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Personality and Personality Disorders > L10: Cognitive models and Cluster C > Flashcards

L10: Cognitive models and Cluster C Flashcards

1
Q

cluster C=

A
  • avoidant PD
  • dependent PD
  • obsessive-compulsive PD
  • vermijdend
  • afhankelijk
  • dwangmatig

the internalising character hides underlying problems & deze problemen gaan vaak schuil achter andere stoornissen. klachten zijn vaak op de achtergrond.

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2
Q

avoidant PD DSM

A

4 van de 7:

  1. Avoiding occupational activities involving significant interpersonal contact
  2. Unwilling to get involved with people unless certain of acceptance
  3. Restraint within intimate relationships
  4. Preoccupied with fears of receiving criticism or rejection in social situations
  5. Social inhibition new interpersonal situations
  6. Feelings of inferiority
  7. Reluctant to take personal risks or to engage in any new activities
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3
Q

Stan’s coworkers invite him for lunch, but he is not sure
where he stands with them. He worries that they don’t
really want him there. He politely declines the invitation,
saying he has other plans.

voorbeeld van

A

unwilling to get involved with people unless certain of acceptance

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4
Q

Although Amanda has been dating Mark for a few
months, she avoids discussing personal topics or
expressing deeper feelings.
She is afraid that if she opens up, he may think she is too
emotional or weak, and leave when he sees the real her.
Amanda keeps conversations superficial and avoids
discussing her past or her insecurities. She deflects
personal questions and quickly tries to change the topic
when it gets too intimate

voorbeeld van

A

restraint within intimate relationships

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5
Q

wat zijn de gevolgen van avoidant PD

A
  • high amounts of stress -> depression, SUD, somatic symptoms, chronic mental health issues, sleep problems
  • often struggle with mentalizing and emotion regulation
  • isolation from friends, collegues and others -> lower social support (very painful because they do crave connections)
  • negative impact on (academic) career
  • self-fulfilling prophecy
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6
Q

etiology of AVPD

A

low degree of (healthy) emotional expression in family
- conflict avoidance in family
- avoidant modeling by parents
- preoccupied avoidant attachment
- ridicule by parents and rejection (emotional abuse)

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7
Q

overeenkomsten AVPD en SAD

A

beiden avoiding interpersonal/social interactions omdat ze bang zijn voor afwijzing of kritiek

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8
Q

twee hypothesen over overeenkomst SAD en AVPD

A
  • continuum: non-generalized SAD -> generalised SAD -> AVPD
  • separate disorders: met een beetje overlap maar wel apart
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9
Q

evidence for 2 separate dimensions

A
  • avoidant PD is also present in samples without SAD (als het een continuum was zou dit niet zo zijn)
  • AVPD patients do not recognize the situational fear response of SAD
  • treatment less effective for patients with AVDP + SAD
  • there is support for qualitative differences in traits
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10
Q

overeenkomst prevalenties van comorbide AVDP en SAD

A
  • 1/3 to 46% individuals also diagnosed with AVPD (Lampe et al., 2015; Friborg et al., 2013).
  • Between 40 and 88% in AVPD also have SAD (Weinbrecht et al., 2016)
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11
Q

qualitative differences AVPD and SAD

A
  • feelings of inferiority provoke a general avoidance strategy in AVPD, but are more related to specific attributes in SAD
  • feared social situations: interpersonal in AVPD, performance in SAD
  • AVPD more strongly related to introversion, openness, agreeableness
  • AVPD more isolation
  • AVPD earlier onset
  • in SAD the anxiety lessens as the relationship develops
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12
Q

dependent PD

A
  1. difficulties making daily decisions, needing advice and reassurance
  2. needs someone else to take over major life areas
  3. difficulty disagreeing with others (abusive relationships?)
  4. difficulty starting projects on their own
  5. go to great lengths to obtain support from others
  6. feeling uncomfortable or helpless when alone
  7. searches for new relationship after one ends
  8. unrealistic preoccupation with being left alone and unable to care for themselves
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13
Q

two types of dependency

A
  • functional dependency (risk of losing relationships)
  • emotional dependency (separation anxiety, BPD, depression)
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14
Q

gender and culture in DPD

A

more women (but maybe because they are pushed into this role)
many cultures in which dependency is more normal

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15
Q

dependent PD: OCEAN trait/personaliteit

A

high on agreeableness
viewed as passive, but can be very pro-active and aggressive/intimidating

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16
Q

cognitive/interactionist model

A

overprotective authoritarian parenting, gender role socialization, cultural attitudes regarding achievements/relatedness
|
cognitive consequences: schema of the self as powerless and ineffectual
|
motivational effects: desire to obtain and maintain nurturant, supportive relationships
|
relationship facilitating self-presentation strategies & performance anxiety, fear of abandonment, fear of negative evaluation

17
Q

obsessive-compulsive PD

A
  1. Preoccupation with details, rules, schedules,
    organization
  2. Perfectionism that interferes with the task
    completion
  3. Devotion to work and productivity to the
    exclusion of leisure activities and friendships
  4. Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
  5. Unable to discard worn-out or worthless objects
  6. Reluctant to delegate tasks
  7. A miserly spending style
  8. Rigidity and stubbornness
18
Q

Jane keeps rewriting her thesis,
and cannot finish because she is
never happy and satisfied with
the result. She misses multiple
deadlines and risks not being able
to graduate.

