Personality and Assessments Flashcards
Personality
Characteristic patterns of thinking, feeling and behaving, with a particular combination of traits
Traits
Pattern and manner of relating to the world
5-Factor Model of Personality
Neuroticism Extroversion Openness to experience Agreeableness Conscientiousness:
Neuroticism
Inclination toward negative emotions
Extroversion
Sociability, energy, affective expression
Openness to experience
Curiosity, creativity, adventurousness
Agreeableness
Trust, helpfulness, altruism
Conscientiousness:
Self-discipline, persistence, motivation
Personality Disorder
Behaviour pattern that deviates from cultural norms onset in adolescence or early childhood, leads to distress and/or impairment
Personality Disorder Behaviour Pattern
Thinking, feeling, interpersonal relationships, impulse control
Must demonstrate persistent difficulties in 2 of these 4 areas
Personality Disorder (DSM-V) -diagnosis and common Elements
A
(odd, eccentric)
Paranoid
Schizoid
schizotypal
-discomfort in interpersonal relations, emotionally distant, isolated, distrustful and suspicious
Personality Disorder (DSM-V) -diagnosis and common Elements B (dramatic, emotional, erratic)
Antisocial Borderline Histrionic Narcissistic Excessive and unstable emotional expression, maladaptive interpersonal interactions, disregard for the needs/rights of others
Personality Disorder (DSM-V) -diagnosis and common Elements C (anxious or fearful)
Avoidant
Dependent
-obsessive-compulsive
Anxiety (fear of rejection or humiliation, need to be cared for, preoccupation with perfection)
Borderline Personality Disorder
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
Prevalence of Personality disorders in Canada
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
Cause of PD
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
PDS – Other Factors
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
Occupational performance issues
Social participation
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
Occupational performance issues
Emotional modulation
Cluster B may have extremes or emotion, impulsivity, self-harm
Occupational performance issues
Coping
Cluster B may have substance use co-morbidities
Cluster C may rely on others for coping
Psychosocial Factors
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
Medical Treatment
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
Recovery as experienced by women with BPD
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
Coping and occupation
Managing and adapting
Both adaptive and maladaptive coping strategies
Managing stress
Managing symtoms
-identify and draw or personal strengths
-in crisis
Emotional regulation Questionnaire (ERQ)
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
Personal Recovery Outcome Measure (PROM)
-recovery outcome measure designed by an OT
-adolescents , adults
30 items
0-4 point scale
- Client centredness
Focus on developing therapeutic relationship
Validate clients emotional experience
Balance trust with boundaries
Your consistency is key
Information
How would you set expectations and boundaries with the client
