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Clinical & Neuropsychology 2 > CP: Lecture 14 Personality Disorders II > Flashcards

CP: Lecture 14 Personality Disorders II Flashcards

1
Q

elaborated diathesis stress model of psychopathology

A

heritable predisposition - early experiences
strength and vulnerability - support and stress
complaints and symptoms

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2
Q

ethiology of personality disorders

A

◦ Abuse, Neglect
◦ Nurture
◦ Modelling
◦ Divorce
◦ Low SES
◦ Peer influences

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3
Q

what does this ethiology influence

A

 Attachment
 Attributional style
 Cognitive biases
 Core assumptions / beliefs, (cogn. triad), schema’s
 Coping
 Neural circuits
 Neuro-endocrine (e.g. HPA-axis tuning)
 Personality traits

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4
Q

heritability of personality disorders

A

35-65%

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5
Q

which neurotransmitter systems are involved in pd

A

◦ Dopamine (cognitive problems, cluster-A)
◦ Serotonin (anger, impulse control)
◦ MAO (agression)

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6
Q

which brain areas are involved in pd

A

◦ Lack of frontal cortical control: impulses and emotions (mid brain)
◦ Dysfunction amygdala: (hyper-emotionality vs. hypo-emotionality)

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7
Q

wat was er met maoa en maltreatment

A

lage MAOA activiteit + maltreatment is meer kans op violence

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8
Q

kijken naar model of psychopathology

A

oke

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9
Q

wat hoort bij heritable predispositions

A

genetics, temperament

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10
Q

wat hoort bij early experiences

A

nurture, trauma, deprivation

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11
Q

wat hoort bij strengths and vulnerabilities

A

Fenotype, schemas/cognitions/attributions, neuro-endocrine, personality etc

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12
Q

support and stress

A

social, medication, psychotherapy, stress, trauma, life events etc

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13
Q

schizotypal dsm 5

A

ssocial and interpersonal deficits, cognitive or perceptual distortions and eccentricities of behaviour, early adulthood, variety of contexts (!) and 5 or more:

ideas of reference
odd beliefs or magical thinking
unusual perceptual experiences
odd thinking and speech
paranoid ideation
inappropriate or constricted affect
eccentric behaviour
lack of close friends
social anxiety that does not diminish with familiarity, tend to be associated with paranoid fears rather than negative judgements about self

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14
Q

which of the pds is the most heterogeneous group

A

paranoid pd?

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15
Q

linehan model goed kennen

A

oke

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16
Q

antisocial pd kenmerken

A
  • Conduct disorder before 15th
  • From 15th violation rights of others
  • Subgroup (15-25%) is also ‘psychopatic’
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17
Q

2 factors of psychopathy

A

Factor 1: Affect / Interpersonal
- callous/unemotional, glib,
Factor 2: Behavior
- antisocial/impulsive

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18
Q

borderline dsm 5 criteria

A

instability of relationships, self-image and affects, marked impulsivity, early adulthood and at least 5:

avoid real or imagined abandonment
unstable and intense personal relationships
identity disturbance
impulsivity, potentially self-damaging
suicidal behaviour
affective instability
chronic emptiness
anger
paranoid ideation or severe dissociative symptoms

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19
Q

when basic needs are not met (safety, boundaries, autonomy), wat krijg je dan

A

early maladaptive schemas -> coping, kan leiden tot submission (the world is just like that)

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20
Q

6 models for bpd

A

Learning / Behavioral
◦ Conditioning, modeling, contingencies
◦ Linehan: Emotion-regulation

Cognitive
◦ Beck: cognitive model
◦ Young: maladaptive schema’s

Psychodynamic
◦ Mentalisation
◦ Object-relations

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21
Q

voorbeelden classical, operant and modelling

A

Classical conditioning:
“if I attach to a person, I will be hurt”

Operant conditioning:
“if I force my way, I get what I want”

