Personality Flashcards
Normal personality
patterns of perceiving relating to and thinking about the world and oneself
* Consistent over time
* Consistent across areas of one’s life
* Shaped by cultural expectations
* Facilitate social and occupational functioning
Unhealthy personality function
rigidity, applying same concept to different situations
Personality disorders
Enduring pattern of inner experience and behavior that deviates markedly from cultural expectations
Manifests in at least two areas
1. Cognition
2. Affectivity
3. Interpersonal functioning
* Dysfunctional relationships, bad at behaving well with others
4. Impulse control
Inflexible and pervasive: using same strategy across situations, pervades all areas of life
Distress or impairment
Stable and long standing
Cognition
Common distorted thinking patterns
All or nothing thinking
Idealizing then devaluing other people of the self
Distrustful,suspicious thoughts
Personality disorders
Often the relationships with PDs form are fraught with problems and difficulties
Many with PD believe there is nothing wrong with them
Onset that can usually be traced back to adolescence or early adulthood
Dont stem from reactions to stress but form developing an inflexible and distorted personality
Over Developed and undeveloped behavioral strategies(ways of existing in the world to get through life) specific to each personality disorder are used across situations and time
Strategies may have been adaptive when first developed
Epidemiology
of Personality disorders
Up to 10-20% of general population
Some more frequent in men (ASPD)
Some more frequent in women (BPD)
Increased rates of unemployment, homelessness,domestic violence, and substance misuse
Indivduals with PD are at higher risk of early death from suicide or accidents
Associated with poorer respond to treatment
Key factor of treatment is therapeutic relationships, but they are not good at maintaining healthy relationships
Cluster A:Odd/eccentric
Paranoid,schizoid, schizotypal
Cluster B: dramatic/erratic
Antisocial
Borderline
Histrionic
narcissistic
Cluster C:Anxious/fearful
Avoidant
Dependent
Obsessive-compulsive
Controversy of clusters DSM
Where is the cut off?
At what point does someone’s score become a personality disorder
Reliability of diagnoses
Very poor reliability of diagnosis in the 80’s
Over time developed more reliable methods
Stability of diagnoses
Overlap of diagnoses
Huge overlap between disorders
Large comorbidity
Gender and cultural issues
Need to infer traits to make diagnosis, don’t have a specific behaviours clinician can judge
Tricky to diagnose
Alternate proposed model
Criterion A: dimensional (0-4) rating of personality functioning in self (identity and self direction) and interpersonal (empathy, intimacy) functioning
Criterion B: dimensional ratings of 25 personality trait “facets” organized into five broad trait “domains”
Criterion C:prototypical system of six PD types
Criterion B: dimensional ratings of 25 personality trait “facets” organized into five broad trait “domains”
high in detachment
withdrawal from interpersonal relationships
Intimacy avoidance
High Negative affectivity
High levels of wide range of negativity
Depression, anxiety, self-harm
Overly dependent on other people
Hostility
antagonism(opposite agreeableness)
Expecting people to do things for you
Unawareness of other peoples needs
Boost ones ego/self enhancement
grandiose attention seeking
Lack of empathy
Manipulative
Disinhibition(opposite consciousness)
Impulsive behavior
No planning for future
Psychoticism(opposite lucidity/openness)
Eccentric
Affecting social relationships
alternate model:Criterion C:prototypical system of six PD types
Avoidant,schizotypal, narcissistic, obsessive-compulsive(less anxiety or fear that OCD), borderline, antisocial
Paranoid Pd
Distrust and suspiciousness
* Unfairly suspects others of exploiting,harming,deceiving
* Preoccupied by doubts about others loyalty trust worthiness
* Reluctant to confide in others
* Reads hidden meanings into benign remarks events
* “Ideas of reference”=reading hidden meanings
Hostility
* Persistently bearing grudges
* Quick to react angry
* Recurrent unjustified suspicions of infidelity
* Generally difficult to get along with, have difficulty with close relationships
* Might appear as excessive aloofness or aggressiveness
Schizoid PD
Detachment from social relationships and restricted emotional expression
Neither desires nor enjoys close relationships
Always choose solitary activities
Little or not interest in sex with others
Indifferent to praise or criticism
Emotionally cold, detached or flattened
Schizotypal PD
Interpersonal difficulties
Unusual or restricted affect
Lack of close friends,confidants
suspiciousness
cognitive/perceptual distortions
Ideas of reference
Odd beliefs/magical thinking
Paranoia
Unusual perceptual experiences
Ie sensing someone there but there isn’t
Eccentric behavior
Odd thinking and speech
Eccentric peculiar behavior
Avoidant PD(cluster c)
Avoidance of social situations
Hypersensitive to negative evaluation and rejection
Inhibition in relationships due to feelings of ineptitude and inadequacy
Avoidance of meeting new people
Fears of being shamed or ridiculed
Overlaps with GAD or social phobia(in characteristics, life course, genetic)
Avoidance of interpersonal relationships
Reluctance to try things that include meeting new people
Dependent PD
Suggested for removal from DSM
Submissive,clinging behavior related to an excessive need to be taken care of
Requires excessive advice/reassurance for everyday decisions
Reluctant to make decisions
Needs others to assume responsibility
Difficulty expressing disagreement with others
Afraid to threaten relationships, don’t want to lose support from people
Lacks confidence to initiative projects or do things on their own
uncomfortable/helpless when alone
Needing a partner right always
Obsessive-compulsive PD
Does not have obsessions or compulsions
Preoccupation with orderliness, perfection, control
Rigid perfectionism interferes with task completion
Excessively devoted to work at cost of leisure time,friendship
Restricted emotional expression
Overly conscientious,inflexible about morality, ethics, values
Overly rigid
Inflexibility
Relationships suffer bc of stubborns
Want tasks to be done in a certain way, not confident other people can do the task their way
Narcissistic PD
Variable and vulnerable self-esteem regulated via attention and approval seeking
Draw sense of self from attention from others
Overt or covert grandiosity, need for admiration
Preoccupied with fantasies of unlimited success
Exploitative,entitled
Envious of others who do have success
Arrogant
Histrionic PD
Excessive emotionality and attention seeking
Uncomfortable when not center of attention
Consistently uses physical appearance to draw attention to self
Theatrical dramatic style
Suggestible
Considers relationships to be more intimate than they are
Borderline PD
Unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
Affective instability due to a marked reactivity of mood
Frantic efforts to avoid real or imagined abandonment
Identity disturbance:markedly and persistently unstable self image or sense of self
Impulsivity in multiple ways that are potentially risky
Recurrent self injury or suicidal behavior or threats
Chronic feelings of emptiness
Intense angry outburst
Transient stress related paranoid ideation or severe dissociative symptoms
Course of BPD
Greatest impairment and risk of suicide in young adulthood
Greater stability in 30s and 40s
50-85% of those diagnosed with BPD do not meet full criteria 10 years later
Etiology of BPD
Biological
Genetic:5x more common among first degree biological relatives
Increases familial risk for substance use disorders,antisocial pd, mood disorder
Poor functioning of frontal lobes
Dysfunction in links between overactive limbic system and underactive amygdala dorsolateral PFC pathway
