HC.10 Flashcards
What is a difficult factor of patiënts in cluster C?
There is so much going on under the surface. The internalizing character hides underlying problems
Name the 7 criteria of Avoidant PD
- Avoiding occupational activities involving significant interpersonal contact.
- Unwilling to get involved with people unless certain of acceptance.
- This feeling can and often stays even if there already is a friendship. - Restraint within intimate relationships (open up, show emotions, being vulnerable)
- Preoccupied with fears of receiving criticism or rejection in social situations.
- Social inhibition new interpersonal situations (stays on the sideline during group activities, you want to participate but your fear of being judged or making mistakes paralyze you)
- Feelings of inferiority (core symptoms that cause the other symptoms)
- Reluctant to take personal risks or to engage in any new activities (afraid that they will fail, and others criticize them)
- They have difficulties mentalizing
- Once they let emotions in, they feel overwhelmed by them because they usually avoid them
Name some consequences of the Avoidant PD symptoms
- Cause a high amount of stress. This can lead to the development of other disorders such as depression, Substance use, somatic symptoms, sleep problems
- Lead to isolation of friends, colleagues and others > lower social support
- Negative impact on career
Describe the etiology of Avoidant PD
- low degree of (healthy) emotional expression in the family
- conflict avoidance in family
- avoidant modelling by parents
- (preoccupied)-avoidant attachment
- Ridicule by parents and rejection > emotional abuse
Name the key differences between avoidant PD and social anxiety disorder
Scope (reikwijdte) of avoidance and fear:
- AVPD: Involves a broad, pervasive pattern of social inhibition and avoidance across various aspects of life, including work, social, and intimate relationships. The avoidance is driven by deep-seated feelings of inadequacy and a general fear of rejection.
- SAD: Fear and avoidance are typically more situation-specific, such as public speaking, meeting new people, or being observed while eating or drinking. The fear is primarily of negative evaluation in specific social contexts.
> AVPD patients don’t recognise the situational fear response of SAD
Severity and generalization:
- AVPD: The symptoms are more pervasive and chronic, affecting almost all areas of the individual’s life. The disorder is deeply ingrained in the person’s personality and self-image.
- SAD: The symptoms can be severe but are often limited to specific social situations. Outside these situations, the individual may function relatively normally
Self-perception:
- AVPD: Individuals typically have a global sense of inadequacy, feeling socially inept, unappealing, and inferior across most situations.
- SAD: The negative self-perception is usually tied to specific social situations rather than being a pervasive self-view
Relationship with others:
- AVPD: people with AVPD may have very few close relationships and may be extremely reluctant to get involved with others unless they are sure of being liked. The fear of rejection and criticism is a central and pervasive theme
- SAD: While individuals with SAD also fear negative evaluation, they may still desire social interactions and relationships but are hindered by their situational anxieties
- Treatment is less effective for AVPD + SAD
- AVPD is also present in samples without SAD
What is the overlap between social anxiety disorder and avoidant PD?
Both disorders involve fear of social evaluation and avoidance of social interactions. Symptoms such as anxiety in social situations, avoidance, and distress are common to both
Describe the 2 hypothese about the connection between SAD and AVPD
- Continuum hypothesis: SAD and AVPD exist on a spectrum of social anxiety severity, with SAD representing milder forms and AVPD representing more sever, pervasive forms of social anxiety and avoidance. This perspective emphasizes the shared characteristics of both disorders and supports a dimensional approach to diagnosis and treatment, recognizing the varying degrees of impairment and the need for personalized intervention strategies. So when you are diagnosed with AVPD you automatically have SAD.
- In this theory AVPD shares characteristics with other disorders and SAD, but it is a different disorder.
Name the qualitative differences between AVPD en SAD
- AVPD patients experience more feelings of inferiority and use general avoidance strategy, SAD is more related to specific attributes
- AVPD patients experience more fear in interpersonal situations and SAD more fear for the performance in the situation
- AVPD more strongly related to introversion, openness and agreeableness
- Clinical experience: AVPD more early experiences of isolation and early onset, SAD has a later onset
- In SAD, anxiety becomes less as relationship develops
Name the 8 criteria for Dependent PD:
- Difficulty making daily decisions advice and reassurance
- Needs someone else to take over major life areas
- Difficulty disagreeing with others
- Difficulty starting projects on their own
- Go to great lengths to obtain support from others (enduring abuse)
- Feeling uncomfortable or helpless when alone
- Searches for new relationship after one ends
- Unrealistic preoccupation with being left alone and unable to care for themselves
Describe the 2 types of dependency
- Functional:
- Afhankelijk van praktische hulp
- advies bij wat te eten/ hulp bij beslissingen - Emotional: in separation anxiety, BPD, depression
- constant bevestiging nodig
- Afhankelijk voor emotionele steun en validatie
Leg het cognitieve model uit over DPD
The 3 factors:
- overprotective, authoritarian parenting
- Gender role socialization
- Cultural attitudes regarding achievement/relatedness
Have cognitive consequences; a schema of the self as powerless and ineffectual
These consequences create motivational effects: a desire to obtain and maintain nurturant, supportive relationships
These motivations result in behavior patterns and affective responses (performance anxiety/ fear of abandonment etc.)
Describe the 8 criteria for Obsessive-Compulsive PD:
- Preoccupation with details, schedules, organization
- Prefectionism that interferes with the task completion
- Devotion to work and productivity to the exclusion of leisure activities and friendships
- Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
5.Unable to discard worn-out or worthless objects - Reluctant to delegate tasks
- A miserly spending style
- Rigidity and stubbornness
Describe some characteristics/ facts about OCPD
- Most common PD, especially in men
- Workaholic (a trait valued by society)
- rel. few patients seek help
- comorbidity with othr PDs
Describe the etiology of OCPD
- lack of emotional expression
- Lack of relaxation, fun and playtime
- Rigid rules, in exchange for love
- Punitive parenting style
- Overprotection
- Emphasis on achievements, rules, production
- Too much responsibility early in life
Describe the overlap between OCPD and OCD
- 25% of OCD patients have OCPD
- OCPD is seen as a less severe form of OCD
- egodystonic vs. egosyntonic
- similar heritability
