CP: Chapter 15 Personality Disorders Flashcards
personality disorders =
problems with forming a stable positive identity and sustaining close constructive relationships
comorbidity bij personality disorders
depression, anxiety, substance abuse
wat is het probleem met de dsm 5 bij personality disorders
personality disorders are not stable over time: 50% of people achieve remission, dus many disorders are not as enduring as the dsm says. but many people still have symptoms and impairment after remission! maar dan niet diagnose waardig. dus dat is niet goed van dsm.
+ geen goede test-retest reliability and high rates of comorbidity
- not stable
- no good test-retest reliability
- comorbidity
alternative for dsm5
includes 6 personality disorders and dimensional system for evaluating five personality trait domains
heritability of personality disorders?
moderate
what is a significant risk factor
childhood abuse or neglect
general criteria personality disorders =
enduring pattern of inner experiences and behaviour that deviated markedly from the expectations of an individuals culture, manifests in 2 of the four domains
what kind of domains heb je
cognition
affectivity
interpersonal functioning
impulse control
3 verschillende severities
pervasive - inflexible in many situations
persistent - stable, longterm, start early adulthood
pathological - distress or dysfunction
wanneer begint personality disorder
meestal in adolescence
zijn personality disorders treatable
vroeger dachten ze niet, nu weten we recovery 5x faster than with natural course
cluster A: odd/eccentric
paranoid PD = distrusting
schizotypical PD = strange perceptions and behaviour (anders dan schizophrenia: geen hallucinations and delusions)
schizoide PD = distant
cluster B: dramatic, emotiona, erratic
histionic PD = emotional, attention seeking
narcissistic PD = inflated ego
antisocial PD = violating rights of others
borderline PD = instability self images, relations, emotions
cluster C: anxious, fearful
avoidant PD = socially inferior
dependent PD = submissive, clinging
obsessive-compulsive PD = perfectionistic, controlling
odd/eccentric cluster en schizophrenia?
similarities to the type of bizarre thinking and experiences, but less severe than schizophrenia
paranoid personality disorder=
4 or more signs of distrust and suspiciousness, from early adulthood:
suspi of being harmed/deceived
suspi of hidden meanings in benign actions of others
suspi of loyalty of friends
not confiding in others due to suspi
grudges for long time
angry reactions to perceived attack on character or reputation
suspi of partners fidelity
schizoid personality disorder=
4 or more signs of aloofness and flat affect, from early adulthood:
lack of desire for enjoyment of close relationships
lack of friends
prefers soltitude over compagnionship
little interest in sex
few or no pleasurable activities
indifference to praise or criticism
flat affect, emotional detachment or coldness
schizotypal personality disorder =
5 or more signs of unusual thinking, eccentric behaviour and interpersonal deficits, from early adulthood:
ideas of reference
odd beliefs or magical thinking
unusual perception and suspiciousness or paranoia
odd thought, speech, behaviour or appearance
inappropriate or constricted affect and lack of close friends
social anxiety and interpersonal fears that do not diminish with familiarity
ideas of reference =
the false belief that irrelevant occurrences or details in the world relate directly to oneself
dus welke van de odd/eccentric is het meest ‘complex’
schizotypal, is een soort combi van paranoid en eccentric behaviour, maar ook social anxiety
dramatic/erratic cluster globaal
range of symptoms from inflated self esteem and rule breaking behaviour to inconsistent behaviour.
verschil psychopathy en sociopathy
sociopath = unofficial term for antisocial personality disorder. psychopathy is not an official diagnosis, wordt meer gebruikt in volksmond voor sociopathy maar dan nog meer gevaarlijk (mass murderer)
antisocial personality disorder
(volksmond: sociopathy)
at least 18, and evidence of conduct disorder before the age of 15
repeated law breaking, lack of remorse, impulsivity and lying
reckless disregard for own safety and of others
irresponsibility as seen in unreliable employment or financial history
psychopathy
niet officieel in dsm 5, maar;
geen emotions
positive feelings for others are an act
superficially charming
manipulating
lack of anxiety -> not learning from mistakes
boldness, meanness
wat zijn risicofactoren voor apd
poverty, exposure to violence, bad parenting, harsh family environment, MOAO gene
psychopathy psychological factors
blunted responses to threat and consequence
lower skin conductance to fear and threat
weakened classical conditioning
lack of empathy
attending negative information during goal persuit
borderline personality disorder =
5 or more signs of instability in relationships, self-image and impulsivity from early adulthood:
efforts to avoid abandonment
unstable interpersonal relationships: where the other is either idealized or devalued
self damaging, impulsive behaviours in at least 2 areas (spending, sex, substance abuse etc)
recurrent suicidal behaviours
mood reactivity
unstable sense of self
chronic feelings of emptiness
recurrent bouts of intense or poorly controlled anger
during stress: paranoid thoughts, dissociative symptoms
vooral vrouwen met borderline!
