Exam 4: Personality Disorders

Question 1

DSMV Diagnosis

Answer 1

enduring pattern of inner experience and behabior, pattern shown in 2+ areas: cognition, affectivity, interpersonal functioning, impulse control; often seek therapy for something other than personality disorder

Question 2

Prevalence

Answer 2

9-13%

Question 3

Inter-rater Reliability

Answer 3

.69-.97 depending on disorder; definitiosn got more specific and structured interviews were developed

Question 4

Stability of Disorders

Answer 4

test-retest reliability varies; not as stable as DSM suggests
highly stable: antisocial
low: schizotypal

Question 5

Comorbidity

Answer 5

50% qualify for another PD; 2/3 meet criteria for another disorder at somepoint in their lifetime

Question 6

Cluster A

Answer 6

odd/eccentric behaviors, emotionally detatched, extreme forms overlap with psychotic disorders, more common in males, rarely seek treatment

Question 7

Cluster B

Answer 7

dramatic/erratic behaviors, fragile ego/sense of self, attention-seeking

Question 8

Cluster C

Answer 8

anxious/fearful behaviors

Question 9

Paranoid

Answer 9

pervasive, unwanted suspiciousness, pathological jealousy, appear cold, serious and devious, lack tender feelings and sense of humor, do not have close relationships, often have difficulties working; Cluster A

Question 10

Schizoid

Answer 10

withdrawn, detatched, reclusive, lacking humor, flat affect, indifferent to praise/criticism, little desire for relationships; Cluster A

Question 11

Schizotypal

Answer 11

oddities of thought/speech/behavior/perception, loose associations, suspiciousness, lacking social skills, socially isolated, often seen as weak form of schizophrenia; Cluster A

Question 12

Histronic

Answer 12

f>m, overly reactive/dramatic, intensely expressive, behaviors and relationships for attention rather than intimacy, seen as manipulative, often ends up in therapy; Cluster B

Question 13

Narcissistic

Answer 13

extreme sense of self-importance and uniqueness, sense of entitlement, expect favors, constant need for attention, grandiose, might exploit others, not much empathy/concern for others, envious of others or thinks others are envious of them; Cluster B

Question 14

Borderline Personality

Answer 14

f>m, (hispanics f=m and higher overall rate), instability in moods, self-image, impulsivity, relationship problems, percieved as manipulative, seems to wish for relationships but denies doing so, “you’re wonderful/you’re horrible” pattern, fear of abandonment, self-harm tendencies, some genetic component, Cluster B

Question 15

Antisocial

Answer 15

m>f, associate with crime and violence, often violate other’s rights, long history of inappropriate behavior, often diagnosed with conduct disorder before 15, pathological lying, no remorse, do not care about others, difficulty maintaining job, careless with money, no sense of responsibility, reckless behavior, may mistreat/abuse others, manipulative, self-centered, relationship problems, rarely seek treatment; Cluster B

Question 16

Avoidant

Answer 16

m=f, strong fear of rejection, desire intimacy but have few relationshis, need guarantee of unconditional acceptance, avoid social interaction, low-self esteem, anxious, sensitive, restrict activities; Cluster C

Question 17

Dependent

Answer 17

f>m, clingy, obedient, fear of separation/abandonment, ongoing need to be taken care of, feel distressed, lonely, sad, lack of belief/confidence that they can function independently; Cluster C

Question 18

Obsessive-Compulsive

Answer 18

m>f, intense focus on orderliness, perfectionism, control, no flexibility or openness, insist others do things their own way, do not seek treatment unless lifestyle is threatened; Cluster C

Question 19

Seeking Treatment

Answer 19

many people with personality disorders do not seek treatment unless it is at someone else’s insistance - don’t believe they need to make changes

Question 20

Paranoid: Psychodymanic Theory

Answer 20

demanding parents, distant/rigid father, over controlling/rejecting mothers. One view is that patients view environment as hostile as result of their parents’ persistently unreasonable demands

Question 21

Paranoid: Cognitive Theory

Answer 21

hold broad maladaptive assumptions

Question 22

Paranoid: Biological Theory

Answer 22

genetic cause. Twin studies in Australia, one twin suspicious, other twin had likelihood. But also could be caused by similar environment

Question 23

Paranoid: Object Relations Treatment

Answer 23

work with patient’s deep wish for a satisfying relationship

Question 24

Paranoid: Self-therapists

Answer 24

help clients reestablish self-cohesion

Question 25

Paranoid: Behavioral Therapy

Answer 25

therapists help individual to master anxiety-reduction techniques and to improve skills at solving interpersonal problems

Question 26

Paranoid: Cognitive Therapy

Answer 26

therapist guide to develop more realistic interpretations of other’s words/actions and to become aware of other’s points of view

