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PSYC 3230 - Psychopathology > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

this psychological treatment of mood disorders addresses cognitive errors in thinking, with the hope of substituting more realistic thoughts
-also includes behavioral components (ex. exercise, increased social activities)
-collaborative, empirical approach
-structured, time-limited; use of homework (thought records)

A

cognitive therapy (CBT)

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2
Q

this psychological treatment of mood disorders involves increased contact with reinforcing events

A

behavioral activation

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3
Q

two components of behavioral activation

A

exercise and increased social contact

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4
Q

this psychological treatment of mood disorders focuses on problematic interpersonal relationships

A

interpersonal psychotherapy (IPT)

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5
Q

are psychological treatments (CBT and IPT) comparable to medications?

A

yes

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6
Q

true or false: combined treatment (psychotherapy and medication) may be more useful for chronic depression

A

true

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7
Q

is maintenance treatment important for the prevention of relapse?

A

yes

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8
Q

these studies emphasize the role of family tension in relapses
-didactics about illness
-work on family communication

A

milkowitz studies

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9
Q

what is the 10th leading cause of death in the US (2010)?

A

suicide

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10
Q

suicide is overwhelmingly a phenomenon among which racial populations?

A

white and native american

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11
Q

two protective factors for suicide:

A
  1. religion (african americans tend to be more religious)
  2. familial support (more prevalent in african american cultures)
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12
Q

states with the highest rates of suicide:

A

white, rural, conservative places
-high gun ownership
-mental health more stigmatized
-high white population
-lots of alcohol consumption

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13
Q

are suicide rates very high or low in elderly populations?

A

very high

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14
Q

are suicide rates higher or lower in those divorced, separated, widowed?

A

higher ; lowest in those married

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15
Q

most common method of suicide

A

firearm (50% completed)

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16
Q

gender differences of suicide:
___ are more likely to commit suicide (4-5x) higher
___ are more likely to attempt suicide (3x higher)

A

males (commit) ; females (attempt)

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17
Q

___ choose more lethal methods (gun, jumping, etc.), while ___ tend more to use pills (more latitude for surviving)

A

men ; women

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18
Q

suicidal attempts (___:___)
-ratio of attempts to completions

A

25:1

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19
Q

mental illness is prevalent in ___% of completed suicides

A

90%

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20
Q

true or false: suicide risk may be 6x higher if family member committed suicide

A

true ; probably a biological connection

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20
Q

risk factors for suicide:

___ dysregulation (related to depression, impulsivity, and aggression)

A

serotonin dysregulation

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21
Q

is evidence of a pre existing psychological disorder a risk factor for suicide?
-depression is linked to suicide but redundant - ___ is key

A

yes ; hopelessness is key

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22
Q

alcohol use and abuse is implicated in ___-___% of suicides

A

25-50%

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23
Q

is past suicidal behavior a risk factor for suicide?

A

yes

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24
Q

is experiencing a shameful/humiliating stressor a risk factor of suicide?

A

yes

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25
Q

interpersonal-psychological theory of suicide (joiner)

3 key factors:

A
  1. sense of thwarted belongingness
  2. perception of self as a burden
  3. acquired capability for suicide
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26
Q

feeling socially isolated and alone is characteristic of

A

a sense of thwarted belongingness

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27
Q

the belief that others would be better off if individual was not alive is characteristic of

A

the perception of self as a burden

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28
Q

person must desensitize the thought of death and physical pain
-repeated attempts (the norm) and non-suicidal self-injury may help with both aspects

A

acquired capability for suicide

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29
Q

professions with high rates of suicide

A

doctors, vets, first responders, police officers, emts, pilots, army vets, military personnel

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30
Q

treatment intervention for suicide:
(5 characteristics)

A
  1. never be afraid to ask about suicide
  2. well-developed plan?
  3. means?
  4. no suicide contract - specific treatment plan
  5. hospitalization (last resort)
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31
Q

three major types of DSM-5 eating disorders

A

anorexia nervosa, bulimia nervosa, binge eating disorder

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32
Q

characterized by severe disruptions in eating behavior, and extreme fear and apprehension about gaining weight

A

eating disorders

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33
Q

do eating disorders have strong sociocultural origins?

A

yes ; westernized views

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34
Q

what percentage of eating disorders are young females from wealthy families?

A

90%

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35
Q

a collection of signs and symptoms which is restricted to a limited number of cultures primarily be reason of certain of their psychosocial features

A

culturally bound syndrome

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36
Q

is anorexia culturally bound?

