Lecture 21 PD 2 Flashcards
Histrionic PD
Excessive emotionality, attention-seeking, ego-centric, flirtatious, seductiveness (focus on grooming),
Denial of anger and hostility
Gregarious, manipulative, low frustration tolerance, suggestibility, somatization
Displays of emotions: shallow and fickle in interpersonal relationships
Comorbid: narcissistic, borderline, anti-social PDs & psychoactive substance abuse
Hitrionic PD mode model
punitive parents: you’re not lovable, you screwed it up, nobody will ever put up with you
vulnerable child: feels unloved, lonely, unseen, need for attention and love
develop strategies to feel love, receive attention, connect with others
attention seeking mode: dramatic behaviour, exaggerated expression of emotions, flirting, having affairs, dressing provocatively
Borderline PD
Emotional instability/affective dysregulation in reaction to environmental and interpersonal situationso
-wide range of extreme emotions, intense anxiety, anger, dissociation
Impulse control
-promiscuity, self-harm, spending, binge eating, poor limit setting, suicidal behaviour(10% suicide)
Identity/insecure attachments
- unstable self-concept, frantic efforts to avoid real or imagined relationships
- inability to integrate +ve and -ve aspects of self leading to a sense of emptiness
Borderline mode model
punitive parent: devalues the patient, invalidates their emotions
inner shell-> abandoned, abused child: intense fears of abandonment, fears of being abused
outer shell-> angry, impulsive child: undisciplined, fulfilling needs without control, regardless of consequences
adult mode: detached protector
- functions to protect from emotions related to child modes
- social withdrawal
- avoidance
- substance use
- binge-eating
- non-suicidal self-injury
prevalence of BPD
most prevalent in clinical settings:
10% outpatients
15-20% inpatients
rarely sole diagnosis, comorbid with mood disorders, eating disorders, substance-use, anxiety (PTSD)
-> shared impulsivity/disinhibition, affective instability
greatest level of disability in all PDs
Antisocial PD
Repeated reckless disregard for others
Victimizing & blaming others for inadequacies
Shallow & manipulative interpersonal relationships
Self-centeredfocus & failure to adhere to regulations
Impulsive, aggressive, charismatic, deceitful
Experience guilt & depression but lack capacity to empathize
Antisocial behaviour: criminal behavioursmay or may not be present
Co-morbiditywith borderline, narcissistic, histrionic & schizotypal PDs
Antisocial mode model
punitive parent: aggressive, abusive
inner shell-> vulnerable child: abused, abandoned
outer shell-> enraged child: aggressive when treated unfairly
adult modes:
predator: hurting or killing to get rid of people they don’t like
bully and attack: acting aggressively in planned manner to accomplish needs
conning/manipulative: lying, cheating
Narcissistic PD
Personalities organised around maintenance of self-esteem by eliciting external admiration to compensate for internal sense of falseness
Fragile self-esteem, envy, self-consciousness, and vulnerability: image replaces substance
Compensatory reaction: self-righteousness, pride, contempt, vanity and superiority
Pervasive pattern of grandiosity, sense of entitlement, privilege, or expectation of preferential treatment, exaggerated sense of self-importance, arrogant behaviour and attitudes
Focus on own issues with insensitivity or impatience to problem of others: cold, disinterested, snobbish, patronizing
Comorbid with: antisocial, histrionic, borderline PDs & substance abuse
Narcissistic PD mode model
demanding parent: extremely high standards for success, showing emotion is weak
vulnerable child: feels like a failure, humiliated, powerless, unable to meet parental standards
enraged child: gets aggressive when others address issues related to the vulnerable child mode
self-aggrandiser:
- inflated sense of self-importance
- unrealistic ideas
- devaluation of those who can’t admire them
- “i deserve recognition”
