PD's Flashcards

1
Q

Personality described as ______________

A

consistent patterns of thinking, feeling, behaving with traits that are consistent over time + context

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2
Q

A personality disorder (PD) arises when

A

traits are; inflexible, self-defeating, cause distress or

dysfunction.

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3
Q

DSM classifies PDs as _________________

A
“enduring pattern of inner experience + behaviour that deviates from the cultural norm" 
persistent and inflexible
onset in adolescence,
stable over time
leads to distress/ impairment
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4
Q

DSM outlines _______ PD’s with ________ clusters

A

10; 3

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5
Q

PD clusters are ___________

A

Odd/eccentric
dramatic/erratic
anxious/fearful

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6
Q

Which is INCORRECT;
a) 10% of gen pop meet criteria for 1+ PD
b) PD are MORE common in people with
psychiatric disorder
c) Cluster B associated with mood disturbances (MDD/anx)
d) All PD’s are lifelong

A

D

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7
Q

There is no difference in using a structured vs unstructured interview for diagnosing PD
T/F

A

False - DSM provides specific criteria + structured interviews for diagnosing.Unstructured
interview= disagreements among practitioners.
Diagnosis from structured interviews give better 5 year prognosis of function + symptoms

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8
Q

Which cluster/s is most associated with physical ilness?

A

A+B

Odd /eccentric + dramatic/irratic

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9
Q

Describe the main issues with the DSM approach of PD’s

A

PD’s are not stable over time, person can fluctuate in severity/ subclinical levels
PD’s often comorbid and so may present with symptoms of several disorders

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10
Q

How does the alternative model of the DSM address the issues of the DSM classification of PD’s

A

Attempts to address the problem of comorbidities by reducing amount of PD’s.
Condensed to 6 disorders, removing;
schizoid, histrionic, dependent, paranoid

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11
Q

How does the alternative model propose to assess PD’s

A

Incorporate personality trait dimensions and diagnosing disorders solely based on extreme scores assessing these traits.

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12
Q

The alternative model of the DSM proposes assessment of __________ personality traits

A
  1. negative affectivity / emotional stability
  2. detachment / extraversion
  3. antagonism / agreeableness
  4. disinhibition / conscientiousness
  5. psychoticism
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13
Q

The advantages of the alternative DSM model are _________

A

a) because PD’s are so variable, alt model is more detailed + allows clinicians to specify area of impairment
b) ratings of TRAITS more stable than assigning broader PD label
c) personality traits give better predictor of outcome i.e. negative affect = worse anx/depression
d) helps link DSM with current research

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14
Q

Some risk factors common to all PD’s are___________

A

Childhood abuse/ neglect
early childhood adversity
aversive/unaffectionate parental styles

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15
Q

Cluster A has ____ disorders that include __________

A

3; schizoid, schizotypal; paranoid

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16
Q

Common to all odd/eccentric PD’s is ____________

A

odd, bizarre thoughts and experiences but to a lesser degree than what is seen in schizophrenia

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17
Q

Paranoid PD symptoms____________

A

suspicious of everyone expect to be mistreated
Secretive,
interpersonal conflicts with others that reinforce beliefs
that others can’t be trusted

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18
Q

DSM criteria for paranoid PD requires _________ amount of symptoms

A

4+ in many contexts

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19
Q

How is paranoid PD DIFFERENT from paranoid schizophrenia?

A

Does NOT involve loss of social + occupational functioning
Hallucinations + delusions absent
Cognitive disorganisation absent

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20
Q

Typical features of schizoid PD____________

A

Lack of desire/enjoyment of close relationships/sex
Lack of close friends
Appear absent, aloof. Do not express warmth
Rarely experience strong emotions
Dont respond to pos/neg feedback. Only interested in pursuing own goals

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21
Q

DSM-5 requires __________ symptoms met for a schizoid PD diagnosis

A

4+

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22
Q

Schizoid PD characterised by ______________

A

Eccentric thoughts + behaviour,
interpersonal detachment, generally aloof
suspicions that others will hurt them, may lack self care
May have delusions, magical thoughts, ideas of reference, illusions
talking to self

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23
Q

The difference between magical thoughts and ideas of reference is that _____________

A

MT - belief that one’s ideas, thoughts, actions influences the course of events i.e. mind reading, seeing future
IoR - beliefs that X event have particular meaning for them personally i.e. news anchor was relaying secret message to them

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24
Q

Difference between schizophrenia and schizotypal PD

A
  • symptoms aren’t as persistent + intense as in schizoph

- clients may be made aware of their false perceptions whereas schizoph lacks insight

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25
Q

DSM- requires ________ symptoms for diagnosis of schizotypal

A

5+

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26
Q

Genetic vulnerability overlap exists between
schizotypal + schizophrenia
T/F

A

True

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27
Q

What neuropathology associated with cluster A PD’s

A

Larger ventricles,

smaller grey matter in temporal lobes

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28
Q

Treatment for schizotypal PD _____________

A

Risperidal to reduce unusual thinking. Limited knowledge about psychotherapy here

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29
Q

Shared qualities in dramatic / erratic PD’s ___________

A

inconsistent behaviour, inflated SE, rule-breaking behaviour, exaggerated emotional displays.