A

no ; descriptions of similar syndrome described in other cultures, a long time ago
-AN has been seen in every non-western culture

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37
Q

is bulimia culturally bound?

A

yes ; exists in non-western cultures, but not in the absence of western influence

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38
Q

what is the hallmark of bulimia?

A

binge eating

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39
Q

eating excessive amounts of food ; eating is perceived as uncontrollable

A

binge

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40
Q

compensatory behaviors related to bulimia nervosa:

A

purging and excessive exercise or fasting

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41
Q

self-induced vomiting, diuretics, laxatives

A

purging

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42
Q

binge eating and compensatory behaviors occur at least __ a week for ___ months

A

1 a week for 3 months

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43
Q

most are 10% within normal weight
-purging can result in severe medical problems
-erosion of dental enamel
-electrolyte imbalance of sodium and potassium
-kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage

A

associated medical features of bulimia nervosa

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44
Q

most are overly concerned with body shape
-fear of gaining weight
-between binges, individuals will typically restrict calories and avoid high fat foods and “trigger foods”
-high comorbidity - anxiety, mood, and substance abuse

A

associated psychological features of bulimia nervosa

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45
Q

what is the hallmark of anorexia nervosa?

A

successful weight loss

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46
Q

restriction of energy intake relative to requirements that lead significantly low body weight in context of age, sex, developmental trajectory, and health
-defined as 15% below expected weight (DSM-IV)

A

anorexia nervosa

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47
Q

how does anorexia often begin?

A

with dieting ; intense fear of obesity

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48
Q

two DSM-5 subtypes of anorexia:

A

restricting subtype and binge-eating/purging subtype

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49
Q

this subtype of anorexia is characterized by limiting caloric intake via diet, fasting, and excessive exercise

A

restricting subtype

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50
Q

this subtype of anorexia is like bulimia, but with significant weight loss

A

binge-eating/purging subtype

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51
Q

marked disturbance in body image
-high comorbidity with other psychological disorders
-weight loss methods have life threatening consequences
-never satisfied with weight - need continuous loss to feel comfortable

A

associated features of anorexia nervosa

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52
Q

amenorrhea (loss of period)
-dry skin
-brittle nails and hair
-sensitivity to cold temperatures
-lanugo (downy hair on limbs and cheeks)
-cardiovascular problems

A

medical consequences of anorexia

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53
Q

depression, withdrawal, anxiety, irritability, reduced sex drive (may be secondary to starvation)

A

psychological consequences of anorexia nervosa

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54
Q

this disorder is characterized by engaging in food binges without compensatory behaviors
-perceived loss of control during binges
-binging associated with eating more rapidly, until uncomfortably full, when not hungry, feeling embarrassed about intake, feeling disgusted/guilty after
-distressed about binge eating

A

binge eating disorder

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55
Q

how often must binge eating occur to be considered binge eating disorder?

A

once a week for three months

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56
Q

many are normal weight or overweight or obese
-often older than bulimics or anorexics
-more psychopathology vs. non-binging obese people
-concerned about shape and weight
-binging used as a coping mechanism
-no major differences across gender or cultural/racial groups

A

associated features of binge eating disorder

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57
Q

true or false: majority of those with bulimia are female

A

true (90%)

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58
Q

onset for bulimia

A

16-19 years of age

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59
Q

___-___% of college women suffer from bulimia

A

6-8%

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60
Q

does bulimia tend to be chronic if left untreated?

A

yes

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61
Q

risk factors for bulimia (2)

A

childhood obesity and early pubertal onset

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62
Q

majority of those who have anorexia are:

A

females from middle-to-upper middle class families

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63
Q

when does anorexia usually develop?

A

around age 13 or early adolescence

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64
Q

is anorexia more or less chronic and resistant to treatment than bulimia?

A

more

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65
Q

anorexia is found in ___ cultures

A

westernized

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66
Q

medical treatment of bulimia nervosa:
___ help reduce binging and purging, but are not efficacious in the long term

A

antidepressants

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67
Q

psychological treatment of choice for bulimia nervosa

A

CBT or interpersonal psychotherapy (does not work as fast as CBT)

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68
Q

medical treatment for binge eating disorder

A

sibutramine (meridian) - used to control hunger

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69
Q

psychological treatment for binge eating disorder

A

CBT, interpersonal psychotherapy

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70
Q

medical treatment of anorexia nervosa

A

none exists with demonstrated efficacy

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71
Q

psychological treatment of anorexia nervosa: primary goal

A

weight restoration

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72
Q

is the longterm prognosis for anorexia better or poorer than bulimia?