Question 27

Schizoid: Psychodymanic Theory

Answer 27

has roots in unsatisfied need for human contact, parents are unaccepting/abusive

Question 28

Schizoid: Cognitive Theory

Answer 28

deficiencies in thinking. Thoughts are empty/vague/without meaning. Unable to pick up emotional cues and unable to process them. Children will develop language/motor skills slowly

Question 29

Schizoid: CBT

Answer 29

Cognitive – present clients with list of emotions to think about/ remember pleasurable experience Behavioral – teaching social skills using role play, exposure techniques, and homework assignments. Also use group therapy

Question 30

Schizotypal: Theories

Answer 30

family conflict, disorders in parents, deficits in attentions, short-term memory

Question 31

Schizotypal: Biological Theory

Answer 31

high activity of NE, enlarged ventricles, smaller temporal lobes, loss of grey matter

Question 32

Schizotypal: Comorbidity

Answer 32

MDD

Question 33

Schizotypal: CBT

Answer 33

help client reconnect with world, recognize limits of thinking/powers. Increase social contacts Cognitive – teach clients to evaluate unusual thoughts, perceptions objectively and try to ignore inappropriate ones. Behavioral – speech lesson, social skills training, help clients blend in and feel more comfortable.

Question 34

Histronic: Psychodymanic Theory

Answer 34

children experienced unhealthy relationships in which cold and controlling parents left the feeling unloved and afraid of abandonment. To defend against fears of loss, individuals learned to behave dramatically, inventing crises that would require others to act protectively

Question 35

Histronic: Cognitive Theory

Answer 35

lack of substance and extreme suggestibility found in people with histrionic personality disorder. Individuals become less and less interested in knowing about the world at large because they are so self-focused. Rely on other people to provide them direction. Think they are helpless so rely on others to meet their needs

Question 36

Histronic: Sociocultural Theory

Answer 36

produced by cultural norms/ expectations

Question 37

Histronic: Therapy

Answer 37

cognitive and psychodynamic; try to change belief that they are helpless, push towards more deliberate ways of thinking. Try to make patients realize own excessive dependency; pretend to have a lot of symptoms to hard for therapists. They seek treatment on own (for attention). Therapists must remain objective.

Question 38

Narcissistic: Psychodynamic

Answer 38

cold rejecting parents. spend lives defending against feelings unsatisfied, rejected, unworthy, wary of world. Believe that they are perfect to cope, while wanting admiration from others. Grandiose self-image as way to convince themselves they are self-sufficient without need of warm relationships with parents or anyone else.

Question 39

Narcissistic: Cognitive/Behavioral Theory

Answer 39

people are treated too positively. Repeatedly reward themselves for minor accomplishments.

Question 40

Narcissistic: Sociocultural Theory

Answer 40

family values/social ideals in certain societies periodically break down, producing generations of youth who are self-centered/materialistic.

Question 41

Narcissistic: Psychodymanic Treatment

Answer 41

help people recognize and work through basic insecurities/ defenses

Question 42

Narcissistic: Cognitive Therapy

Answer 42

redirect client’s focus to opinions of others, reach them to interpret criticism more rationally, increase ability to empathize.

Question 43

Narcissistic: Treatment Success

Answer 43

No treatment has had much success, patients do not recognize need for treatment or value of treatment. Try to manipulate therapists.

Question 44

Borderline: Psychodynamic Theory

Answer 44

early lack of acceptance by parents lead to loss of self-esteem, increased dependence, inability to cope with separation. Research indicates early sexual abuse.

Question 45

Borderline: Biological Theory

Answer 45

overly reactive amygdala, underactive prefrontal cortex, lower serotonin activity (abnormality in 5-HTT gene).

Question 46

Borderline: Biosocial (diathesis-stress)

Answer 46

combination of internal forces (difficulty identifying/controlling emotions/abnormal neurotransmitter) and external forces (environment in which child’s emotions are punished, ignored).

Question 47

Borderline: Psychoanalytic Treatment

Answer 47

traditional doesn’t work because patients take it as insults, don’t think they have enough attention with free association. Relational psychoanalytic theory therapist take more supportive/egalitarian posture, they work to provide empathic setting within which patients can explore central relationship disturbance, poor sense of self, pervasive loneliness/emptiness.

Question 48

Borderline: Dialectical Behavior Therapy

Answer 48

acceptance and change (that is: accepting yourself and that there is a reason for what you did, but that you need to change the behavior because it isn’t working well for you; starts by addressing harmful behaviors, then behaviors that interfere with therapy; based on cognitive/behavioral technique such as homework assignments, psych education, teaching of social skills, modeling, goal setting, reinforcements for appropriate behavior, collaborative examination of thinking with client and patient. Empathize with patients. Works in groups. Most supported treatment. Patients deal better with stress, more appropriate social skills. Fewer suicide symptoms/ hospitalization.

