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PSYC 440 > Lecture 19 - Personality Disorders > Flashcards

Lecture 19 - Personality Disorders Flashcards

1
Q

General criteria

A

A. Impairments in personality (self and interpersonal) functioning
B. Pathological personality traits stability across time and consistency across situations
- Not accounted by developmentally or culturally normative personality features and not due to the direct
physiological effects of a substance or medical condition

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2
Q

Categorical Approach: clusters

A
  • Cluster A: odd/eccentric; paranoid, schizoid or schizotypal
  • Cluster B: dramatic, emotional, erratic; antisocial, borderline, histrionic, narcissistic
  • Cluster C: fearful or anxious; avoidant, dependent, Obsessive compulsive personality disorder

-Other: personality change due to medical condition

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3
Q

Diagnostic Challenges

A
  • Lack of specificity
  • Multiple Diagnosis
    • Most people receive more than one PD
    • Lots of heterogeneity in one disorder (ex: there are SO MANY ways to meet criteria for BPD)
  • Limited validity/arbitrary thresholds:
    • Poor inter-rater reliability (two clinicians might rate one person differently); can use self-report for PD – advantages; more detailed description/more time to freely express BUT disadvantages; biased, as a clinician you can ask more questions and get more details…so it isn’t used as much because the disadvantages are too bad
    • Stability sometimes questionable
    • In older DSM system: most people diagnosed with PD fell into the “residual” category; Personality disorder not otherwise specified
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4
Q

Traits

A
  • Stability of traits depend on age: stability of normal traits increases as people grow older: it is low in childhood, rises from adolescence to young adulthood, and continues to stabilize at age 60
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5
Q

Personality Disorder - stability over time

A

o Often has roots in childhood/adolescents
o Is often not diagnosed (labelled)
o However stability over time of a PD is debatable
- STUDY: only 36% kept diagnosis over time
o Several longitudinal studies show low stability of personality disorder diagnosis
o Mismatch clinical practice

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6
Q

Gender Differences

A

o Women tend to get histrionic personality diagnosis and males tend to get more antisocial - there ARE sex differences in personality disorder

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7
Q

Paranoid Personality disorder - clinical description

A 
• Mistrust and Suspicion (NOT SCARED FOR LIFE) 
   - Pervasive 
   - Unjustified
• Few meaningful relationships 
• Volatile 
• Tense 
• Sensitive to criticism  
• Tend to blame others 
• Core features: paranoia 
- In large clinic sample, never diagnosed alone 
• Poor validity of diagnosis 
- Suspiciousness and hostility traits
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8
Q

Paranoid Personality disorder - prevalence

A

Community: 1.7%
Clinical: 9.7%

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9
Q

Schizoid - Clinical description

A

• Appear to nether enjoy nor desire relationships
• Limited range of emotions
- Cold, detached
• Appear unaffected by praise, criticism
- Unable or unwilling to express emotion
• No thought disorder

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10
Q

Schizoid - Prevalence

A
  • Community: .0.9%
  • Clinical: 2.2%
  • but they probably stay away from others, so lacking people
  • Very little research
  • Distinction with avoidant PD: lack of desire for relationship
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11
Q

Schizotypal - Clinical description

A 
• Psychotic-like symptoms 
- Magical thinking 
- Ideas of reference 
- Illusions 
• Odd and/or unusual 
- Behaviour 
- Appearance 
• Socially isolated 
• Highly suspicious
- Originally introduced to describe non-psychotic relatives of patients with schizophrenia
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12
Q

Schizotypal - Prevalence

A 
• Community: 0.9% 
• Clinical: 1.9% 
- Diagnostic criteria 
- Positive symptoms 
• Psychotic-like symptoms 
- Negative symptoms 
• Deficit-like symptoms
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13
Q

Narcissistic Personality - Clinical description

A
  • Exaggerated and unreasonable sense of self importance
  • Require attention
  • Lack sensitivity and compassion
  • Sensitive to criticism
  • Envious
  • Arrogant
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14
Q

Narcissistic Personality - Prevalence

A

• Community: 0.5%
• Clinical settings: 5.7% (don’t need to know the exact numbers; just know around 1-5% overall)
- Grandiosity, need for admiration and impaired empathic capacity