A

poorer

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73
Q

schizophrenia vs. psychosis

A

psychosis: broad term (ex. hallucinations, delusions)
schizophrenia: a type of psychosis

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74
Q

nature of schizophrenia and psychosis:

this person used the term dementia praecox (premature dementia)
-focused on subtypes of schizophrenia (paranoid, catatonic)
-recognized it as a “disease of the brain”
-recognized that several distinct symptoms appeared to be part of a broader syndrome
-differentiated “dementia praecox” from manic-depressive illness

A

emil kraepelin

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75
Q

nature of schizophrenia and psychosis:

this person introduced the term “schizophrenia”
-“splitting of the mind” ; inability to keep a consistent train of thought
-described “positive” and “negative” symptoms

A

eugen bleuler

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76
Q

characteristic symptoms: two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

-delusions
-hallucinations
-disorganized speech (frequent derailment or incoherence)
-grossly disorganized or catatonic behavior
-social/occupational dysfunction
-continuous signs of disturbance for at least 6 months
-not schizoaffective or mood disorder
-not due to substance abuse

A

DSM-IV diagnostic criteria for schizophrenia

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77
Q

active and obvious manifestations of abnormal behavior, excess or distortion of normal behavior

A

the positive symptoms of schizophrenia

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78
Q

two positive symptoms of schizophrenia

A

delusions and hallucinations

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79
Q

distortion in thought content
-erroneous beliefs that usually involve a misinterpretation of perception or experiences. beliefs are typically held very strongly

A

delusions

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80
Q

the most common delusion
-“the FBI is after me”

A

persecutory delusion

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81
Q

___ delusion: “when madonna waved to the audience, she was really signaling to me”

A

referential delusion

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82
Q

___ delusion: “madonna is in love with me”

A

erotomanic delusion

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83
Q

___ delusion: “my liver is dead and rotting inside me”

A

somatic delusion

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84
Q

___ delusion: “the world is ending”

A

nihilistic delusion

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85
Q

___ delusion: “I am the president of the entire world”

A

grandiose delusion

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86
Q

___ delusions: thought insertion, thought withdrawal, outside forces are controlling one’s body or actions

A

“bizarre” delusions

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87
Q

experience of sensory events without environmental input
-can experience any sensory mode (auditory, visual, olfactory, gustatory, tactile)

A

hallucinations

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88
Q

___ are the most common hallucinations; usually in the form of “voices,” familiar or not, that are heard as being distinct from own thoughts

A

auditory hallucinations

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89
Q

scary form = “___” hallucinations

A

command hallucinations

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90
Q

___ or more voices conversing or ___ voice keeping a running commentary are considered highly characteristic of schizophrenia

A

two ; one

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91
Q

absence or insufficiency of normal behavior

A

the negative symptoms of schizophrenia

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92
Q

spectrum of negative symptoms: (5 A’s)

A
  1. avolition (or apathy)
  2. alogia
  3. anhedonia
  4. asociality
  5. affective flattening
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93
Q

lack of initiation and persistence (ex. lack of hygiene)

A

avolition (or apathy)

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94
Q

relative absence of speech - may be due to a decrease in thought production

A

alogia

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95
Q

lack of pleasure, or indifference

A

anhedonia

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96
Q

limited interest in social interactions

A

asociality

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97
Q

little expressed emotion

A

affective flattening

98
Q

include severe and excess disruptions in speech, behavior, and emotion

A

the disorganized symptoms of schizophrenia

99
Q

the nature of disorganized speech (3 components)

A
  1. tangentiality (going off on a tangent)
  2. loose associations (conversation in unrelated directions)
  3. word salad; neologisms (make up new words)
100
Q

inappropriate emotional behavior - behavior not consistent with context (ex. smiling when talking about death)

A

nature of disorganized affect

101
Q

includes a variety of unusual behaviors (disheveled; odd appearance; inappropriate or unpredictable behavior)
-catatonia (wild agitation, waxy flexibility, immobility)

A

nature of disorganized behavior

102
Q

schizophrenic symptoms for a few months (less than 6; more than 1)
-impaired functioning not required
-some never progress on to schizophrenia, but more do (or schizoaffective disorder)

A

schizophreniform disorder

103
Q

symptoms of schizophrenia and a mood disorder (unlike a mood disorder with psychotic features)
-both disorders are independent of one another (at times, you are psychotic when you are not in a mood state)
-prognosis is similar for people with schizophrenia
-such persons do not tend to get better on their own
-need to have delusions and/or hallucinations that are present for at least two weeks in the absence of the mood disorder

A

schizoaffective disorder

104
Q

two types of schizoaffective disorder:

