lecture 6 Flashcards
what does the DSM-5 suggest that personality disorders are?
enduring patterns of inner experience and behaviour that deviates from cultural expectations, is pervasive and inflexible, has an onset in adolescence/early adulthood, is stable over time and leads to impairment
what is inner experience impacted by?
cognitions
affectivity
interpersonal functioning
impulse control
what does it mean for a personality disorder to be stable?
can be traced back to adolescence or before
what are the two forms of classification for a personality disorder?
categorical classification
dimensional classification
what is categorical classification?
absence or presence of a mental disorder
qualitatively distinct from each other, and normal personality
no assumptions about their underlying dimensions/structure
used by the DSM-5
what is dimensional classfication?
continuous dimensions of traits
quantitvely distinct from normal personality
extreme and maladaptive levels of personality traits
how many clusters is the categorical classification composed of?
3
what are the personality disorders in cluster a?
paranoid
schizoid
schizotypal
what are the personality disorders in cluster b?
antisocial
borderline
histrionic
narcissistic
what are the personality disorders in cluster c?
avoidant
dependent
obsessive-compulsive
what is paranoid personality disorder?
distrust and suspicion of others across contexts and without reason
what is schizoid personality disorder?
detachment from relationships and restricted emotional expression
what is schizotypal personality disorder?
pervasive discomfort with relationships
eccentric behaviour and cognitive or perceptual distortions
what is the similarity between disorders in cluster a?
not wanting to confide in people
what is antisocial personality disorder?
pervasive disregard of the rights of others, since or before 15 years of age
what is borderline personality disorder?
pervasive instability of inter-personal relationships, self-image and affect
marked impulsivity
what is histrionic personality disorder?
pervasive and excessive emotionality and attention seeking behaviours
what is narcisstic personality disorder?
grandiosity, need for admiration and lack of empathy
what are the similarities between disorders in cluster b?
experiencing high intensity emotions, displaying erratic/provocative behaviours/altered perceptions of others
what is avoidant personality disorder?
pervasive social inhibition, inadequacy, hypersensitivity to negative evaluation
what is dependent personality disorder?
pervasive need to be taken care of
submissive and clingy behaviour
what is obsessive compulsive personality disorder?
pervasive pre occupation with order, perfection and control, at the cost of flexibility
what are the similarities between disorders in cluster c?
underlying fear/anxiety behind behaviour/avoiding situations or people
why does hopwood et al (2018) criticise categorical classification of personality disorders?
instead we should use dimensional classification
no evidence to support discrete personality disorder categories- comorbidity between categories
why does Marinageli et al (2000) criticise categorical classification of personality disorders?
examined comorbidity in personality disorder classification
156 participants were voluntarily admitted to a psychiatric ward
a large percentage of people received multiple diagnoses
suggests there is an underlying dimension
why did Costa and McCrae (1992) criticise the categorical classification of personality disorders?
Five Factor Model: psychoticism is also considered to be a dimensional personality trait
should see a relationship between the personality disorders and 5 factor model
why did Samuel and Widiger (2008) criticise the categorical classification of personality disorders?
conducted a meta-analysis of studies measuring the 30 facets of the Five Factor Model and categorical personality disorders
high neuroticism is associated with most personality disorders
openness to experience doesn’t seem to be related
what was Widiger and Simonsen (2005) dimensional approach to personality disorders?
reviewed proposals which could update the DSM-3 with a dimensional approach to Personality Disorder Classification
proposals can be integrated into a hierachial strcuture of maladaptive personality traits
5 broad traits are:
extraversion-introversion
antagnonism-compliance
constraint-impulsivity
negative affect-emotional stability
unconventiality-closed to experience
how does the trait of detachment relate to FFM?
absence of extraversion
how does the trait of disinhibition relate to FFM?
absence of consc
how does the trait of negative affect relate to FFM?
presence of neuroticism
how does the trait of psychoticism relate to FFM?
no clear consensus
what are the stages in Skodol et al’s alternative model for assessing personality disorders?
step 1: assess impairment in personality functioning
step 2: assess pathological personality traits/dimensional traits
step 3a: apply criteria A and B for specific personality disorders/categorical personality disorders
step 3b: apply criteria A and B for personality disorder trait specified
step 4: apply other inclusion and exclusion criteria
what is criteria A?
maladaptive personality functioning assessed from 0 (no impairment) to 5 (extreme impairment)
what is the hybrid approach to assessing personality disorders?
moderate impairment in at least two areas of identity/self direction/empathy/intimacy
experience 4+ of the 7 facets of maladaptive traits
what did Samuel et al (2013) find out about personality disorders?
clinical sample of 370 participants receiving treatment for substance abuse
55% antisocial, 33% borderline, 18% avoidant
self report measures of traits from the FFM, and a clinical interview for personality disorders
neuroticism trait was the main trait
what did Suzuki et al (2017) investigate about personality disorders?
looked at how similar traits are in the FFM and DSM-5 alternative model
neuroticism vs negative affect had the highest similarity
openness vs psychoticism had the lowest similarity
what did Ahmed et al (2013) find out about the clinical utility of dimensional classification?
compared taxonic vs dimensional classification of schizotypal personality disorder
participants completed the structured clinical interview for DSM-IV
found a higher correlation for the dimensional approach
what did Anderson et al (2014) find out about the clinical utility of the dimensional classification?
compared taxonic vs dimensional classification of borderline personality disorder
looked at key outcomes, eg) self-harm, risky sexual behaviours
clinical sample of newly admitted patients, and a university sample of 399 students
administered the PID-5 for maladaptive traits, and the DSM-4 Axis II personality questionnaire
in both samples, categorical (taxonic) and dimensional maladaptive traits were correlated with key outcomes, and the dimensional maladaptive trait model performed better than the categorical model
what are the advantages of the DSM-5 Alternative Personality Trait Model?
empitical model extending knowledge of the FFM
predicts clinical outcomes
relates to the complexity of syndromes observed in clinical practice
can make finer analysis of the patient’s characteristics
what are the disadvantages of the DSM-5 alternative personality model?
loss of categories thought to have had significant clinical utility
question the strength of the openess to experience-psychoticism dimension