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30
Q

Antisocial personality disorder is characterised by________

A

Disregard for others, aggression, impulsive, show little remorse,

31
Q

APD requires that clients have history of _________ before age 15

A

Conduct disorder

32
Q

APD can be illustrated as ____________in adulthood

A

Difficulty keeping jobs, low financial stability, law breaking,

33
Q

Which is INCORRECT;

a) Men are 5x more likely to have APD.
b) MDD often associated with APD
c) 75% of felons meet APD criteria.
d) Disregard for others <15yo, identified by 3 symptoms

A

B - associated with SUD not MDD

34
Q

Which is INCORRECT;

a) Psychopathy is diagnosable by the DSM
b) Characterised by poverty of emotions
c) Pschopaths don’t experience anxiety
d) Psychopaths dont experience empathy

A

A - not a DSM disorde.

35
Q

How does lack of anxiety in psychopathy affect behaviour

A

Due to not experiencing the apprehension we typically associate with law breaking etc., they lose the ability to LEARN from mistakes. Leads them to repeat misconduct even if it means harsh consequences.

36
Q

3 core traits underlying psychopathy are ________. This is best identified with ____________ assessment tool

A

meanness, impulsivity, boldness; Psychopathy checklist revised (PCL-R). 20 item questionnaire based on clinical interview + criminal/MH record

37
Q

The distinction/s between APD and psychopathy are __________

A

a) APD criteria has more affective descriptors that aren’t covered in PCL-R
b) APD requires that person displays symptoms before 15

38
Q

People scoring HIGH on APD will subsequently score high on PCL-R
T/F

A

False

39
Q

Aetiology of APD / psychopathy ____________

A

APD - Parental negativity, lack of warmth, inconsistency, poverty, exposure to violence, deficits in PFC
Psychopathy - Polymorphism of MAO-A gene ALONGSIDE childhood adversity (abuse, lack of maternal affection)

40
Q

The INCORRECT statement is;

a) BPD is very common in clinical settings,
b) Often experience multiple lifetime suicide attempts
c) BPD clients develop a strong sense of self
d) BPD clients are impulsive and have unstable relationships + moods

A

C - false

41
Q

DSM requires ____ symptoms for BPD. Some of these are_________.

A

5+;
Frantic efforts to avoid abandonment, unstable relationships where others are devalued OR idealised, Unstable sense of self,
Recurrent suicidality / self harm, frequent+ poorly controlled anger,
Chronic feelings of emptiness
Self-damaging + impulsive behaviours (Sex, substances, reckless driving, binge eating)

42
Q

Twin studies regarding BPD suggest ____________however social predictors also include ___________

A

High heritability;

child abuse + neglect

43
Q

How does neurobiology explain BPD symptoms

A

lower serotonin function = low mood
increased amygdala activation = emotion dysregulation
deficits in PFC = impulsivity
disrupted connectivity between PFC +amygdala = poor control of emotional reactivity

44
Q

Linehan’s diathesis stress model explains BPD in terms of ____________

A

Child has pre-existing biological vulnerability. When they are exposed to an invalidating family environment, they feelings get discounted and child’s demands are NOT MET.
= child has emotional outbursts as a consequence to which parents DO RESPOND TO
their response reinforces the child’s emotional reactivity

45
Q

The CORRECT one is;

a) hospitalisation is often required for BPD patients
b) hospitalisation is not required for BPD
c) voluntary hospitalisation is common in BPD
d) none of the above

A

A - often required

46
Q

A struggle that therapists face in treating BPD clients is

A

They are temperamental in their therapeutic relo as they are in personal ones, so find it hard to trust others

47
Q

Dialectical therapy works in 2 stages, they attempt to

A

Combine the ‘thesis’ (phenomenon) and ‘antithesis’ (opposite) to create a COMPROMISE between both (synthesis).
 Therapist both accepting client as they are + helping client change
 Client realising that world doesn’t need to be dichotomous, instead can be a synthesis of
both

48
Q

Dialectical therapy is a combination of ____________ approaches

A

Acceptance + CBT

49
Q

Psychotherapy for BPD invovles____________

A
  1. Dangerous impulsive behaviours are addressed i.e. suicidality = develop coping strategies
  2. Learn to modulate emotions, coach to tolerate emotional distress, learn to notice emotions
    in a non-judgemental manner i.e. without rushing to impulsive action
  3. Improve relationships + SE
  4. Improve connectedness + happiness
50
Q

