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Personality Disorders > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

What are the key aspects of construct validity of PD?

A 
Should a
1. Medical/categorical approach 
or
2. Dimensional approach be used?
Also: what is an ab/normal personality?
What instruments should be used to assess these constructs?
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2
Q

What are the two alternative models of PD?

A

the Five-Factor Model (FFM) & the Alternative Model of Personality Disorder (AMPD)

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3
Q

What are the five factors of the FFM?

A
  1. Openness to Experience
  2. Conscientiousness
  3. Extraversion
  4. Agreeableness
  5. Neuroticism
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4
Q

What are the 5 domains of the AMPD?

A 
Dimensional model, where 25 traits are based on 5 domains: 
1. Negative affectivity
2. Detachment 
3. Antagonism
4. Disinhibition
5. Psychoticism 
ICD-11 uses this approach.
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5
Q

What does personality assessment for PD entail and what does it include?

A

Written, oral and projective instruments
Includes: personal history, weaknesses and strengths, intelligence, defense mechanisms, attachment style, coping styles, social abilities, childhood, traumatic experiences, cognitions, affects, emotion regulation styles, personality traits, environment, support system

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6
Q

Why are we checking for the information we are checking for during the personality assessment?

A

To obtain objective data on a patient’s psychological functioning.

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7
Q

How is personality assessed?

A 
with evidence-based practices.
The "unstructured clinician" is biased by:
1. Personal interest/bias
2. Gender stereotypes
3. Overdiagnosis or underdiagnosis
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8
Q

What are recent developments in assessment of PDs?

A

The clinical value of DSM-V classification:
- underlying personality dynamics
- descriptive/categorical vs structural dynamic assessment
- context
Need for “performance based” measures

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9
Q

What are the six domains of psychodiagnostics?

A 
Domain 1: Manifest Pathology/Symptomatology
D 2: Relationships/Support System
D 3: Cognition and Schemas
D 4: Personality Structure/Dynamics
D 5: Attachment / Early Trauma 
D 6: Temperament / Biological Make-Up
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10
Q

What is the aim of the “Manifest Pathology/Symptomatology” Domain?

A

The use of objective and subjective symptoms

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11
Q

What is the aim of the “Relationships/Support System” Domain?

A

Gaining knowledge about the clients support system

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12
Q

What is the aim of the “Cognition and Schemas” Domain?

A

Gaining knowledge about implicit and explicit schemas.

-> they are dominant themes regarding oneself, others and the world. They are conscious and familiar

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13
Q

What is the aim of the “Personality Structure/Dynamics” Domain?

A

The aim is not to diagnose, but to generate hypotheses about the structural and underlying vulnerability of the patient.

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14
Q

What is the aim of the “Attachment / Early Trauma “ Domain?

A

To get an idea of someone’s attachment style, their interpersonal dynamics in short-term and long-term interpersonal relationship.
-> Type of attachment (avoidance and anxiety) can be mapped on two-dimensional scale

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15
Q

What is the aim of the “Temperament / Biological Make-Up” Domain?

A

Knowledge of stable personality characteristics/biology

-> trait-oriented

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16
Q

What instruments are used to measure the “Cognition and Schemas” Domain?

A
  1. Young schema questionnaire (YSQ)

2. Nederlandse Persoonlijkheids Vragenlijst -2

17
Q

What instruments are used to measure the “Relationships/Support System” Domain?

A

Clinical interviews/hetero-anamnesis

18
Q

What instruments are used to measure the “Personality Structure/Dynamics” Domain?

A
  1. MMPI-2-RF/MMPI-3 (Minnesota Multiphasic Personality Inventory
  2. Dutch Short Form of the MMPI
  3. Projective Tests
19
Q

What instruments are used to measure the “Attachment / Early Trauma” Domain?

A
  1. Adult Attachment Interview
  2. Trauma-related questionnaires
  3. Video Early development
20
Q

What instruments are used to measure the “Temperament / Biological Make-Up” Domain?

A
  1. Temperament and Character Questionnaire

2. Revised NEO Personality Inventory (NEO-PI-3)

21
Q

What instruments are used to measure the “Manifest Pathology/Symptomatology” Domain (4)?

A
  1. File research, clinical judgement
  2. WAIS-V (intelligence)
  3. SCID-5 (asking for presence of each criterion from DSM-5) or PID-5
  4. UCL (coping), SCL-90 (psychological and physiological symptoms)
22
Q

What are three approaches to PDs different to the DSM?

A
  1. Taxometrics
    - > evidence for dimensional structure: Cluster C, Paranoid PD & Borderline PD
    - > evidence for categorical structure: schizotypal PD
  2. Three-step criterion (Millon, 1986) of functional inflexibility, self-defeating circles and tenuous stability under stress
  3. Tripartite criterion by Liveseley (2003)
    a) failure of the self-system to establish stable and integrated representation of self and others
    b) Maladaptive functioning in interpersonal relationships
    c) Failure to develop and maintain prosocial and cooperative relationships
23
Q

What are pro’s of the DSM-5’s all-or-none representation of PDs?

A
  1. Practical appeal (easier to define)
  2. can be clearly described
  3. guide clinical decision making
  4. can serve as convenient and efficient shorthand communication
24
Q

How does diagnosing of PDs look like in the DSM 5?

A

Two-step procedure:

  1. Establishing whether patient meets the general criteria (manifestation of pattern in two or more: cognition, affectivity, interpersonal functioning or impulse control)
  2. Establishing whether pattern has been inflexible and pervasive across a broad range of personal and social situations and has led to clinically significant distress or impairment in social, occupational or other areas of functioning.
25
Q

What pros and cons of the polythetic criteria used to define PDs in the DSM-5?

A

Pro:
- possibility to capture a wide range of psychopathology;
- gives a possibility for a variety of different people to share the same diagnostic criteria
Con:
- some criteria are more essential than others

26
Q

DMS-5 PDs are a mixture of symptoms, behavioral expressions of traits, and traits themselves. What are major advantages and disadvantages of this view?

A

Major advantage: minimal inference is needed on part of the diagnostician, promoting interrater reliability
Major disadvantage: operationalized criteria tend to favor behavioral expressions at the expense of characteristic patterns of inner experience (e.g. motivation of behavior, affective experience)

27
Q

What are the links between the FFM and the DSM-5 AMPD?

A
  1. Negative affectivity - Neuroticism
  2. Detachment - Extraversion (low)
  3. Antagonism - Agreeableness
  4. Disinhibited - Conscientiousness
  5. Psychoticism - Openness

Personality Disorders (4 decks)

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