PD's Flashcards
Personality described as ______________
consistent patterns of thinking, feeling, behaving with traits that are consistent over time + context
A personality disorder (PD) arises when
traits are; inflexible, self-defeating, cause distress or
dysfunction.
DSM classifies PDs as _________________
“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
DSM outlines _______ PD’s with ________ clusters
10; 3
PD clusters are ___________
Odd/eccentric
dramatic/erratic
anxious/fearful
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
D
There is no difference in using a structured vs unstructured interview for diagnosing PD
T/F
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
Which cluster/s is most associated with physical ilness?
A+B
Odd /eccentric + dramatic/irratic
Describe the main issues with the DSM approach of PD’s
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
How does the alternative model of the DSM address the issues of the DSM classification of PD’s
Attempts to address the problem of comorbidities by reducing amount of PD’s.
Condensed to 6 disorders, removing;
schizoid, histrionic, dependent, paranoid
How does the alternative model propose to assess PD’s
Incorporate personality trait dimensions and diagnosing disorders solely based on extreme scores assessing these traits.
The alternative model of the DSM proposes assessment of __________ personality traits
- negative affectivity / emotional stability
- detachment / extraversion
- antagonism / agreeableness
- disinhibition / conscientiousness
- psychoticism
The advantages of the alternative DSM model are _________
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
Some risk factors common to all PD’s are___________
Childhood abuse/ neglect
early childhood adversity
aversive/unaffectionate parental styles
Cluster A has ____ disorders that include __________
3; schizoid, schizotypal; paranoid
Common to all odd/eccentric PD’s is ____________
odd, bizarre thoughts and experiences but to a lesser degree than what is seen in schizophrenia
Paranoid PD symptoms____________
suspicious of everyone expect to be mistreated
Secretive,
interpersonal conflicts with others that reinforce beliefs
that others can’t be trusted
DSM criteria for paranoid PD requires _________ amount of symptoms
4+ in many contexts
How is paranoid PD DIFFERENT from paranoid schizophrenia?
Does NOT involve loss of social + occupational functioning
Hallucinations + delusions absent
Cognitive disorganisation absent
Typical features of schizoid PD____________
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
DSM-5 requires __________ symptoms met for a schizoid PD diagnosis
4+
Schizoid PD characterised by ______________
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
The difference between magical thoughts and ideas of reference is that _____________
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
Difference between schizophrenia and schizotypal PD
- symptoms aren’t as persistent + intense as in schizoph
- clients may be made aware of their false perceptions whereas schizoph lacks insight
DSM- requires ________ symptoms for diagnosis of schizotypal
5+
Genetic vulnerability overlap exists between
schizotypal + schizophrenia
T/F
True
What neuropathology associated with cluster A PD’s
Larger ventricles,
smaller grey matter in temporal lobes
Treatment for schizotypal PD _____________
Risperidal to reduce unusual thinking. Limited knowledge about psychotherapy here
Shared qualities in dramatic / erratic PD’s ___________
inconsistent behaviour, inflated SE, rule-breaking behaviour, exaggerated emotional displays.
Antisocial personality disorder is characterised by________
Disregard for others, aggression, impulsive, show little remorse,
APD requires that clients have history of _________ before age 15
Conduct disorder
APD can be illustrated as ____________in adulthood
Difficulty keeping jobs, low financial stability, law breaking,
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
B - associated with SUD not MDD
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 - not a DSM disorde.
How does lack of anxiety in psychopathy affect behaviour
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.
3 core traits underlying psychopathy are ________. This is best identified with ____________ assessment tool
meanness, impulsivity, boldness; Psychopathy checklist revised (PCL-R). 20 item questionnaire based on clinical interview + criminal/MH record
The distinction/s between APD and psychopathy are __________
a) APD criteria has more affective descriptors that aren’t covered in PCL-R
b) APD requires that person displays symptoms before 15
People scoring HIGH on APD will subsequently score high on PCL-R
T/F
False
Aetiology of APD / psychopathy ____________
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)
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
C - false
DSM requires ____ symptoms for BPD. Some of these are_________.
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)
Twin studies regarding BPD suggest ____________however social predictors also include ___________
High heritability;
child abuse + neglect
How does neurobiology explain BPD symptoms
lower serotonin function = low mood
increased amygdala activation = emotion dysregulation
deficits in PFC = impulsivity
disrupted connectivity between PFC +amygdala = poor control of emotional reactivity
Linehan’s diathesis stress model explains BPD in terms of ____________
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
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 - often required
A struggle that therapists face in treating BPD clients is
They are temperamental in their therapeutic relo as they are in personal ones, so find it hard to trust others
Dialectical therapy works in 2 stages, they attempt to
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
Dialectical therapy is a combination of ____________ approaches
Acceptance + CBT
Psychotherapy for BPD invovles____________
- Dangerous impulsive behaviours are addressed i.e. suicidality = develop coping strategies
- 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 - Improve relationships + SE
- Improve connectedness + happiness
Histrionic PD is associated with____________ behaviours
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
Histrionic PD requires ___________ symptoms
5+
Narcissistic PD features_____________
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
Narcissists are vulnerable to feeling _________ and are _________ to criticism. DSM requires ________ amount of symptoms
envy; sensitive; 5+
How does parenting contribute to narcissism development?
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
How does Kohut describe the self-psychology model of NPD?
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
What is the social-cognitive model of NPD
(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
Avoidant PD is part of __________cluster
C - Anxious/fearful
Avoidant PD is likely to present as___________
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.
The PD’s in cluster B are__________ and is called the _________ cluster
antisocial, narcissistic, histrionic, borderline; dramatic/erratic
Cluster A consists of __________ and is called the ________ cluster
paranoid, schizoid. schizotypal; odd/eccentric
Avoidant PD requires___________ symptoms count
4+
Treatment for Avoidant PD is ___________
CBT with exposure therapy, 20 sessions
group CBT
Anidepressants
Dependant PD mainly involves
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
DSM requires_______ symptoms for dependent PD, some of these are___________
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,
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
D - more likely to get BN + anx
The parenting style associated with DepPD is________
Overprotective - reinforce dependency
Authoritarian - limit child’s opportunities to develop self efficacy
Obsessive-compulsive PD is characterised by_____________
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.
OC - PD have a tendnecy to _____________
be unable to disregard useless objects even if they are not sentimental, are FRUGAL
Difference between OCD / OC-PD
does not have same obsessions + compulsions, BUT often co-occur and may share genetic aetiology.
DSM requires___________ symptoms for OC-PD, one of these are Miserliness, this refers to__________
4+; being frugal
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 - do NOT have insight
Which type of therapy is oftne used for PD and WHY
Psychodynamic; because PD often related to childhood trauma. Involves
reconsider these experiences
become aware of how these experiences drive their current behav
Is treating specific personality traits effective for PD?
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
