Personality disorder

Question 1

Defining characteristics of Avoidant Personality Disorder?

Answer 1

Pervasive patterns of social inhibition, feelings of inadequacy, and hypersensitivity to criticism, often see themselves as inept.

It is also marked by a deep fear of rejection and a negative self view, but often still accompanied by a desire to connect.

Question 2

Differentials to Avoidant Personality disorder?

Answer 2

Social anxiety (Both involve intense fear of social situations and fear of negative evaluations, but avoidant more pervasive feelings of inadequacy, often avoid all social interactions as opposed to specific ones)

Dependent personality disorder (Both involve fear of rejection, reliance on others for validations, but DPD becomes dependant on others, avoidant avoids relations altogether)

Borderline (Both fear of abandonment and sensitivity to criticism, but AP marked by avoidance and social inhibition, borderline has a pattern of emotional dysregulation, instability and impulse behaviours)

Schizoid personality disorder (Both exhibit social withdrawal, but those with Sz lack desire for connection and have a limited range of emotion whereas avoidant desire connection but avoid it.

Paranoid personality (Both distrust of others, but paranoid more emphasis on suspicion, avoidant more based on fear of inadequacy).

Question 3

Main techniques for Avoidant personality disorder?

Answer 3

CBT most effective (Identify cognitive distortions, reframe)

Exposure therapy (gradually expose client to feared scenario)

Schema therapy (identify maladaptive schemas that underly beliefs, e.g reimagining.

Interpersonal therapy (focus on exploring underlying fear in relationships)

Mindfulness techniques.
Self-compassion training.
Role-playing
Group therapy

Question 4

Personality disorder assessment tools?

Answer 4

MMPI -A

MMPI- II

MAPI (Million Adolescent Personality Inventory)

NEO personality inventory (self-administered 35min to complete)

Meyers brings type indicator. (self report, highschool and colleges)

Question 5

Characteristics of Antisocial Personality Disorder?

DSM crit?

Answer 5

Persistent and pervasive pattern of disregard for and violation of the rights of others present since age of 15. Centres on violation (eg. lying, deceit, aggression, recklessness)

Needs to exhibit 3 or more of the following:

Failure to obey laws and norms
Lack of empathy, remorse or guilt
Inability to plan ahead
Irritability and aggressiveness
Disregard of safety self-others
Failure to maintain employment or financial stability
Lack of remorse for hurting, or stealing from others, lack of concern

ASPD only personality disorder with a specific age – NEEDS TO BE AT LEAST 18. If younger, conduct disorder. Must have evidence of conduct disorder before age 15.

Question 6

Comorbid for Antisocial personality disorder?

Answer 6

Narcissism – relies more on underlying feeling of inferiority and need for admiration.

Borderline – Manipulation stems from fear of abandonment, may make desperate attempts to keep someone close by threatening suicide or self-harm. In ASPD more self-centred goals without regard for others.

Question 7

Best approach to working with Antisocial?

Answer 7

Practical behaviour goals work best. Develop practical skills, avoiding legal issues. Set clear boundaries.

Clients often in therapy due to law or family member (not always voluntary).

Question 8

Assessment tools for Antisocial Personality Disorder?

Answer 8

Hare psychopathy checklist revised (psychiatric/ institution setting)

Hare psychopathy checklist screening version (Quicker than hare checklist, half time)

Millon Clinical Multiaxial Inventory MCMI psychological assessment scales for personality D (true false) most common.

MMPI

SCID-5 semi structured

Antisocial process screening device (for youth conduct disorder)