Cluster A: Paranoid, Schizoid, Schizotypal Flashcards
•Underlying features (via DSM-IV) for all personality disorders, including common themes, core beliefs/assumptions •Features that can assist in differentiating each personality disorder from other Axis I and II disorders •Raine’s developmental model of Schizotypy (e.g., 2 forms of Schizotypal PD)
What are the common themes of the Paranoid Prototype?
- mistrust is predominant
- defensive, seeks protections from others
- vacillation between enhancement & preservation
- cable of either passive or active approaches, depending on intention
- can be self-focused (victimized) or other oriented (focus on acts of others)
What are some of the Paranoid Personality Disorder DSM-IV Criteria?
Pervasive destruct and suspiciousness of others (Need 4 of following)
- suspects other are harming him or her
- preoccupied with unjustified doubts about the loyalty of friends/associates
- reluctant to confide in others, information will be used against them
- reads hidden demeaning or threatening meanings into benign remarks or events
- persistently bears grudges
- Perceives attacks as his/her character or reputation that are not apparent to others
- has recurrent suspicions, w/o justification
What are some early sings of Paranoid Personality Disorder?
solitary activities, poor peer relationships, social anxiety, underachieves in school, hypersensitivity, peculiar thoughts/language
Paranoid PD Differentials
Psychotic Disorders (Delusional, schizophrenia), Mood disorder w/ Psychotic Features, symptoms associated with chronic substance abuse,
Other personality disorders- Schizotypal (suspiciousness, paranoid ideation), Borderline/Histrionic (anger reactions), Avoidant (reluctant to confide in others), Narcisstic (suspiciousness)
Treatment of Paranoid PD
Decrease perceptions of threat
Decrease defensiveness
Increase perceptions and participation in pleasurable social activities
Increase awareness of others’ perceptions of his/her behaviors
Treatment of Paranoid PD- Therapeutic Relationship
Allow time to vent frustrations
Hold off on challenging thoughts
Validate emotions, not distorted thoughts
Collaboration- find something else to collaborate on
Be trustworthy
What are some common themes for the Schizoid Prototype?
General indifference to life
Autonomy, detachment from others
Apathy is typical affect
Weakness on both enhancement and preservation
Passive adapters- react to things as they occur
Average self-orientation, weak other-orientation
What are some of the Schizoid Personality Disorder DSM-IV Criteria?
Pervasive pattern of detachment from social relationships and a restricted range of expression of emotions
- Neither desires nor enjoys close relationships
- Almost always chooses solitary activities
- Has little, if any, interest in having sexual experiences with another person
- Takes pleasure in few, if any, activities
- Lacks close friends, other than first-degree relatives
- Appears indifferent to the praise or criticism of others
- Shows emotional coldness, detachment, or flattened affectivity
What are some early sings of Schizoid Personality Disorder?
solitary activities, poor peer relationships, underachievement in school
Schizoid PD: Differentials
Psychotic Disorders (Delusional, Schizophrenia), Mood Disorders with psychotic features, Autism, Other personality disorders (all similar in social detachment)- Scizotypal, Avoidant, Obsessive-Compulsive
Treatment for Schizoid
Often don’t present for treatment
Low desire for social affiliations, little pleasure in activities: few incentives to remain in therapy
Encourage interests and engagement in pleasurable activities
Increase adaptive initiative to avoid painful encounters
Develop greater sensitivity to needs of others
What are some common themes for the Schizotypal Prototype?
Lack of a specific and defining self view
Eccentric/odd behaviors (bizarre phrases, gestures, movements)
Unstable weakness at each polarity
- vacillate between poles: sometimes experiencing pleasure, sometimes prioritizing pain avoidance, going with the flow vs. acting impulsively
What are some of the Schizotpal Personality Disorder DSM-IV Criteria?
Social and interpersonal deficits marked by acute discomfort with, and reduced capacity for close relationships as well as by cognitive an perceptual distortions (need 5)
- Ideas of reference
- Odd beliefs or magical thinking
- Unusual perceptual experiences
- Odd thinking and speech
- Suspicousness or paranoid ideation
- Inappropriate or constricted affect
- Behavior or appearance that is odd eccentric or peculiar
- Lack of close friends/confidants, other than first-degree relatives
- Excessive social anxiety that does not diminish with familiarity, tends to be associated with paranoid fears vs. negative judgements
What are some early sings of Schizotypal Personality Disorder?
solitary activities, poor peer relationships, social anxiety, underachievement in school, hypersensitivity, peculiar thoughts/language, bizarre fantasies
Raine’s developmental model of Schizotypy (e.g., 2 forms of Schizotypal PD)
Two types of Schizotypal-
1) Neuro-SPD (more likely to lead to schizophrenia)
2) Pseudo Schizotypal- may be more influenced by environmental events and cognitive perceptual features are more promising
