Personality and Assessments

Question 1

Personality

Answer 1

Characteristic patterns of thinking, feeling and behaving, with a particular combination of traits

Question 2

Traits

Answer 2

Pattern and manner of relating to the world

Question 3

5-Factor Model of Personality

Answer 3

Neuroticism 
Extroversion
Openness to experience
Agreeableness 
Conscientiousness:

Question 4

Neuroticism

Answer 4

Inclination toward negative emotions

Question 5

Extroversion

Answer 5

Sociability, energy, affective expression

Question 6

Openness to experience

Answer 6

Curiosity, creativity, adventurousness

Question 7

Agreeableness

Answer 7

Trust, helpfulness, altruism

Question 8

Conscientiousness:

Answer 8

Self-discipline, persistence, motivation

Question 9

Personality Disorder

Answer 9

Behaviour pattern that deviates from cultural norms onset in adolescence or early childhood, leads to distress and/or impairment

Question 10

Personality Disorder Behaviour Pattern

Answer 10

Thinking, feeling, interpersonal relationships, impulse control
Must demonstrate persistent difficulties in 2 of these 4 areas

Question 11

Personality Disorder (DSM-V) -diagnosis and common Elements
A
(odd, eccentric)

Answer 11

Paranoid
Schizoid
schizotypal
-discomfort in interpersonal relations, emotionally distant, isolated, distrustful and suspicious

Question 12

Personality Disorder (DSM-V) -diagnosis and common Elements
B (dramatic, emotional, erratic)

Answer 12

Antisocial 
Borderline 
Histrionic 
Narcissistic 
Excessive and unstable emotional expression, maladaptive interpersonal interactions, disregard for the needs/rights of others

Question 13

Personality Disorder (DSM-V) -diagnosis and common Elements
C (anxious or fearful)

Answer 13

Avoidant
Dependent
-obsessive-compulsive
Anxiety (fear of rejection or humiliation, need to be cared for, preoccupation with perfection)

Question 14

Borderline Personality Disorder

Answer 14

10% of outpatients and 20% of inpatients in psychiatric settings

• high rate of crisis, self-harm and suicide attempts
• instability in interpersonal relationships, self-image and affect, combined with impulsivity
• polarized thinking, intense reactions
• histories of early life trauma, neglect and abuse are common

Question 15

Prevalence of Personality disorders in Canada

Answer 15

PDs affect between 6 and 15 of the population
Most common PDs are obsessive compulsive (7.7%) avoidant (6.6%), Paranoid (5.6%), borderline (5.4%), and schizotypal (5.2%)
-recognizable by adolescence or early adulthood
 may not seek clinical attention till such later
-may be exacerbated by loss of supports or stress

Question 16

Cause of PD

Answer 16

Both behavioural and genetic roots
May have relatives with PD
-especially cluster A
-Borderline PD increased likelihood with first-degree relative
-antisocial PD increased likelihood with first-degree relative (even if adopted)
Brain changes
-Borderline PD has shown overactive amygdala (ability to perceive danger) and underactive prefrontal cortex (decision-making)
May link to early childhood experience
-sexual abuse history 40-70% for people with borderline PD
-unmet needs (attachment), lack of emotional reinforcement

Question 17

PDS – Other Factors

Answer 17

Diagnosed in adolescence and early adulthood 
-tend to be stable over life course 
 antisocial and borderline PD may become less evident with age 
More commonly diagnosed for women 
 histrionic, dependent, borderline PD 
-Most commonly diagnosed for me 
 antisocial PD 
-Cultural considerations

Question 18

Occupational performance issues

Social participation

Answer 18

 cluster A may have difficulty with trust, interest in social connection, may seem odd or eccentric
Cluster B may have intense emotions but lack empathy, have unpredictable behaviours
Cluster C may feel anxious socially or be inflexible

Question 19

Occupational performance issues

Emotional modulation

Answer 19

Cluster B may have extremes or emotion, impulsivity, self-harm

Question 20

Occupational performance issues

Coping

Answer 20

Cluster B may have substance use co-morbidities

Cluster C may rely on others for coping

Question 21

Psychosocial Factors

Answer 21

Affect/mood
 negative emotions (cluster A)
 unstable emotions and low empathy (cluster B)
Anxiety (cluster C)
Actions
-coping/resilience – many demands placed on the determinant
-self-awareness, self-monitoring and regulation – play a role in adaption
Interpersonal Processes
 difficulties here from childhood thought to adulthood
May avoid contact with people or may need excessive reassurance
 Low empathy, ability to perceive needs of others
Self-evaluations
 may lack self-awareness or have unstable sense of self
Thought Process
May under or over interpret information, lack logic and rationality
-thought process may interact with self-evaluations and actions

Question 22

Medical Treatment

Answer 22

Medications: no cure
Cluster A: low dose antipsychotic
Cluster B: mood stabilizer or antidepressant
Cluster C: anti-depressant and benzodiazepines
Psychotherapy
CBT for patterns of thinking
-Dialectical Behaviour Therapy (DBT) for borderline PD
-group and individual therapy
-Distress tolerance skills

Question 23

Recovery as experienced by women with BPD

Answer 23

Person
 letting go of the past, emotional engagement, assertiveness, defining the self
Environment
 healthy relationships
Occupational
 meaningful activities, taking care of oneself, having a project or a job
Facilitators
 education about BPD, self-reflection, social support, daily routine, meaningful roles and activity, anticipation in therapy
Obstacles
-unstable family relationships substance use, stigma

Question 24

Coping and occupation

Answer 24

Managing and adapting
Both adaptive and maladaptive coping strategies
Managing stress
Managing symtoms
-identify and draw or personal strengths
-in crisis

Question 25

Emotional regulation Questionnaire (ERQ)

Answer 25

Designed to assess two emotion regulation strategies:
Cognitive reappraisal and expressive suppression
10 questions, 1-7 scale
Adolescents and adults
Reappraisal items (1, 3, 5, 7, 8, 10)
Suppression items (2, 4, 6, 9)
Gives an indication of the use of cognitive strategies to manage emotions

Question 26

Personal Recovery Outcome Measure (PROM)

Answer 26

-recovery outcome measure designed by an OT
-adolescents , adults
30 items
0-4 point scale

Question 27

1. Client centredness

Answer 27

Focus on developing therapeutic relationship
Validate clients emotional experience
Balance trust with boundaries
Your consistency is key

Question 28

Information

Answer 28

How would you set expectations and boundaries with the client