Class 1 Flashcards
Personality
enduring patterns of thinking, feeling & reacting that define a person
Personality Disorder
“an enduring pattern of inner experience and
behaviour that deviates markedly from the expectations of the individual’s culture”
GENERAL PERSONALITY DISORDER CRITERIA
- Pattern of deviation must be evident in two or more of the following domains:
- Cognition (ways of perceiving and interpreting self, others, events)
- Emotional responses (range, intensity, lability, appropriateness)
- Interpersonal functioning (capacity for intimacy, stability of relationships, autonomy)
- Impulse control (over- or under-control)
- Must be inflexible, pervasive across a broad range of situations
- Must be a source of clinically significant distress or functional impairment
- Must be stable and of long duration, onset in adolescence or early adulthood
Cluster A
• Paranoid
• Schizoid
• Schizotypal
odd/eccentric
Cluster B
• Antisocial • Borderline • Histrionic • Narcissistic dramatic/emotional/erratic
Cluster C
• Avoidant
• Dependent
• Obsessive-compulsive
anxious/fearful
GENERAL PD SCREENING MEASURES
- The Standardized Assessment of Personality – Abbreviated Scale (SAPAS)
- The Iowa Personality Disorder Screen (IPDS)
Clinical interviews
- SCID II
- International Personality Disorder Examination (IPDE)
- Diagnostic Interview for Borderlines (DIB)
Self-report measures
- SCID II questionnaire
- Personality Diagnostic Questionnaire (PDQ)
- Multi-source Assessment of Personality Pathology (MAPP)
- Millon Clinical Multiaxial Inventory (MCMI)
PARANOID PD
- Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
- 4 or more of the following:
- Suspects others are exploiting or deceiving him/her
- Preoccupied with unjustified doubts about loyalty or trustworthiness
- Reluctant to confide in others, believes they will use the information against him/her
- Reads hidden demeaning meanings into benign remarks
- Persistently bears grudges
- Perceives attacks on his/her character, is quick to react angrily or counterattack
- Recurrent suspicions regarding fidelity of spouse or sexual partner
SCHIZOID PD
- Pervasive pattern of detachment from social relationships and restricted expression of emotion
- 4 or more of the following:
- Neither desires nor enjoys close relationships
- Almost always chooses solitary activities
- Little if any interest in sexual experiences with another person
- Takes pleasure in few in any activities
- Lacks close friends other than first-degree relatives
- Appears indifferent to the praise or criticism of others
- Shows emotional coldness or flattened affect
SCHIZOTYPAL PD
- Pervasive pattern of interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior
- 5 or more of the following:
- Ideas of reference
- Odd beliefs or magical thinking
- Unusual perceptual experiences, including bodily illusions
- Odd thinking and speech
- Suspiciousness or paranoid ideation
- Inappropriate or constricted affect
- Behavior or appearance that is odd or eccentric
- Lack of close friends other than first-degree relatives
- Excessive social anxiety that does not diminish with familiarity
ANTISOCIAL PD
- Pervasive pattern of disregard for and violation of the rights of others occurring since the age of 15 years
- 3 or more of the following:
- Failure to conform to social norms with respect to lawful behaviors
- Deceitfulness, such as lying, using aliases, conning others for personal profit or pleasure
- Impulsivity or failure to plan ahead
- Irritability or aggressiveness as indicated by repeated fights or assaults
- Reckless disregard for safety of self or others
- Consistent irresponsibility (e.g., failure to honor work or financial obligations)
- Lack of remorse
- Evidence of Conduct Disorder with onset before age 15
BORDERLINE PD
- Pervasive pattern of instability of interpersonal relationships, self image and affect and marked impulsivity
- 5 or more of the following:
- Frantic efforts to avoid abandonment
- Unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- Identity disturbance
- Impulsivity in at least two areas that are potentially self-damaging
- Recurrent suicidal behaviors, gestures or threats or self-mutilating behaviors
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger, of difficulty controlling anger
- Transient, stress-related paranoia or dissociation
HISTRIONIC PD
- Pervasive pattern of excessive emotionality and attention seeking
- 5 or more of the following:
- Uncomfortable in situations in which he is not the center of attention
- Interactions often characterized by inappropriate sexually seductive behavior
- Displays rapidly shifting and shallow expression of emotion
- Consistently uses physical appearance to draw attention to self
- Has a style of speech that is excessively impressionistic and lacking in detail
- Shows self-dramatization and exaggerated emotion
- Is suggestible
- Considers relationships to be more intimate than they are
NARCISSISTIC PD
• A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack
of empathy
• 5 or more of the following:
• Grandiose sense of self-importance
• Preoccupied with fantasies of unlimited success, power, brilliance or beauty
• Believes he/she is “special” and can only be understood or should associate with other special or high status people
• Requires excessive admiration
• Has a sense of entitlement
• Is interpersonally exploitive
• Lacks empathy
• Is often envious of others and believes others are envious of him
• Shows arrogant, haughty behaviors or attitudes
AVOIDANT PD
- Pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
- 4 or more of the following:
- Avoids social occupations that involve significant interpersonal contact
- Is unwilling to get involved with people unless certain of being liked
- Is preoccupied with being criticized in social situations
- Shows restraint in intimate relationships because of fear of being shamed or ridiculed
- Inhibited in new interpersonal situations because of feeling inadequate
- Views self as socially inept and unappealing
- Unusually reluctant to take personal risks or engage in any new activities because they may prove embarrassing
DEPENDENT PD
- Pervasive and excessive need to be taken care of that leads to submissive and clinging behaviors and fears of separation
- 5 or more of the following:
- Has difficulty making everyday decisions without an excessive amount of reassurance
- Needs others to assume responsibility for most major areas of his/her life
- Has difficulty expressing disagreement with others because of fear of loss of approval
- Difficulty initiating projects on his/her own because of lack of self-confidence
- Goes to excessive lengths to obtain nurturance and support from others
- Feels uncomfortable or helpless when alone
- Urgently seeks another relationship as a source of care/support when a relationship ends
- Is unrealistically preoccupied with fears of being left to take care of himself
OBSESSIVE-COMPULSIVE PD
- Pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control at the expense of flexibility, openness, and efficiency
- 4 or more of the following:
- Preoccupied with details, rules, lists, order or schedules to the extent that the major point of the activity is lost
- Shows rigidity and stubbornness
- Perfectionism that interferes with task completion
- Excessively devoted to work/productivity to the exclusion of leisure activity and friends
- Overly conscientious and inflexible about matters of morals or ethics
- Is unable to discard worn or worthless objects, even those without sentimental value
- Reluctant to delegate tasks, unless others submit exactly to his/her way of doing things
- Adopts miserly spending style toward self and others
OTHER SPECIFIED PERSONALITY DISORDER
OSPD
Symptoms characteristic of a PD that cause clinically
substantial suffering or deficiency in social,
occupational, or other important domains of functioning
but do not meet full criteria for specific PDs. This term
is used when the clinician elects to link the reason that
the presentation does not meet the criteria for any
specific PD. This is done by recording OSPD followed
by the specific reason (e.g. “mixed personality
features”).
UNSPECIFIED PERSONALITY DISORDER (UPD)
Symptoms characteristic of a PD that cause clinically
substantial suffering or deficiency in social,
occupational or other important domains of functioning
but do not meet the full criteria for specific PDs. The
UPD is used when clinicians elect not to indicate the
reason that the criteria are not met for a PD, and
potentially when there is inadequate data to make a
specific diagnosis.