A

bipolar type and depressive type

105
Q

if mania is part of the presentation

A

bipolar type

106
Q

if only major depressive episodes are part of the presentation

A

depressive type

107
Q

presence of one or more delusions that persist for one month or more
-lack other positive and negative symptoms
-rare (0.2%)
-better prognosis than schizophrenia

A

delusional disorder

108
Q

one or more positive symptoms of schizophrenia (delusions, hallucinations, disorganized behavior/speech)
-lasts at least 1 day but not longer than 1 month
-not due to substance use
-usually precipitated by extreme stress or trauma
-tends to remit on its own

A

brief psychotic disorder

109
Q

may reflect a less severe form of schizophrenia
-immense idiosyncrasies
-lies on the schizophrenia spectrum

A

schizotypal personality disorder

110
Q

classification systems and their relation to schizophrenia:

process vs. reactive distinction

A

process: insidious onset, biologically based, negative symptoms, poor prognosis
reactive acute onset (extreme stress), notable behavioral activity, best prognosis

111
Q

classification systems and their relation to schizophrenia:

good vs. poor premorbid functioning in schizophrenia

A

focus on functioning prior to developing schizophrenia (no longer widely used)

112
Q

classification systems and their relation to schizophrenia:

type I vs. type II distinction

A

type I: positive symptoms, good response to medication, optimistic prognosis, and absence of intellectual impairment
type II: negative symptoms, poor response to medication, pessimistic prognosis, and intellectual impairments

113
Q

defunct subtypes of schizophrenia: (5 types)

A
  1. paranoid type
  2. disorganized type (hebephrenic)
  3. catatonic type
  4. undifferentiated type
  5. residual type
114
Q

presence of prominent hallucinations and delusions (usually persecutory or grandeur) but have relatively intact cognitive skills and affect; organized around coherent theme
-do not show disorganized behavior (speech, thought, or affect)
-later onset
-the best prognosis of all types of schizophrenia

A

paranoid type

115
Q

marked disruptions in speech and behavior
-flat or inappropriate affect
-hallucinations and delusions, if present, tend to be fragmented (unlike paranoid type)
-develops early, tends to be chronic, associated with a continuous course without remissions

A

disorganized type (hebephrenic)

116
Q

show unusual motor responses and odd mannerisms (immobility, excessive motor activity, motor negativism - resistance to instructions or attempts to be moved, waxy flexibility)
-tends to be severe and quite rare

A

catatonic type

117
Q

wastebasket category (if a patient did not fit in another subtype, they would be classified in this way)
-major symptoms of schizophrenia
-fail to meet criteria for another type

A

undifferentiated type

118
Q

past diagnosis of schizophrenia
-absence of prominent delusions, hallucinations, disorganized speech and behavior (positive symptoms have faded, negative symptoms remain)
-continue to display less extreme residual symptoms

A

residual type

119
Q

when does schizophrenia usually develop?

A

early adulthood

120
Q

onset of first psychotic episode for men vs. women

A

men - early to mid 20s
women - late 20s
bimodal distribution for women (second onset in 40s)

121
Q

what percentage of those with schizophrenia die via suicide? what percentage of those attempt suicide?

A

5-6% die via suicide ; 20% attempt suicide

122
Q

are positive or negative symptoms more treatable?

A

positive

123
Q

schizophrenia affects males and females about equally, but there is a slightly higher prevalence in ___

A

men

124
Q

____ tend to have a better long-term prognosis for schizophrenia

A

females

125
Q

high comorbidity of schizophrenia with ___ use disorder and ___ disorders

A

tobacco use disorders and anxiety disorders

126
Q

____ deficits (ex. working memory) are common and partially explain significant functional impairment

A

cognitive deficits

127
Q

true or false: schizophrenia has a weak genetic component

A

false ; strong genetic component

128
Q

family studies: inherit a ___ for schizophrenia ; do not inherit specific forms of schizophrenia

A

tendency

129
Q

monozygotic twins vs. fraternal (dizygotic) twins risk for schizophrenia:

A

monozygotic: 48%
fraternal: 17%

130
Q

twin studies: both parents schizophrenic - ___%
one schizophrenic parent - ___%

A

46% ; 16%

131
Q

according to adoption studies, risk for schizophrenia remains ___ in cases where a biological parent has schizophrenia

A

high

132
Q

among the most prominent theories of schizophrenia
-drugs that increase dopamine (agonists, amphetamines, L-Dopa) result in schizophrenic like behavior
-drugs that decrease dopamine (antagonists) reduce schizophrenic-like behavior and produce side effects that look like parkinson’s disease, which is known to be related to too little dopamine

A

the dopamine hypothesis

133
Q

is the dopamine hypothesis problematic?

