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PSYC3018 Abnormal Psychology > Lecture 22 & 23 - Personality Disorders 1 & 2 > Flashcards

Lecture 22 & 23 - Personality Disorders 1 & 2 Flashcards

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1
Q

What are the key factors and issues concerning (DSM-5) classification of personality disorders?

A

Categorical vs. dimensional approach

DSM-5 represents a categorical approach
• assumes that personality disorders represent distinct clinical syndromes
• Advantages: clarity and ease of communicating information
• Disadvantages: difficult to distinguish the threshold where the person goes from a ‘normal’ personality traits through to meeting criteria for a personality disorder
• A gradual move towards a dimensional approach to classifying personality disorders

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2
Q

What are the 3 core features of personality disorders?

Millon, 1981

A
  1. Functional inflexibility
    - Failure to adapt to situations: rigid response
  2. Self-defeating
    - Behavioural responses damaging
  3. Unstable in response to stress
    - Emotional, behavioural & cognitive instability
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3
Q

What are the 3 core features of personality disorders?

Millon, 1981

A
  1. Functional inflexibility
    - Failure to adapt to situations: rigid response
  2. Self-defeating
    - Behavioural responses damaging
  3. Unstable in response to stress
    - Emotional, behavioural & cognitive instability
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4
Q

How are personality disorders organised in the ICD-10?

A

• 9 personality disorders but not clustered & with slightly different labels
• E.g., Antisocial – Dissocial
Obsessive-compulsive - Anankastic

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5
Q

Which PD does this represent?

Consistent & pervasive pattern of distrust, suspiciousness and prolonged grudges held:
• Believing others intentionally exploit, harm or deceive them
• Severely sensitive to criticism & threat
• Misinterprets comments to indicate concealed, hidden or malevolent intent or motivation
• Hostility, aggression & anger to perceived insults
• Jealousy (distrust & misinterpretation)

A

Paranoid PD

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6
Q

What is Paranoid PD co-morbid with?

A

Two thirds meet criteria for other PDs

• e.g., Schizotypal, Narcissistic, Borderline & Avoidant

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7
Q

Which PD does this represent?

• Detachment and disinterest in social relationships
• withdrawal into internal world to avoid affect and
maintain distance from others
• Sees others as intrusive and controlling
• Flatness of affect: coldness, aloofness, self-absorption, social ineptitude or conceit
• Unresponsive to social criticism: sexually apathetic reflecting incapacity to form interpersonal bonds
• Anhedonia

A

Schizoid PD

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8
Q

What is Schizoid PD co-morbid with?

A

schizotypal and avoidant PDs

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9
Q

Which PD does this represent?

  • Marked interpersonal deficits, behavioural eccentricities and distortions in perception & thinking (that do not meet criteria for schizophrenia)
  • e.g.magicalthinking,extremesuperstition,beliefin paranormal phenomenon, bodily illusions
  • Odd thoughts & speech patterns: vague, abstract but retains coherence
  • Often seek treatment for anxiety, depression & affective dysphoria (constricted or inappropriate affect)
A

Schizotypal PD

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10
Q

Which PD does this represent?

  • Marked interpersonal deficits, behavioural eccentricities and distortions in perception & thinking (that do not meet criteria for schizophrenia)
  • e.g. magical thinking, extreme superstition, belief in paranormal phenomenon, bodily illusions
  • Odd thoughts & speech patterns: vague, abstract but retains coherence
  • Often seek treatment for anxiety, depression & affective dysphoria (constricted or inappropriate affect)
A

Schizotypal PD

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11
Q

Which PD does this represent?

  • Repeated reckless disregard for others
  • Victimizing & blaming others for inadequacies
  • Shallow & manipulative interpersonal relationships
  • Self-centered focus & failure to adhere to regulations
  • Impulsive, aggressive, charismatic, deceitful
  • Experience guilt & depression but lack capacity to empathize
  • Anti-social behaviour: criminal behaviours may or may not be present
A

Antisocial PD

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12
Q

Which PD does this represent?

  • Repeated reckless disregard for others
  • Victimizing & blaming others for inadequacies
  • Shallow & manipulative interpersonal relationships
  • Self-centered focus & failure to adhere to regulations
  • Impulsive, aggressive, charismatic, deceitful
  • Experience guilt & depression but lack capacity to empathize
  • Anti-social behaviour: criminal behaviours may or may not be present
A

Antisocial PD

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13
Q

What is Antisocial PD co-morbid with?

A

borderline, narcissistic, histrionic & schizotypal PDs

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14
Q

Which PD does this represent?

