personality [ch.15, WA7, ]

Question 1

Describe the level of inter-rater reliability obtained for the DSM-5 personality disorders with structured diagnostic interviews and with unstructured diagnostic interviews.

Answer 1

Most personality disorders can be reliably assessed when structured diagnostic interviews are used: Inter-rater reliability correlations have been .79 or higher, with the exception of schiz- oid personality disorder, where agreement is more modest. Inter- rater reliability when clinicians use unstructured interviews is not adequate for personality disorders;

Question 2

List two primary concerns about the DSM-5 approach to personality disorders.

Answer 2

Personality disorders are not as stable as the definition implies, and they are highly comorbid with each other.

Question 3

List two ways in which the alternative DSM-5 approach to personality differs from the approach that appears in the main body of the DSM manual.

Answer 3

Six personality disorders instead of 10, and the use of person- ality trait domains and facets (dimensional scores)

Question 4

What is the level of heritability for personality disorders?

Answer 4

Moderately high, with estimates for the six specific personality disorders ranging from .64 to .78;

Question 5

Describe the magnitude of the effect of childhood adversity on the risk for personality disorders
observed in the Children in the Community Study.

Answer 5

Children who experienced abuse or neglect were 18 times as likely to develop narcissistic personality disorder, more than seven times as likely to develop borderline personality disorder, and about five times as likely to develop antisocial personality disorder compared with those with no history of abuse or neglect. Parental neglect also increased the risk of avoidant personality disorder.

Question 6

Which personality disorder is most related to schizophrenia in family history studies?

Answer 6

schizotypal PD

Question 7

Which personality disorder is most centrally characterized by an aloof interpersonal style?

Answer 7

Schizoid PD

Question 8

Which personality disorder is most common in clinical settings?

Answer 8

borderline PD

Question 9

Which two of the cluster B personality disorders are strongly related to impulsivity?

Answer 9

antisocial + borderline PD

Question 10

Which personality disorder is most common in forensic settings?

Answer 10

antisocial PD

Question 11

clinical case:
Mariana refuses to meet with customers. She states that she is terrified that they will see that she does not know much. It turns out that she has called in sick the last three times her boss scheduled an appoint- ment with her, and her colleagues barely know her name. When asked, she says that meeting with any of these people makes her feel horribly nervous about potential rejection of her ideas. She asks for a position that would involve little social contact.

Answer 11

avoidant PD

Question 12

clinical case:
Sheila has had three subordinate employees request transfers from her department. They each stated that she was too controlling, picked on small mistakes, and would not listen to any new ideas for solving problems. At the interview, she brought in a typed, 15-page chart of the goals she would like to execute for the company. Despite having an inordinate number of goals, she has failed to complete a single project during her first year with the company.

Answer 12

Obsessive-compulsive PD

Question 13

clincial case:
Police contact you to let you know that they have arrested Sam, one of your employees. He was caught at a bank trying to cash a $10,000 company check on which he had forged the signature. You learn that Sam had previously defrauded three other companies. When you meet with Sam, he does not seem the least bit sorry.

Answer 13

antisocial PD

Question 14

What type of medication is used in the treatment of schizotypal personality disorder?

Answer 14

antipsychotic medication

Question 15

What types of treatments have been shown to be more helpful than treatment as usual for borderline
personality disorder?

Answer 15

Dialectical behavior therapy(DBT) and two forms of psychodynamic therapy (transference-focused therapy and mentalization therapy)

Question 16

What are the 4 stages of treatment in DBT?

Answer 16

Phase 1: Address danger- ous behaviors, Phase 2: Teach emotion regulation skills such as mindfulness, Phase 3: Improve relationships and self-esteem, Phase 4: Promote connectedness and happiness

Question 17

True or false?: personality dimensions cannot be changed

Answer 17

False, they (some) can

Question 18

Which of the following statements regarding personality disorders is true?

• A personality disorder is by definition manifested in one’s perception of identity.
• A personality disorder is manifested in one’s relationships, cognitions, emotions, and/or impulse control.
• In order to be diagnosed with a personality disorder, one must have symptoms that are more serious than the symptoms of other disorders that do not involve a personality problem.

Answer 18

• A personality disorder is manifested in one’s relationships, cognitions, emotions, and/or impulse control.

Question 19

A pitfall in diagnosing a personality disorder is that

• clinicians may be biased, for example because they are more likely to consider certain behaviors as pathological in women than in men.
• some clinicians still use an old version of the DSM, for example the DSM-IV instead of the DSM-5, which may cause a client to get a wrong diagnosis.
• the answers to questions about perceived symptoms given by friends and family may differ from the answers given by the client.

Answer 19

• clinicians may be biased, for example because they are more likely to consider certain behaviors as pathological in women than in men.

Question 20

In what way do the traits found in personality disorders differ from ‘normal’ personality traits?

1. The degree of rigidity and inadequacy of certain personality traits.
2. The burden they place on the person concerned and/or others.
3. Both 1 and 2 are correct.

Answer 20

3. Both 1 and 2 are correct.

Question 21

Which personality trait occurs mainly in the odd/eccentric cluster of personality disorders ?

• Deviations in thinking and perceiving.
• Considerable worry and inflexibility.
• A dramatic emotional presentation.

Answer 21

• Deviations in thinking and perceiving.

Question 22

Which personality disorder is most common in the community (i.e. not in treatment settings)?

• Antisocial personality disorder.
• Dependent personality disorder.
• Borderline personality disorder

Answer 22

Antisocial personality disorder.

Question 23

cluster A - odd/eccentric

Answer 23

paranoid, schizoid, schizotypal

Question 24

cluster B - dramatic/erratic

Answer 24

antisocial, borderline, histrionic, narcissistic

Question 25

cluster C - anxious/fearful

Answer 25

avoidant, dependent, obsessive-compulsive