A

yes

134
Q

current theories emphasize many ____
-higher density of dopamine receptors
-may make and release more dopamine
-excessive stimulation of dopamine D2 receptors in the striatum
-deficient stimulation of prefrontal dopamine D1 receptors

A

neurotransmitters

135
Q

enlarged lateral ventricles (50 studies) ; real problem is that the areas next to the ventricles may never have developed fully or atrophied ; not found in all schizophrenics ; found in “healthy” siblings of schizophrenic patients
-less active frontal and temporal lobes
-less frontal, temporal, and whole-brain volume (smaller hippocampus - most reliable difference)
-BRAIN DYSFUNCTION APPEARS BEFORE ONSET OF SCHIZOPHRENIA

A

structural and functional abnormalities in the brain

136
Q

those with schizophrenia exhibit higher or lower intelligence and achievement scores than healthy siblings as children

A

lowe

137
Q

normalities or abnormalities in social behavior? more or less socially responsive, more or less positive emotion, better or poorer social adjustment?

A

abnormalities ; less ; less ; poorer

138
Q

true or false: delays and abnormalities in motor development (ex. walking)

A

true

139
Q

subclinical signs of psychosis (unusual ideas and sensory experiences; eccentric behavior - signs of schizotypal personality disorder) show during ___

A

adolescence

140
Q

mothers exposed to influenza in second trimester may have children more predisposed

A

viral infections during early prenatal development

141
Q

cognitive dysfunctions are substantial and are linked with functional impairment (2)

A

episodic memory and executive functioning

142
Q

medical treatment of schizophrenia:

historical precursors (5)

A
  1. wrap in wet sheets
  2. electric shock
  3. insulin comas
  4. frontal lobotomies
  5. institutionalized
143
Q

usually the first line treatment for schizophrenia

A

antipsychotics (neuroleptics)

144
Q

most antipsychotics reduce or eliminate ___ symptoms

A

positive

145
Q

what is often a problem with medications for schizophrenic patients?

A

compliance with medications (3/4 patients stop taking medication for at least 1 week in a two year period)

146
Q

true or false: acute and permanent side effects are common

A

true

147
Q

extrapyramidal side effects

A

movement problems

148
Q

expressionless face, slow motor activity, shuffling gait

A

parkinsonian symptoms

149
Q

feeling restless and a need to move

A

akathisia

150
Q

abnormal muscle tone - muscle spasms

A

dystonia

151
Q

involuntary movements of the tongue, face, mouth, and jaw (ex. tongue sticking out, chewing motions)

A

tardive dyskinesia

152
Q

according to this psychologist, personality is an individual’s characteristic patterns of thought, emotion, and behavior together with the psychological motivation behind those patterns

A

finder

153
Q

according to this psychologist, a personality trait is a long-standing pattern of behavior expressed across time and in many different situations

A

millon

154
Q

five factor model: OCEAN

A

Openness to experience
Conscientiousness
Extraversion
Agreeableness
Neuroticism

155
Q

personality disorders are composed of personality traits that are: (3)

A
  1. inflexible
  2. maladaptive
  3. cause signification, functional impairment, or subjective distress
156
Q

various ___ disorders are associated with:
-decreased social functions
-decreased occupation functions
-increased risk of substance abuse
-increased risk of depression/anxiety
-increased risk of schizophrenia
-increased risk of suicide
-increased risk of imprisonment
-increased risk of hospitalization

A

personality disorders

157
Q

an enduring pattern of inner experience and behavior that deviates markedly from the expectations of an individual’s culture. this pattern is manifested in two (or more) of the following areas:
-cognition
-affectivity
-interpersonal functions
-impulse control

A

DSM-IV/5 criteria for personality disorders

158
Q

the ways of perceiving and interpreting self, other people, and events

A

cognition

159
Q

range, intensity, lability, and appropriateness of emotional response

A

affectivity

160
Q

theoretical issues with personality disorders: comorbidity

A

if diagnosed with a personality disorder, likely to have more than one

161
Q

certain personality disorders are believed to be more common in men vs. women
___: paranoid, schizoid, schizotypal (cluster A); antisocial, narcissistic, OCPD
___: histrionic, borderline, dependent

A

men ; women

162
Q

coverage: most common personality disorder diagnosis in clinical practice

A

PD NOS

163
Q

PD NOS

A

personality disorder not otherwise specified (have a PD not recognized by the DSM or have features of more than one PD but don’t meet criteria for any specific PD but features cause distress/impairment)