Modelling:
witnessing your parents resolve conflict with
clashes over and over again

22
Q

linehans emotional dysregulation model of BPD

A

biological diathesis -> emotional dysregulation in the child -> great demands on the family -> invalidation by parents through punishing or ignoring the demands -> emotional outbursts by child to which parents attend -> emotional dysregulation etc

23
Q

kijken naar linehans model

A

oke

24
Q

cognitive model of beck

A

situation -> automatic thought -> schema -> alarm

25
Q

kijken naar cognitive model

A

oke

26
Q

schema theory of young

A

when basic needs are not met -> ealry maladaptive schemas -> coping with schemas -> modes

27
Q

voorbeelden basic needs

A

safety
autonomy
boundaries etc

28
Q

voorbeelden coping with schemas

A

submission
avoidance
overcompensation

29
Q

submission =

A

the world is just like that

30
Q

avoidance

A

geen sociaal contact bijv. omdat je bang bent om gereject te worden

31
Q

overcompensation

A

juist het tegenovergestelde doen

32
Q

modes voorbeeld

A

◦ Vulnerable child
◦ Angry child
◦ Detached protector
◦ Demanding parent
◦ Healthy adult

33
Q

example of a schema van mistrust

A

The expectation that others will hurt, abuse, humiliate,
cheat, lie, manipulate, or take advantage. Usually
involves the perception that the harm is intentional or
the result of unjustified and extreme negligence. May
include the sense that one always ends up being
cheated relative to others or “getting the short end of
the stick.

34
Q

object-relations

A

gaat om interpersonal relationship!
Internalized representation of Self in relation to the object (another
person, such as father, mother, men, etc.)

In PD immature defence mechanisms such as ‘splitting’: All good, all bad

35
Q

kijken naar model object-relations

A

oke

36
Q

mentalization

A

understanding the behaviour of others in terms of his or her mental state (ik ben boos dus zij zijn ook allemaal boos)

37
Q

hypothese bij mentalization

A

Mentalization is learned as primary caretakers mirror and name the child’s emotions -> ohhh heb je pijn??

38
Q

what is needed to treat personality disorders

A

Safety /Safe environment
◦ Clear rationale / structure
◦ Attachment figure(s)

Incentive / invitation to revise coping
Possibility of new (positive) experience

39
Q

Dialectical Behavioral Therapy

A

DBT; Linehan

lots of structure, skills training (bv emotion regulation) -> gaat om acceptance and change

40
Q

schema focused therapy

A

ST; Young

Integrative: attachment theory, experiential therapy, cognitive
therapy. Limited reparenting, imagery rescripting, chair
dialogue.

41
Q

limited reparenting=

A

Het verwijst naar een therapeutische techniek waarbij de therapeut de rol van een gezonde ouderfiguur aanneemt om de cliënt te helpen bij het helen van emotionele wonden uit het verleden.

42
Q

mentalization based treatment

A

MBT; Bateman and Fonagy

Foster mentalization: modelling, small steps

43
Q

transference focused psychotherapy

A

TFP; Kernberg

Object-relations: the relationship with the therapist as working
material

44
Q

what are similarities between all these treatment types

A

Theory
◦ Influence early childhood
◦ Internal working model of world
◦ Distorted experience of the other

Treatment
◦ Building trusting relationship
◦ Novel experiences
◦ Use of transference?

45
Q

welke therapy is goed voor crisis, destabilizing and automutilation

A

dialectical behaviour therapy

46
Q

which therapy has the widest scope

A

schema therapy

47
Q

which is the most simple

A

mentalisation based treatment

48
Q

which is the most demanding

A

schema therapy

49
Q

which works well for severe cases

A

mentalisation based treatment

50
Q

which has the highest dropout

A

transference focused therapy

51
Q

Genetically inherited vulnerabilities are combined
with an internal working model of the world is too
rigid and not adaptive

A

oke

Clinical & Neuropsychology 2 (30 decks)

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