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15
Q

Histrionic - Clinical Description

A
  • Overly dramatic
  • Attention-seeking
  • Sensational
  • Sexually provocative
  • Impulsive
  • Appearance-focused
  • Impressionistic
  • Vague, superficial speech
  • Common in females
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16
Q

Histrionic - Prevalence/Core symptoms

A
  • Prevalence: 1.5% community
  • Core characteristics
    • Self-centeredness, attention seeking, excessive emotionality, low frustration tolerance
    • Not specific to this disorder
  • Often comorbid with Borderline
17
Q

Obsessive-Compulsive PD - Clinical description

A
  • Fixation on doing things the right way
  • Rigid
  • Perfectionistic
  • orderly
  • Preoccupation with details
  • Poor interpersonal relationships
18
Q

OCD - Prevalence; greater risk for…; core features

A 
Prevalence 
• Community: 2.1% 
• Clinical: 13.1% 
Greater risk for 
• Depression recurrence 
• Suicide attempt during depressive episode 
• Health care utilization 
Core features 
• Rigidity: interpersonal control 
• Perfectionism: cognitive and intrapersonal control
19
Q

Dependent Personality - Clinical description

A
  • Rely on others for major and minor decisions
  • Unreasonable dear of abandonment
  • Clingy
  • Submissive
  • Timid
  • Passive
  • Feelings of inadequacy
  • Sensitivity to criticism
  • High need for reassurance
20
Q

Dependent Personality - Prevalence

A
  • Community: 0.7%
  • Clinical: 5-22%
  • Pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation
21
Q

Avoidant Personality - Clinical Description

A
  • Extreme sensitivity to opinions
  • Avoid most relationships
  • Interpersonally anxious
  • Fearful of rejection
  • ** more extreme form of social anxiety disorder**
22
Q

Avoidant Personality - Prevalence

A

• Community: 1.7%
• Clinical: 20.4%
- A more severe form of social phobia?
• 42% co-morbidity
• Patterns of comorbidity not consistent with the idea of the same diagnosis
• Genetic overlap with social anxiety disorder

23
Q

Antisocial Personality Disorder - Clinical Description

A 
• Noncompliance with social norms 
• Social predators 
- Violate rights of others 
- Irresponsible 
- Impulsive deceitful 
• Lack conscience, empathy and remorse
24
Q

Antisocial Personality Disorder - Prevalence, comorbidity, low fear hypothesis, developmental prevalence

A
  • Prevalence
    • 1.1% population
    • Up to 15% of male prisoners and 7% of female
  • Frequently co-morbid with substance abuse (60% of people with ASPD)
  • DSM does not capture who do not exhibit antisocial behaviour
    • Business professional, evangelist, politicians
  • Developmental perspective
    • Antisocial behaviour in childhood: best predictor of development of ASPD
  • Childhood vs. adolescent onset
    • Criminal behaviour tends to decline after age 40
  • Low Fear Hypothesis
    • Kids who were more difficult to condition a fear response at age 3 were more likely to be criminals at age 23
25
Q

Models of Personality Disorder

A
  • Categorical: observable symptoms
  • Dimensional
    • Big 5
  • Prototype approach (stereotype description and rate how much does this person fit this stereotype)
    • Harder to use
26
Q

Cognitive model of Personality disorder

A

o Essence of personality disorder is revealed in the dysfunctional beliefs that characterize and perpetuate it
o These core beliefs influence behaviour, feeling and physiology
- Ex: “no people can be trusted” can be for paranoid; “I’m very special and admirable” histrionic; “I am weak and needy” dependent; “I’m a failure and boring” avoidant

27
Q

Social-Cognitive Theory of PD - 3 schema processes

A
  • Schema maintenance
    • Cognitive distortions that directly reinforce or perpetuate a schema; behaviours that are in line with your schema
    • Ex: choose friends who fit with your schema
  • Schema avoidance
    • Person tend to avoid triggering a schema and the related intense affect
    • Ex: avoid situations that can trigger the schema
  • Schema compensation
    • Behaviours or cognitions that overcompensate for their schema; are the opposite from what schema is pointing to
    • Ex: really demanding in relationships (being unlovable)

PSYC 440 (17 decks)

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