164
Q

DSM-5 personality disorders: cluster A is referred to as

A

“the weird”

165
Q

three cluster A (“the weird”) personality disorders

A

paranoid PD, schizoid PD, and schizotypal PD

166
Q

a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

A

paranoid PD

167
Q

a pattern of detachment from social relationships and a restricted range of emotional expression

A

schizoid PD

168
Q

a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

A

schizotypal PD

169
Q

which two cluster A personality disorders were almost removed as a diagnosable disorder from DSM-5

A

paranoid PD and schizoid PD

170
Q

DSM-5 cluster B personality disorders are referred to as

A

“the wild” (dramatic/erratic)

171
Q

4 cluster B (“the wild”) personality disorders:

A
  1. antisocial personality disorder
  2. borderline personality disorder
  3. histrionic personality disorder
  4. narcissistic personality disorder
172
Q

a pattern of disregard for, and violation of, the rights of others
-chronic criminality - chronic violation of rules, laws, norms

A

antisocial PD

173
Q

a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity
-tremendous emotional instability
-variability in how you view yourself - no core sense of identity

A

borderline PD

174
Q

a pattern of excessive emotionality and attention seeking
-emotions change in a manipulative/attention-seeking way

A

histrionic PD

175
Q

a pattern of grandiosity, need for admiration, and lack of empathy

A

narcissistic PD

176
Q

DSM-5 cluster C personality disorders are referred to as

A

“the worried”

177
Q

three cluster C (“the worried”) personality disorders:

A
  1. avoidant PD
  2. dependent PD
  3. OCPD
178
Q

a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

A

avoidant PD

179
Q

a pattern of submissive and clinging behavior related to the excessive need to be taken care of
-“you need someone to captain your ship”)

A

dependent PD

180
Q

a pattern of preoccupation with orderliness, perfectionism, and control

A

OCPD (obsessive-compulsive personality disorder)

181
Q

a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. has a grandiose sense of self-importance
  2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. believes that he or she is “special” and unique and can only be understood by, or should associate with other special or high-status people (or institutions)
  4. requires excessive admiration
  5. has a sense of entitlement
  6. is interpersonally exploitative
  7. lacks empathy
  8. is often envious of others or believes that others are envious of him or her
  9. shows arrogant, haughty behaviors or attitudes
A

DSM-5 criteria for narcissistic personality disorder (NPD)

182
Q

assessment issues: self-report vs. other report

A

problems with both

183
Q

gold standard assessment:

A

semi-structured interviews

184
Q

psychopathy described by the five factor model: (11 characteristics)

A
  1. glib and superficial charm
  2. grandiose sense of self-worth
  3. pathological lying
  4. conning/manipulative
  5. lack of remorse or guilt
  6. callous lack of empathy
  7. impulsivity
  8. irresponsibility
  9. early behavior problems
  10. parasitic lifestyle
  11. failure to accept responsibility for own actions
185
Q

theoretical implications:

using a general model of personality is very clearly a dimensional approach - no attempt to delineate normal from “disordered”

A

dimensional vs. categorical

186
Q

theoretical implications:

the number of PD diagnoses patients typically receive varies: 2.4 and 4.6
-comorbidity expected to the extent that the same broad domains and/or specific traits underlie the various PDs

A

comorbidity

187
Q

theoretical implications:

gender differences in prevalence rates of PDs should be consistent with gender differences in general personality functioning

A

gender differences

188
Q

men lower in agreeableness

A

antisocial, narcissistic

189
Q

women higher in neuroticism

A

borderline, dependent

190
Q

coverage: most common PD diagnosis in clinical practice

A

PD NOS (personality disorder not otherwise specified)

191
Q

DSM-5 was set to use a radical new approach, derived largely from the type of FFM-like work
-viewed as too untested at the last moment, and was put in section ___ for further study

A

section III

192
Q

this DSM-5 section approach is:

-moderate or greater impairment in personality (self/interpersonal) functioning
-one or more pathological traits
-inflexible/pervasive
-longstanding

A

section III approach

193
Q

two forms of impairment

A

self and interpersonal

194
Q

two components of self impairment

A

identity and self-direction

195
Q

experience oneself as unique, with clear boundaries between self and others; stability of self-esteem and accuracy of self-appraisal; capacity/ability to regulate emotional experience
-impairment potentially evidence of a personality disorder

A

identity

196
Q

pursuit of coherent and meaningful short and long-term goals; use of constructive and prosocial internal standards of behavior; ability to self-reflect

