Lecture 9: Cluster C and Cognitive Models Flashcards
what are 3 consequences of avoidant PD
- high amounts of stress
- isolation from friends and family (low social support)
- negative impact on (academic) career
what are 4 factors that may contribute to development of AVPD
- Conflict avoidance in family
- Avoidant modeling by parents
- (preoccupied)-Avoidant attachment
- Ridicule by parents and rejection → Emotional abuse
what are two hypotheses considering the overlap/differnce between AVPD and SAD
- Continuum hypothesis; AVPD is a more specific part of a larger bubble that includes (non)generalised SAD –> dimension
- Two separate dimensions; AVPD and SAD are 2 different diagnoses with some overlap between them
what are 5 qualitative differences in traits between AVPD and SAD
- Feelings of inferiority; AVPD general avoidance strategy and inferiority, in SAD, more related to specific attributes
- Feared (social) situations; Interpersonal vs. performance
- AVPD more strongly related to introversion, openness, agreeableness
- Clinical experience: AVPD more early experiences of isolation and early onset –> SAD has a later onset.
- In relationships: in SAD, anxiety lessens as relationship develops - in AVPD it doesn’t
for which of the two hypothesis considering the overlap between AVPD and SAD is more evidence
there is evidence for both the continuum hypothesis and the separate dimensions hypothesis. however, AVPD is also present in samples without SAD, patients to do recognise the situational fear response of SAD and there is support for qualitative differences in traits –> this would point towards separate diagnoses
what are the diagnostic criteria for dependent PD
5 out of 8:
1. Difficulty making daily decisions advice and reassurance
2. Needs someone else to take over major life areas
3. Difficulty disagreeing with others
4. Difficulty starting projects on their own
5. Go to great lengths to obtain support from others
6. Feeling uncomfortable or helpless when alone
7. Searches for new relationship after one ends
8. Unrealistic preoccupation with being left alone and unable to care for themselves
what are 2 types of dependency and when are they more common
- Functional dependency; although can be active in certain situations, risk losing relationships –> specifically in DPD
- Emotional dependency; mainly seen in separation anxiety, BPD, depression
explain the cognitive/interactionist model
overprotective/authoritarian parenting, gender role socialisation and cultural attitudes regarding achievements
–> cognitive consequences; schema of the self as powerless and ineffectual
–> motivational effects; desire to obtain and maintain nurturant, supportive relationships
–> behavior patterns; relationship-facilitating self-representation strategies
and
–> affective responses; performance anxiety, fear of abandonment, fear of negative evaluation
what are 2 things you can do as a therapist to minimize the misdiagnosing of DPD
ascertain;
1. age of onset of relevant symptoms
2. the degree to which problematic dependency maybe secondary to another disorder
what are 3 examples of common transference and 4 examples of common countertransference in (response to) patients with DPD
transference:
1. idealisation; maintained through denial of therapist’ imperfections
2. possessiveness
3. projective identification = adopting the therapist’ language/mannerisms
countertransference
1. frustration
2. hidden hostility; passive-aggressiveness
3. overindulgence
4. pleasurable feelings of power/omnipotence; may lead to exploitation
schema
= knowledge representation of the self, others or the world; main function is to help people deal with the enormous amount of info we receive in an automatic manner
–> can be verbal (beliefs and assumptions) or non-verbal
Early Maladaptive Schemas (EMS)
= schemas that develop during childhood from the interaction between biological and environmental factors (eg. maltreatment, parenting practices, lack of supervision, etc)
what are 3 levels of beliefs
from inner to outer circle:
1. core beliefs; who you are and who you believe others to be
2. conditional beliefs; if x than y
3. strategic/intrumental beliefs; do A to get B
what are 3 clusters of coping responses to certain schemas
- overcompensation (fight) = fighting the triggered EMS
- avoidance (flight) = prevent triggering the EMS or it’s triggered to avoid emotions/thoughts
- surrender (freeze) = survive by submitting to what the EMS dictates
schema mode
= an emotional-cognitive-behavioural state which is like a trait; a combination of an activated specific EMS and specific coping style
