Chater 14 Personality Psychopathology Flashcards
What is a personality disorder
based on trait perspective, inflexible/maladaptive traits that interfere with function, are relatively stable across time and situations
-many never diagnosed, prevalence estimates the difficulty
-5-15% hospital admissions/outpatient clinics
-lifetime prevalence: 9-13%(axis 1 and axis 2
-many go get help with other problems not knowing its the personality
What is axis 1
short term, more immediate, temporal/emotional, depression, anxiety, mood disorders
What is Axis 2
long term; childhood extended into adulthood
What does the DSM say about personality disorders
represent a significant impairment/adaptive failure in the individual’s self-function (identity/self-direction issues)+ in his/her ability to engage in effective interpersonal functioning(empathy/intimacy issues)
What is an example of a personality disorder
- Individual rigidly responds with anger all the time, even if the situation calls for it; this is why it is maladaptive
What is the difference between trait and state
A trait is constant, the state is not
ex. A young shy girl is shy but not around close friends
What is general personality disorder
An enduring pattern of inner experience/behavior that differs markedly from the expectations of the individual’s culture; inflexible/pervasive across personal/social situations
What does the DSM say about GPD
-clinically significant distress/impairments in function
-manifest 2+
—–cognition(ways of perceiving self, other, events)
—–Affect(range, intensity, inability of emotional responses)
—–Interpersonal function
—–Impulse control
-Stable/long duration; onset adolescense or early adulthood
-not explained by other mental disorder, substance, or medical condition
What are the 3 clusters of a GPD
odd/eccentric, Anxious/fearful, Dramatic/emotional/erratic
What are the subtypes of Odd/eccentric
Paranoid, Schizoid, Schizotypal
What is paranoid
extreme suspciousness
What is schizoid
isolated, indifferent to others
-don’t care that they are isolated, that’s what separates them from social anxiety because those individuals are aware/uncomfortable by their social behavior
What is a schizotypal
eccentric thoughts/actions, poor concentration(risk for schizophrenia disorders)
What is anxious/fearful
avoidant, dependent, obsessive compulsive
What is avoidant
extreme fear of rejection, pervasive social anxiety, low self-esteem
-high distressed by social behavior, symptoms similar to social anxiety but more extreme and long term
What is dependent
over-reliance on others; poor sense of identity
What is obsessive compulsive
rigid focus on details; control/ perfectionism; sightly more in men(reflects a high need for control, don’t do well in occupations)
-NOT OCD, no compulsive ritual, less serious
What are the dramatic/emotional/erratic
histrionic, narcissistic, borderline, Antisocial Personality disorder(APD)
What is histrionic
dramatic displays of extreme emotion; attention seeking
-overly dramatic signs of emotion tat are meant to draw attention to the self in hopes of gaining sympathy or secondary gain
What is Narcissistic
self centered, lack empathy, exploits others, Heinz Kohut, Theodore Millon
Who is Heinz Kohut
self psychology; narcissism is compensation for inadequate life(love+approval from ones parents), ‘If you don’t love me, I’ll love myself”
Who is Theodore Millon
social learning theory; narcissism created by parents who hold inflated views of their child
-participation trophies: can be cultural
What is Borderline
unstable relationships, impulsive, poor sense of self; poor sense of interpersonal boundaries(extreme fear of abandonment)
-propensity to view thing in black or white(People are either all good or all evil)
-feeling empty
prone to episodes of severe depression, manipulative suicide events(leave me and I’ll kill myself)
-relationship idealization
-all roles have scripts, one understands not to violate scripts, interpersonal boundaries, fear of abandonment
What happens if a borderline goes through high stress
they can temporarily lose touch with reality(lie between Neurosis and Psychosis)
What is neurosis
non-psychotic mental disorders; neurotic but not out of touch with reality
What is Psychosis
propensity to lose touch with reality
What is APD
psychopath(hereditary), Sociopath(learned it from environment), more in men, harm others more than selves; criminal behavior, not all diagnosed with this are tru psychopaths(cutthroat businessmen)
-can be antisocial without psychopath
Who is Herve Cleckley(Mask of Sanity)
