Lecture 2 Flashcards
Why is it important to have knowledge about epidemiology in personality disorders ?
To help with detection, prevention, and effective treatment of personality disorders
What is prevalence rate ?
The proportion of a population that has a disorder at a given time
Which personality disorders are most prevalent in the general population ?
- Obsessive-compulsive
- Avoidant
- Paranoid
How do prevalence rates of PDs compare between the general population and clinical settings ?
Prevalence rates are higher in clinical settings, ranging from 30–50% of psychiatric patients
Which personality disorders are most common in clinical settings ?
- Borderline
- Avoidant
- Paranoid
Which personality disorders are more common in men ?
- Paranoid
- Schizoid
- Antisocial
- Narcissistic
Which personality disorders are more common in women ?
- Histrionic
- Avoidant
- Dependent
What factors influence the variation in prevalence rates of PDs ?
- Population type
- Type of assessor (laypeople vs. trained clinicians)
- Type of assessment (self-report vs. interview)
What are the prevalence rates of different PD clusters in community samples ?
- Cluster A: 2.9%
- Cluster B: 3%
- Cluster C: 2.8%
What demographic factors are associated with Cluster A PDs ?
More common in individuals who are separated, unemployed, and from lower social classes
What is the prevalence of specific Cluster A PDs in community samples ?
- Paranoid PD: 1.1% (more common in individuals with less education & relatives with schizophrenia)
- Schizoid PD: 0.9% (twice as frequent in men)
- Schizotypal PD: 0.6%
What demographic factors are associated with Cluster B PDs ?
More common in younger individuals, those who are separated, and from lower social classes
What are the prevalence rates of specific Cluster B PDs in community samples ?
- Histrionic PD: 1.8% (more common in women)
- Antisocial PD: 1.2% (four times more common in men, linked to instability and low education)
- Borderline PD: 1.1% (more common in younger groups)
- Narcissistic PD: 0.4% (more common in men)
What is the prevalence of psychopathy in the general population and in prisons ?
- General population: ~1%
- Prison population: 15–25%
How is Cluster C PD prevalence related to demographic factors ?
Less related to demographic variables
What are the prevalence rates of specific Cluster C PDs ?
- Avoidant PD: 1.5%
- Dependent PD: 0.8% (more common in women)
- Obsessive-Compulsive PD: 3.2% (more common in men in older studies)
Which disorders are associated with personality disorder stability ?
- Major depressive disorder (MDD)
- Other personality disorders (AVPD, OCPD)
- Borderline personality disorder (BPD)
How stable are PD impairments in functioning ?
PDs are associated with stable impairments in relationships, occupational and leisure functioning, and quality of life
Which PDs are associated with the most reduced quality of life ?
- Schizotypal
- Borderline
- Avoidant
Which PDs are least associated with impairments in functioning ?
- Obsessive-Compulsive
- Histrionic
What percentage of BPD patients achieve clinical remission in a 10-year follow-up ?
- 93% have remission for at least 2 years
- 86% have remission for at least 4 years
- 39.3% achieve remission within 2 years
What are the risk factors for poor outcomes and suicide in BPD ?
Parental emotional/sexual abuse, adult adversity, family history of suicide, and poor social cohesion
What childhood factors predict antisocial behavior in adulthood ?
Delinquency in youth, low parental education, poor supervision, poor child-rearing skills, and large family size
What is the mortality rate of antisocial men under 40 years old ?
24% (due to violence and cardiovascular disease)
What factors are associated with good outcomes in ASPD ?
Job stability, no alcohol abuse, and stable marriage
What is the co-occurrence rate of PDs ?
High; individuals with one PD often have another
What PDs commonly co-occur ?
- Cluster B & Cluster A/C PDs.
- Dependent & Histrionic PDs with BPD
- Avoidant PD with Dependent & Obsessive-Compulsive PDs
What other mental disorders commonly co-occur with PDs ?
- Anxiety disorders
- ADHD (with ASPD and BPD)
- Schizophrenia (with Schizotypal PD)
- Autism (with Cluster A and C PDs)
- Mood disorders
What is the estimated genetic contribution to PDs ?
Varies by cluster:
- Cluster A: 21-26%
- Cluster B: 31-56% (highest for ASPD and BPD)
- Cluster C: 27-37%
What neurotransmitters are implicated in PDs ?
- Serotonin (impulsivity and aggression in ASPD and BPD)
- Dopamine (novelty-seeking in Cluster B and avoidance in Cluster C)
- Noradrenaline (reward dependence in Cluster B)
What role does child abuse play in PD development ?
Physical, emotional, and sexual abuse increase the risk of PDs, particularly BPD & Schizotypal PD
What PDs are least associated with childhood abuse ?
Dependent
Which PDs have no significant gender difference ?
- BPD
- Obsessive-Compulsive
- Schizotypal
How might gender biases affect PD diagnoses ?
Women are more often diagnosed with BPD and Histrionic, while men are more often diagnosed with Antisocial and Narcissistic
