Lecture - Psych Med - Personality Disorders Flashcards
- What is the mood improving ingredient in chocolate?
- Is it true that elderly people have depression?
- What do getting an episode of depression and risk of getting another one have to do with each other?
- What is adjustment disorder?
- Resveratrol
- Myth because that’s the good part of life when they reflect and have fun with fam and they are retired
- Getting an episode of depression means a 65% risk of getting another one
- Adjustment disorder: adjustment of both or one of mood/anxiety in face of a stressor – symptoms more than bereavement. Criteria is same but locking into a stressor and when stressor relieves, the symptoms will also be relieved.
Personality
1. What is a reductionist approach?
Reductionist approach is when we want to know who we are and what we are like based on quizzes, what category of people we fit into etc
Psychologiclly, the reduction is based on psycholgiical theoraies abt what the fundamental attributes of people are
What does personality mean?
It refers to:
1. PERSONAL CHARACTERISTICS
- EMOTIONAL RESPONSE - how we respond
- TEMPERAMENT: that’s the aspect of personality you’re born with like being fussy. Even when kids are born into the world, they have an inborn series of characteristics - they aren’t completely hard-wired bc even influences in uterus that can change how the person is
- CHARACTER: develops and changes overtime and exposure to people and knowledge
- MENTAL ABILITY - how people perceive us also depends on this
- GENES AND ENVIRONMENT:
Eysenck:
- What is it?
- What are the three things in the personality-finding-out that is in the Eysenck model?
- Tell me about the brain stem and extroverts vs introverts
- I’m pretty sure it’s just a system to find out your personality
- He talks about EXTRAVERSION (vs introversion)
-Do you like mixing with people
-Are you lively
Then he talks about NEUROTICISM (vs emotional stability) - refers to worry and anxiety
-Do you often feel ‘fed up’?
-Do you often feel lonely?
Then he talks about PSYCHOTICISM (vs self control) - disorganisation vs being in control
-Do good manners and cleanliness matter to you?
-Do you like taking risks for fun? - Eysenck believed that personality is a function of how much arousal is produced in the brain stem. Extroverts require a high amount of input from external environ to reach homeostasis/baseline level of arousal and introverts are people who have a high level of internal cortical stimulation so more from environment is overloading them. In our world, we cater for extroverts and introverts are seen as bad - they don’t want to get up and talk in public.
What are the big 5 personality characteristics (in the Big5 theory)?
- Neuroticism:
- anxious vs oblivious to danger - Extraversion
- intense attachment vs cold - Openness
- unrealistic vs concrete - Agreeableness
- Gullible vs skeptical - Conscientiousness
- perfectionist vs lax (this trait has to do with success)
What is the Cloninger’s model of personality?
He says that four things are in born and three things are what we acquire. Like for the things that are inborn:
- NOVELTY SEEKING (aka getting bored of things and wanting more experiences - Sehaj has a very high level of novelty seeking)
- HARM AVOIDANCE
- REWARD DEPENDENCE: how much we want input from other people
- PERSISTENCE: how determined you are kinda
Then the three things that are ‘character’ aka developed overtime:
- SELF-DIRECTEDNESS: How much you can change course in your life etf
- COOPERATIVENESS: how much you cooperate with others
- SELF-TRANSCENDENCE: your sense of higher purpose (like God) or higher good and your connection to that
There is genetic variation that accounts for the expression of these characteristics. The brain volume in different areas varies in size according to these characteristics
Personality disorders:
- What is it a deviation in?
- _____, inflexible across range of situations
- Causes significant d_____
- What sort of pattern and duration? What about onset?
- Not better accounted for by…..
- Not due to…..
- Deviation in cognition, affect, interpersonal functioning and impulse control. So it’s like across a range of situations and doesn’t change as a function of info coming in.
- Pervasive, inflexible across range of situations
- Significant distress/impairment
- Stable pattern, long duration. Onset is in early adulthood but shouldn’t diagnose until mid-20s
- Not better accounted for by another mental disorder
- Not due to the direct effects of a substance or medical condition
What are the three clusters of personality disorders?
Cluster A: oddness/unusualness like being paranoid
Cluster B: Dramatic/emotional - unstable sense of self
Cluster C: Having tremendous fear or anxiety
What is the prevalence of PDs and associated things with them?
- Around fifteen percent of general population but it’s hard to get data bc people don’t own up to the symptoms
- There will be tremendous diability
- There will be a greater risk of disease if you have PD
What are the pros and cons of being diagnosed with a PD?
Cons:
- you’re judged - it’s like someone is fundamentally wrong with who the person is at their core
- they’re unreliable
- it will become part of their identity
Pro:
- allows people to seek out treatment
- allows for research
Describe Borderline Personality Disorder and its 9 criteria
What might accompany BPD?
It is a wide-spreading INSTABILITY of relationships, self-image and affects (emotions). It is a marked IMPULSIVITY beginning in early adulthood and present in a variety of contexts, as indicated 5 or more of the following:
- Frantic efforts to avoid real or imagined ABANDONMENT
- Pattern of UNSTABLE interpersonal relationships characterised by alternating bw extremes of idealisation and devaluation
- IDENTITY DISTURBANCE: unstable self-image
- IMPULSIVITY in at least two areas that are potentially self-damaging
- Recurrent SUICIDAL behaviour etc
- Marked REACTIVITY OF MOOD (leading to affective instability)
- Feeling EMPTY chronically
- Intense ANGER
- STRESS-RELATED paranoid ideation
- Self-harm may accompany BPD. We hospitalise the patients to keep them safe bc they self-harm but if that’s chronic self harm and frequent hospitalisation - you’re reinforcing self-harm bc they’ll self harm enough to get admission. This hospitalisation can bring problem like iatrogenic harm, decreased sense of autonomy, they don’t learn an alternative and it doesn’t reinforce their ability to cope with a crisis
How does someone develop a PD?
So attachment - attatchment refers to the connection with our carers; when we cried and they regarded us as important and soothed us etc – they taught us that we were of value and that the world could be trsuted. But if you weren’t given that and your parents were distressed too – if you cried, no one came or if you cried, they harmed you. Then learnt that the world cant be trsuted and something is wrong with you and all that.
Other factors that let a PD develop:
- temperament (people might come out with bad temperament due to e.g. forces in uterus like misuse of alcohol/drugs. They come into world with a different temperament
- goodness of fit bw parents and child - don’t need to be a perfect parent but at least respond 2 out of 3 times with warmth
- your upbriniging
- trauma
- learning of emotional regulation skills
Treatment:
- it’s possible
- requires a trusting relationship though