A

perfectionism that interferes with the task completion

19
Q

Robin refuses to compromise on
his ethical standards. He others
harshly for behaviors he considers
unethical. For example, he may
distance himself from friends that
don’t make the same dietary
choices

A

is overconscientious, scrupulous and inflexible about matters of morality, ethics or values

20
Q

Jane micromanages her
employees and refuses to
delegate even minor tasks. She
redoes their work, leading to
inefficiency and resentment
among her staff

A

reluctant to delegate tasks

21
Q

David refuses to spend money on
basic things he actually needs,
such as a new winter coat. He
hoards his money and therefore
does not have a coat that is warm
enough.

A

a miserly spending style

22
Q

OCDP kenmerken/facts

A
  • most common in the general population
  • more common in men
  • workaholics (traits valued by society -> positive reinforcement)
  • relatively few patients seek help
  • overcompensating coping -> no surrending to the ideas that they may fail, do everything in their power not to fail
  • a lot of comorbidity with other PDs
23
Q

OCPD etiology

A
  • Lack of emotional expression
  • Lack of relaxation, fun, playtime
  • Rigid rules, in exchange for love
  • Punitive parenting style
  • Overprotection
  • Emphasis on achievements, rules, production
  • Too much responsibility early in life -?> parentification
24
Q

dus hoe ontstaan de 3 PDs uit dit cluster

A

emotional abuse/ridicule -> avoidant
overprotective parents -> dependent
parentification -> OCPD

25
Q

avoidant PD prevalences

A
  • Around 2.5% healthy population
  • 25% clinical population
  • More in women and low SES
26
Q

dependent PD prevalences

A
  • Around 1% healthy population
  • 15% clinical population
  • More in women and low SES
27
Q

OCPD prevalences

A
  • Around 2% healthy population
  • 10% clinical population (low ratio 5:1)
  • Probably more in women and higher SES
28
Q

dus welke van deze PDs meeste in general en weke meeste in population

A

ocpd in general, avoidant meeste in clinical

29
Q

schema

A
  • knowledge representation of the self, others, the world (and relationships)
  • explicit (can be verbalized) and implicit (attachment) beliefs
  • originates in childhood (Early Maladaptive Schemas (EMS)
30
Q

soorten beliefs

A
  • core beliefs (i am…, others are…)
  • conditional beliefs (if x, than y)
  • strategic beliefs (do A to get B)
31
Q

dependent PD: core/conditional/strategic beliefs

A

Core: I am weak and ignorant; Others are strong, have knowledge, and can help me
Conditional: If I turn to someone else for help,
he or she will solve it for me
Strategic: Let others decide; cling to others

32
Q

paranoid PD: core/conditional/strategic

A

Core: I am a target, I am righteous; Others are
out to abuse me
Conditional: If you let others know too much
about you, they will use it against you
Strategic: Keep an eye on others; look for hidden intentions

33
Q

borderline PD: core/conditional/strategic

A

Core: I am evil, victim, helpless, lost; Others
abuse or abandon you, or reject you
Conditional: If you let others get too close,
they will abandon, abuse or reject you
Strategic: I need to find someone who will help me and will never leave me

34
Q

2 ways information is integrated in schemas

A
  • assimilation: inclusion of info into already existing schema, sometimes adjusted (dominant process)
  • accommodation: adjustment of schema according to new information (difficult)
35
Q

schemas influence information processing by:

A
  • Attention and selection of information
  • Interpretation of information
  • Memory
36
Q

cognitive model of PDs

A

information -> selection (attentional bias) -> interpretation (interpretational bias & associations) -> evaluation (evaluation style) -> response (coping style) -> memory encoding (encoding bias) -> autobiographical memory -> retrieval (memory bias)

zie schrift

37
Q

what did a study regarding interpretation bias show

A

that the pds more often selected interpretations from the short stories that aligned with their disorder.

except for ocpd: these were selected more often in the general populations!

38
Q

conclusions cognitive models

A
  • PDs are characterized by: specific sets of ‘beliefs’ & Specific cognitive biases (also implicit)
  • Schemas cause cognitive processes and maintain personality disorders
  • No direct causal evidence yet
  • Cognitive model useful for experimental research and translation to practice and treatment!

Personality and Personality Disorders (18 decks)

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