A

self-direction

197
Q

two components of interpersonal impairment

A

empathy and intimacy

198
Q

comprehension and appreciation of others’ experiences and motivations; tolerance of differing perspectives; understanding the effects of one’s own behavior on others

A

empathy

199
Q

depth and duration of connection with others; desire and capacity for closeness; mutuality of regard reflected in interpersonal behavior

A

intimacy

200
Q

DSM-5 trait model:

5 domains (25 specific traits)

A
  1. negative affectivity
  2. detachment
  3. antagonism
  4. disinhibition
  5. psychoticism
201
Q

according to the DSM-5 trait model, only six disorders would remain:

A
  1. schizotypal
  2. antisocial
  3. borderline
  4. narcissistic
  5. avoidant
  6. OCPD
202
Q

prevalence of personality disorders in the general population

A

about 0.5% to 2.5% of the general population

203
Q

___-___% prevalence of personality disorders in inpatient settings

A

10-30%

204
Q

personality disorders are thought to begin in ___
-predicted by sexual, physical, emotional abuse, neglect

A

childhood

205
Q

personality disorders run a ___ course

A

chronic

206
Q

comorbidity rates are ___ both within and across different psychopathology (other personality disorders and other disorders)

A

high

207
Q

men are more likely to have cluster ___ PDs (APD, NPD, OCPD)

A

A

208
Q

women are more likely to have

A

bordeline, histrionic, dependent

209
Q

pervasive and unjustified mistrust and suspicion

causes:
-biological and psychological contributions are unclear
-early learning that the world is a dangerous place
-evidence unclear whether it is a variant of a psychotic disorder; research suggests “no” or “maybe”

treatment:
-few seek professional help on their own
-treatment focuses on development of trust
-cognitive therapy to counter negativistic thinking
-lack of good outcome studies

A

paranoid PD

210
Q

pervasive pattern of detachment from social relationships
-not interested in close relationships
-little interest in sexual experiences
-no close friends
-indifferent to praise or criticism
-very limited range of emotions in interpersonal situations (takes pleasure in few things; flattened affectivity - appear cold, detached)

causes:
-etiology unclear
-preference for social isolation resembles autism; extreme variant of shyness/introversion

treatment options:
-few seek professional help on their own
-focus on the value of interpersonal relationships
-building empathy and social skills
-lack good outcome studies

A

schizoid PD

211
Q

which cluster A PDs were almost removed from the DSM-5? (2)

A

paranoid and schizoid were going to be removed - only schizotypal to remain

212
Q

odd and unusual behavior, appearance, and cognition
-most are socially isolated, highly suspicious (paranoid)
-magical thinking, ideas of reference, and illusions
-unusual perceptual experiences
-many meet criteria for major depression

causes:
-phenotype of a schizophrenia genotype?
-diagnosis came about as a result of research on family members of schizophrenics; higher rates of schizotypal PD in family members of schizophrenic
-generalized cognitive deficits

treatment options:
-main focus on developing social skills
-treatment also addresses comorbid depression
-medical treatment similar to schizophrenia - use of antipsychotics
-treatment prognosis is generally poor

A

schizotypal PD

213
Q

noncompliance with social norms
-violate rights of others
-irresponsible, impulsive, and deceitful
-lack empathy and remorse
-lack concern for safety of self or others
-must be evidence of conduct disorder before age 15

A

antisocial PD

214
Q

early histories of behavioral problems (ex. conduct disorder)
-families with inconsistent parental discipline and support
-families have histories of criminal and violent behavior

A

relation with conduct disorder and early behavioral problems

215
Q

neurobiological contributions and treatment of antisocial personality

brain damage - little or large support for this view?

A

little support

216
Q

neurobiological contributions and treatment of antisocial personality

underarousal hypothesis: ___
-future criminals have lower skin conductance activity, lower resting heart rate, and more slow frequency brain activity

A

cortical arousal is too low

217
Q

neurobiological contributions and treatment of antisocial personality

cortical immaturity hypothesis - ___
-based on evidence that theta waves are correlated with psychopathy. theta waves uncommon in adults; could be due to lack of anxiety

A

cortex is not fully developed

218
Q

neurobiological contributions and treatment of antisocial personality

fearlessness hypothesis - ___

A

fail to respond to danger cues

219
Q

underactive “behavioral inhibition system” paired with overactive “behavioral activation system”

A

gray’s model of behavioral inhibition and activation

220
Q

cognitive problem: once psychopathic people have a routine set, they do not take in new information to change course very easily