• Emotional instability/ affective dysregulation in reaction to environmental & interpersonal situations
• wide range of extreme emotions, intense anxiety, anger, dissociation
• Impulse control
• promiscuity, suicidal behaviour (10% suicide),
self-harm, spending, binge eating, poor limit setting
• Identity/insecure attachments
• Unstable self-concept, frantic efforts to avoid real or
imagined relationships
• Inability to integrate + and - aspects of self leading
to sense of emptiness

A

Borderline PD

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15
Q

Which is the most most prevalent PD in clinical settings?

A

Borderline PD
• 10% of outpatients
• 15-20% of inpatients

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16
Q

What is Borderline PD comorbid with?

A

Rarely sole diagnosis: comorbid with mood disorders, substance-use disorders & anxiety disorders (PTSD)

In fact:
•  15% Major depression
•  10% Dysthymia
•  15% Bipolar I
•  20% Bulimia/anorexia
•  10% Substance abuse
Meet criteria for BPD
17
Q

Which is arguably associated with the greatest levels of disability of all the PDs?

A

Borderline PD

18
Q

Which PD does this represent?

• 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

A

Histrionic PD

19
Q

What is Histrionic PD Comorbid with?

A

narcissistic, borderline, anti-social PDs & psychoactive substance abuse

20
Q

Which PD does this represent?

Fragile self-esteem, envy, self-consciousness, & vulnerability: “image replaces substance”
• Compensatory reactions: self-righteousness, pride, contempt, vanity & superiority
• Pervasive pattern of grandiosity, sense of entitlement, privilege, or expectation of preferential treatment,
exaggerated sense of self-importance, arrogant behaviour & attitudes
• Focus on own issues with insensitivity or impatience to problem of others: cold, disinterested, snobbish, patronizing

A

Narcissistic PD

21
Q

What is Narcissistic PD comorbid with?

A

anti-social, histrionic, borderline PDs & substance abuse

22
Q

Which PD does this represent?

  • Pervasive social inhibition, discomfort in social situations, feelings of inadequacy, low self esteem, hypersensitivity to criticism, disapproval, shame, ridicule & rejection
  • Avoidance of activities involving personal contact & groups
  • Socially inept/incompetent, personally unappealing, inferior to others
A

Avoidant PD

23
Q

What is Avoidant PD comorbid with?

A

dependent PD & Axis I mood, anxiety, & eating disorders

24
Q

Which PD does this represent?

  • Pervasive need to be taken care of
  • Exaggerated fear of being incapable of doing things or taking care of things on their own => reliance on others
  • Lacking in self confidence & requiring constant reassurance
  • Often find themselves exploited and in abusive relationships, fearing abandonment
A

Dependent PD

25
Q

Explain the view of Dependent PD, what makes them feel threatened, their strategy and affect?

A

• Self view: needy, weak, helpless & incompetent
• View of Others: Strong caretaker idealized. Function well as long as the idealized figure is accessible
• Threats: Rejection or abandonment
• Strategy: Cultivate a dependent relationship by
subordinating
• Affect: Anxiety heightened – disruption to the
relationship. Depression if their strong figure is
removed, euphoria/ gratification when dependent wishes granted

26
Q

Which PD does this represent?

Pervasive pattern of perfectionism and orderliness
• Rigidity, inflexibility & stubbornness
• Excessive need for control interfering with ability to maintain interpersonal relationships or employment
• Preoccupied with rules, minor details, structure
• Attention to detail interferes with ability to complete tasks
• Unrealistic standards of morality, ethics or values
• Reluctance to delegate tasks

A

Obsessive-Compulsive PD

27
Q

What is Obsessive-Compulsive PD comorbid with?

A

borderline, narcissistic, histrionic, paranoid, schizotypal PDs

28
Q

Explain the view of Obsessive-Compulsive PD, what makes them feel threatened, their strategy and affect?

A

• Self view: Responsible for themselves & others. Driven by ‘shoulds’.
• View of others: Too casual, irresponsible, self indulgent and incompetent
• Threats: Any flaws, errors, disorganisation.
Catastrophic thinking: things will be out of control
• Strategy: System of rules, standards & ‘shoulds’. Overly directing, punishing and disapproving
• Affect: Regrets, disappointment, and anger toward self and others because of perfectionistic standards

29
Q

Name 2 treatments for Borderline PD?

A
  • Dialectic Behavioural therapy(DBT)

* Schema-focused therapy

30
Q

FIX CARD

A

Epidemiology, Aetiology & Treatment of personality

disorders

PSYC3018 Abnormal Psychology (29 decks)

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