Histrionic PD is associated with____________ behaviours

A

dramatic + attention-seeking behaviour, expressed through clothes, makeup, hair.
emotionally shallow
uncomfortable when not centre of attention.
inappropriately seductive
Speech dramatic but lacks detail
Misreads relationships as more intimate than they are

51
Q

Histrionic PD requires ___________ symptoms

A

5+

52
Q

Narcissistic PD features_____________

A

Grandiose sense of self preoccupied with fantasies of great success, lack of empathy, arrogance, envy, habitual use of others, entitlement, excessive need to be in
charge

53
Q

Narcissists are vulnerable to feeling _________ and are _________ to criticism. DSM requires ________ amount of symptoms

A

envy; sensitive; 5+

54
Q

How does parenting contribute to narcissism development?

A

over indulgence leading to inflated sense that they are more special than other kids
OR in cases of child abuse/neglect narcissism is a defence-mechanism against underlying feelings of inadequacy

55
Q

How does Kohut describe the self-psychology model of NPD?

A

NPD tendencies arise out of a chronic need for validation due to a crippling low SE, supported by evidence that NPD has greater sensitivity to shame

56
Q

What is the social-cognitive model of NPD

A

(1) NPD=fragile SE that constantly needs reassurance
(2) interpersonal relations important to bolster SE, rather than closeness.
Is likely to brag, (cogntive biases) which is tolerated by others by extent, when others don’t like it, NPD will vilify, alienate bc don’t serve them anymore

57
Q

Avoidant PD is part of __________cluster

A

C - Anxious/fearful

58
Q

Avoidant PD is likely to present as___________

A

Fearful of criticism, rejection, disaproval. Avoid jobs + relationships to protect against negative
feedback (though they want to).
Socially timid bc of fear of behaving foolishly,
embarrassment/ showing signs of anxiety.
Believe they are incompetent + inferior,
reluctant to try new things.

59
Q

The PD’s in cluster B are__________ and is called the _________ cluster

A

antisocial, narcissistic, histrionic, borderline; dramatic/erratic

60
Q

Cluster A consists of __________ and is called the ________ cluster

A

paranoid, schizoid. schizotypal; odd/eccentric

61
Q

Avoidant PD requires___________ symptoms count

A

4+

62
Q

Treatment for Avoidant PD is ___________

A

CBT with exposure therapy, 20 sessions
group CBT
Anidepressants

63
Q

Dependant PD mainly involves

A

Excessive reliance on others. Intense need to be taken care of, uncomfrotable being alone. Will compromise their own needs in order to preserve protective relationship with other. See self as weak

64
Q

DSM requires_______ symptoms for dependent PD, some of these are___________

A

5+;
cant make decisions without reassurance, need others to be responsible for major areas of their life; difficulty disagreeing with others bc fear losing them, doing bad things to get approval, preoccupied with fears of taking care of self alone,

65
Q

The INCORRECT statement is;

a) despite passivity, dependent PD is actually capable of tasks
b) overreliance in DepPD is a method of maintaining relo rather than goal attainment
c) men with DepPD prone to violence
d) DepPD are likely to get AN + BN

A

D - more likely to get BN + anx

66
Q

The parenting style associated with DepPD is________

A

Overprotective - reinforce dependency

Authoritarian - limit child’s opportunities to develop self efficacy

67
Q

Obsessive-compulsive PD is characterised by_____________

A

Perfectionist, preoccupied with details. oriented towards work than pleasure/social relationships, extreme difficulties making decisions + time allocation. Interpersonal relationships strained bc they insist on it being their way. serious, rigid, formal, inflexible, especially regarding morals.

68
Q

OC - PD have a tendnecy to _____________

A

be unable to disregard useless objects even if they are not sentimental, are FRUGAL

69
Q

Difference between OCD / OC-PD

A

does not have same obsessions + compulsions, BUT often co-occur and may share genetic aetiology.

70
Q

DSM requires___________ symptoms for OC-PD, one of these are Miserliness, this refers to__________

A

4+; being frugal

71
Q

The INCORRECT one is;

a) PD patients often have good insight
b) often enter tmt for another issue i.e. SUD
c) PD’s typically mean slower improvement
d) psychotherapy is the tmt of choice for PD

A

a - do NOT have insight

72
Q

Which type of therapy is oftne used for PD and WHY

A

Psychodynamic; because PD often related to childhood trauma. Involves
 reconsider these experiences
 become aware of how these experiences drive their current behav

73
Q

Is treating specific personality traits effective for PD?

A

useless bc they are too ingrained and change from cases so instead therapist
seeks to change disorder into a more adaptive way of approaching life