Question 49

Borderline: Comorbidity

Answer 49

high comorbidity with with anxiety, PTSD, depression, eating disorder, substance abuse

Question 50

Antisocial: Comorbidity

Answer 50

substance abuse

Question 51

Antisocial: Psychodynamic Theory

Answer 51

absence of parental love during infancy, leading to lack of basic trust. Children become emotionally distant. Bond with others through use of destructiveness and power. Evidence is people who have it had family stress (violence, poverty, conflict, divorce)

Question 52

Antisocial: Behavioral Theory

Answer 52

antisocial symptoms may be learned through modeling/imitation. Higher rate are found with people whose parents has it as well. Another theory, parents reward aggressive behavior.

Question 53

Antisocial: Cognitive Theory

Answer 53

hold attitudes that trivialize importance of other people’s needs. Have genuine difficulty recognizing point of view of others.

Question 54

Antisocial: Biological Theory

Answer 54

low serotonin level, deficient functioning in frontal lobe, people have less anxiety (vital for learning, people with disorder have low arousal in presence of stress, linked with tuning out threatening/emotional situations.)

Question 55

Antisocial: Cognitive Treatment

Answer 55

teaches patients to think about moral issues and about the needs of other peoples; typically ineffective because patients do not want to change

Question 56

Antisocial: Biological Treatment

Answer 56

atypical, antipsychotics drugs (not supported)

Question 57

Avoidant: Psychodynamic Theory

Answer 57

focus on general sense of shame, early bowel/bladder incidents. If parents punish, child gets negative self-image, and will distrust love of others

Question 58

Avoidant: Cognitive Theory

Answer 58

harsh criticism/ rejection I nearly childhood leads to think environment always judges and thinks badly of them. Individuals expect rejections, misinterpret positive feedback, fear social involvements

Question 59

Avoidant: Behavioral Theory

Answer 59

fail to develop normal social skills, failure helps maintain disorder. Deficits result from avoiding social situations.

Question 60

Avoidant: Psychodynamic Treatment

Answer 60

help clients recognize and resolve unconscious conflict that may be operating

Question 61

Avoidant: Cognitive Treatment

Answer 61

help change distressing beliefs and thoughts, carry on in face of painful emotions, and improve self-image

Question 62

Avoidant: Behavioral Treatment

Answer 62

provide social skills training as well as exposure treatments that require people to gradually increase social contact; group therapy is helpful

Question 63

Avoidant: Biological Treatment

Answer 63

Antianxiety/antidepressants reduce social anxiety but symptoms may return when medication is stopped

Question 64

Dependent: Psychodynamic Theory

Answer 64

unresolved conflicts during oral state gives rise to lifelong need for nurturance. Early parental loss. Rejection man prevent normal experience of attachment and separation. Some say parents are overprotective, so children become more dependent

Question 65

Dependent: Behavioral Theory

Answer 65

parents unintentionally reward clinging behavior while pushing acts of independence away. Or Parents’ own dependent behavior modeled by kids.

Question 66

Dependent: Cognitive Theory

Answer 66

two maladaptive thoughts: (1) inadequate and helpless to deal with world (2) must find person to provide protection so I can cope. Also (3) if I am to be dependent, I must be completely helpless.

Question 67

Dependent: CBT

Answer 67

place all well-being on clinician. Must make clients accept responsibility; help take control of lives Behavioral – therapists often provide assertiveness training Cognitive – help clients challenge and change assumptions of incompetence and helplessness

Question 68

Dependent: Drug Treatments

Answer 68

• Anti-depressants drug therapy good for personality disorder accompanied by depression

Question 69

Dependent: Group Therapy

Answer 69

good for support from number of peers, can serve as models for each other

Question 70

Obsessive-Compulsive: Psychodymanic Theory

Answer 70

anal regressive, overaly harsh toile training, become angry and get fixated. Struggles with parents over control and independent ignite aggressive impulses

Question 71

Obsessive-Compulsive: Cognitive Theory

Answer 71

illogical thinking processes keep OCPD going. People with disorder tend to misread/ exaggerate potential outcomes of errors

Question 72

Obsessive-Compulsive: Psychodynamic Treatment

Answer 72

help recognize and accept underlying feelings/insecurities

Question 73

Obsessive-Compulsive: Cognitive Treatment

Answer 73

focus on changing “all-or-nothing” thinking, perfectionism, chronic worrying

Question 74

Obsessive-Compulsive: Medication

Answer 74

Respond well to SSRIs but no research yet.

Question 75

Personality Traits: The Big Five

Answer 75

``` Neuroticism Extroversion Openness to experience Agreeableness Conscientiousness ```