the Genetic Influences of APD?
-Concordance MZ > DZ
-Higher rates of antisocial behaviors among adopted children of biological parents with APD
How does the Biological Dimension explain Antisocial PD?
-Lower emotional responsiveness and stress reactivity
–less susceptible to fear and anxiety
–interfere with fear conditioning
–diminished reactivity in the amygdala when shown pictures of fearful facial expressions
–especially prominent among psychopaths
–psychopaths found to have lower autonomic stress reactivity
How does the Psychological Dimension explain APD?
-Psychodynamic perspective: people with APD are dominated by id impulses
-Cognitive perspective: core beliefs that world is dangerous and hostile
-Behavioral perspective: impaired fear conditioning; lack of positive role models; learn antisocial behaviors from others
How does the Social Dimension explain Antisocial PD?
-Childhood history of emotional and physical maltreatment
-Low parental warmth, harsh parenting - nurturing parenting can help minimize antisocial traits
-Association with antisocial peers