- Psychopath: superficial charm/good intelligence, shallow emotions/lack of empathy, guilt, remorse; behaviors indicate little life plan/order; failure to learn from experiences/absence of anxiety; unreliability, insecurity, untruthfulness
- Passive avoidance learning: tendency to have difficult stopping making response that results in punishment
Who is Robert Hare(without conscience)
4 Facets:
-Deceitful interpersonal style/deficient affect
-irresponsible lifestyle/antisocial activities
-“instrumental aggression: aggression is goal-oriented, yet calm/control(versus hostile aggression(normal) more emotionally charged)
-not all people diagnosed with ADP are psychopathic, psychopaths are wired differently
What are the PCL-R administration and scoring
-semi-structured interviews, case histories, file information
-checklist ratings, 5 omits invalidates; diagnostic cutoff: 30+
What is the etiology for psychodynamic
early parent/child relationship; separation-individuation failure(crawling away from mothers—–> seperation-motor behavior/physical; individual psychological), results in weakend ego
-undeveloped superego, free expression of ID
What is the Parenting approach in separation individuation failure
let the child crawl away but then grab it and hold it, sends the same message as a drunk parent not watching the kid; sets the tone for a child that the world is not safe
What is the behavioral etology
maladaptive behaviors via reinforcement/modeling;
What is the cognitive etiology
extreme/exaggerated schemas; modify distorted belief systems
-deficit in social information processing
What is the bio etiology
assumes link to Axis 1 disorders(expresses itself through Axis 1 disorders like depression/anxiety); use medications to treat Axis 1 symptoms
-Genetics
-Under arousal theory
What is the Family/socialization Risk factors
poor parental supervision/involvement; parental rejection/deprivation; dysfunction family structure; parental seperation/absence; do not learn to pay attention to social stimuli; antisocial father
What are some sociocultural etiology
societal injustices (forms of oppression)
What is behavioral treatment
modeling, noncontingent reinforcement
-Punishment shows no link to the desired behavior+child, learns no rules—> fail to learn social rules of conduct+ get aggressive
-Want the child to get contingent reinforcement so they learn right from wrong;( I get this response because I expressed this behavior)
What is the under arousal theory
less sensitive to ANS; less responsive to the environment; increased tolerance to pain; less sensitive to anxiety, more sensation seeking; all compensate for under arousal
-less adept at passive avoidance learning(they continue to do things that make them have pain, so they can’t avoid behaviors that have an outcome of punishment), psychopaths settle down in middle age, soon learn to avoid punishment
What types of drugs help
Tranquilizing drugs reduce antisocial behavior,
What also helps treat APD
BEST-skill based+behavioral function using material rewards, but not long-lasting
-build rapport/guide APD toward higher level thinking regarding self and others
-current treatment not effective, need family and peers
-disorder tends to diminish with age
What are some DSM changes
removal of paranoid, schizoid, histrionic, dependent
Reasons:
1. absence of research, excessive co-occurrence, arbitrary diagnostic thresholds
2.NEOAC extremes of normal personality
What are some behavioral treatments
skill training, Dialectical behavioral treatments for BPD(combines social skills + teaching emotional control)
Old DSM model of APD
pharmaceuticals/psychiatrists want to keep disease model intact
What is NEOAC
Want to stop medicalizing personality
-Prevalence; rare in the general population, but more common in clinical settings: more likely to come in for specific problem(axis 1, anxiety, martial problem)
-gender
—–disorders for emotionality more common in women
—–disorders for self-centeredness/callousness more in men
stereotypes: more socially acceptable for women to be dependent, nurturing; men are stoic, emotionless
can create a bias/inequality: are we pathologizing the very traits society encourages
-cultural context: lack of eye contact—–> respect or avoidance
What are the main takeaways from this class
mental disorder chronicity+severity(distress+impairment)
reduce stigmas of mental illness, correct myths/misconceptions
deal with ambiguity/uncertainty(can still help people)
think holistically(mutiple interacting influences over time, multipath model)