neurobiological factors of borderline personality disorder
lower serotonin levels: for anger and impulse control
emotion dysregulation: increased amygdala activity (= hyper emotional)
deficits in prefrontal cortex: impulse and emotions
kijken naar borderline model in docs
oke
bdp en social factors
veel mensen report abuse
ook parental genetic vulnerability
linehans diathesis stress theory
biological diathesis - emotional dysregulation in child - great demands on family - invalidation by parents through punishment or ignoring the demands - emotional outbursts by child via which parents attend
histrionic personality disorder =
5 or more symptoms of emotionality and attention seeking;
need to be center of attention
inappropriate sexual behaviour
rapidly shifting and shallow expression of emotion
use physical appearance to draw attention to self
impressionistic speech, lacking in detail
exaggerated, theatrical emotional expression
misreads relationships as more intimate than they are
narcissistic personality disorder
5 or more signs of grandiosity, increased self esteem and lack of empathy from early adulthood:
grandiose view of own importance, preoccupation with ones brilliance
belief that they are special
extreme need for admiration
exploit others and arrogant behaviours or attitudes
association parenting and narcissistic personality disorder
parents who are overly indulgent, foster childrens beliefs that they are special = more risk
self-psychology bij narcisism
inflating their own self worth to combat feelings of shame and protect a low self esteem
social cognitive model
proposes that the behaviour of the person with npd is shaped by the goal of maintaining specialness and the belif that the purpose of interpersonal relationships is to boost self esteem
avoidant personality disorder (=anxious/fearful cluster)
pattern of social inhibition, feelings of inadequacy and hypersensitivity to criticism,
4 or more:
avoidance of occupational activities that involve interpersonal contact
alleen met mensen om willen gaan als er certainty is dat ze hen leuk vinden
no intimate relationships: bang for being shamed
inhibited in new interpersonal relationships want shame
views self as socially inept, unappealing or inferior
reluctant to try new things because they are embarrased
difference social anxiety disorder and avoidant personality disorder
The main difference is that people with social anxiety disorder often know their fears are irrational, while people with avoidant personality disorder believe that they are inferior to others and therefore rejection and humiliation are not only inevitable, but deserved.
dependent personality disorder
excessive need to be taken care of, 5 or more;
geen decisions kunnen maken zonder hulp
need others to take responsibility
difficulty disagreeing with others want fear of losing support
difficulties doing things on their own want lack of self confidence
doing unpleasant things to get approval
urgently seeking new relationships when one ends
preoccupation of fears of having to take care of self
obsessive compulsive personality disorder
intense need for order, perfection and control, at least 4:
preoccupation with rules, details and organization
extreme perfectionism
excessive devotion to work the exclusion of leisure and friendships
inflexibility about morals and values
reluctance to delegate unless others conform to ones standards
bv monica friends
wat is het verschil tussen ocd en ocpd
OCD is ruled by intrusive thoughts called, obsessions that cause anxiety and force the person to perform compulsions for relief. OCPD is ruled by perfectionism and detail. Unlike individuals with OCD, people with OCPD are not self-aware and can hurt the people around them.
dus ocd is echt intrusive thoughts en vaak compulsions om anxiety te verminderen
ocpd is perfectionism and control
psychodynamische therapie=
reconsider early experiences that are the root of personality disorders, become aware on how they drive behaviour and reconsider beliefs and responses to those early events
schematherapy =
child that has unmet needs -> try to account for those
mentalisation based treatment
helping understand behaviour of others in terms of their mental states
transferance focused psychotherapy
internalized representation of self in relation to the object, the relationship with the therapist is the working material.
dus treatment for personality disorders bv
schematherapy
mentalisation based treatment
transferance focused psychotherapy
treatment schizotypical personality disorder
antipsychotic drugs vooral
treatment avoidant personality disorder
zelfde als social anxiety: antidepressants, cbt (for negative beliefs about social interactions by teaching strategies for dealing with thiss) + exposure treatment.
treatment of borderline personality disorder
dialectical behaviour therapy: client centered empathy and acceptance with cbt problem solving, emotional regulation techniques and social skills training
four stages of dialectical behaviour therapy
- dangerous impulsive behaviours are targeted
- learning to modulate extreme emotionality
- improving self esteem and interpersonal relationships
- happiness