A

response modulation difficulties

221
Q

There is a pervasive pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:
-Frantic efforts to avoid real or imagined abandonment
-A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
-Identity disturbance: marked and persistently unstable self-image or sense of self
Impulsivity in at least two areas that are potentially self-damaging
-Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
-Affective instability due to marked reactivity of mood
-Chronic feelings of emptiness
-Inappropriate, intense anger or difficulty controlling anger
-Transient stress-related paranoid ideation or severe dissociative symptoms

A

borderline PD

222
Q

most common of ten DSM-IV personality disorders in psychiatric settings

A

borderline PD

223
Q

the causes: runs in families (see higher rates in families with mood disorders)
-early trauma and abuse seem to play some role

A

causes of borderline PD

224
Q

major theory: biosocial theory (linehan) - two components

A

emotionally vulnerable individual and invalidating environment

225
Q

excessive reaction to stress; long recovery rate following stressor

A

emotionally vulnerable individual

226
Q

broadly conceived, being told feelings are not okay or reasonable, being told perceptions are wrong; physical or sexual abuse - invalidates one’s autonomy, sense of boundaries, privacy

A

invalidating environment

227
Q

antidepressant medications - short-term relief
antipsychotic - reduces aggression
-dealectical behavior therapy (DBT) - most promising treatment

A

treatment options for borderline PD

228
Q

Overly dramatic, sensational, and sexually provocative
Impulsive and need to be the center of attention
Thinking and emotions are perceived as shallow
Common diagnosis in females

A

histrionic PD

229
Q

etiology largely unknown
-sex-typed variant of antisocial personality? variant of NPD?

A

the causes of histrionic PD

230
Q

focus attention seeking long-term consequences
-address problematic interpersonal behaviors
-little evidence that treatment is effective

A

treatment options for histrionic PD

231
Q

exaggerated/unreasonable sense of self-importance
-preoccupation with receiving attention
-lack sensitivity and compassion for other people
-sensitive to criticism, envious, and arrogant
-mainly causes social impairment. mildly distressing over time, but secondary to impairment it causes

A

narcissistic PD

232
Q

Link with early failure to learn empathy as a child because of parents’ fai;ure to effectively “mirror” child (Kohut)
Parents are spiteful and cold but find 1 talent or quality in the child to reward (ex. Athlete, student, genius). Grandiosity conceals concerns about defectiveness (Kernberg)
Child over-valued - parents provide non-contingent praise, attention, and tribute to the child (Millon)
Appears that over OR under valuation can cause it. Too much or too little attention; pampering or neglecting; excessive praise or no praise

A

causes of NPD

233
Q

Extreme sensitivity to the opinions of others
Highly avoidant of most interpersonal relationships
Interpersonally anxious and fearful of rejection
“Look like” schizoid individuals - different motivations for similar outward behavior

A

avoidant PD

234
Q

Numerous factors have been proposed
Difficult temperament and early rejection
Recall feeling isolated and rejected in childhood
Extreme variant of introversion?

A

causes of avoidant PD

235
Q

Several well-controlled treatment outcome studies exist
Treatment is similar to that used for social phobia
Treatment targets include social skills and anxiety-reduction

A

treatment options for avoidant PD

236
Q

which cluster C personality disorder was proposed to be removed from DSM-5?

A

dependent PD

237
Q

Reliance on others to make major and minor life decisions
Unreasonable fear of abandonment
Clingy and submissive in interpersonal relationships
Focused on maintenance of supportive/nurturing relationships
Correlates strongly with borderline PD

A

dependent PD

238
Q

Still largely unclear
May be due to feelings of incompetence and low self-efficacy
Linked to early disruptions in learning independence
Early disruption of important attachment relationships
Temperamental differences in negative emotionality

A

causes of dependent PD

239
Q

Research on treatment efficacy is lacking
Therapy typically progresses gradually
Treatment targets include skills that foster independence
On surface, seem to be perfect patient population; must confront patients’ dependence on therapy and therapist

A

treatment options for dependent PD

240
Q

Excessive and rigid fixation on doing things the right way (ex. “My way or the highway”)
Frugal
Highly perfectionistic, orderly, and emotionally shallow
True obsessions and compulsions are rare
“Can’t see the forest for the trees”
Looking at the specifics, missing the full picture

A

obsessive-compulsive PD

241
Q

Largely unknown
Impairment may be more limited than other PDs

A

causes of OCPD

242
Q

Data supporting treatment are limited
Addresses fears related to the need for orderliness
Address rumination, procrastination

A

treatment options for OCPD

PSYC 3230 - Psychopathology (4 decks)

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