Personality Disorder I Flashcards
1
Q
What is Personality?
A
- A persona (plural personae/personas): Latin for ‘mask’
- Used by Greek & Roman amphitheater actors
- Outward or surface aspect presented to audience
2
Q
DSM-5: What is a Personality Disorder?
A
Enduring pattern of inner experience and behaviour that:
- Deviates markedly from the individual’s culture
- It is pervasive, inflexible & stable over time
- Leads to distress or impairment
The pattern is manifested in two or more areas:
- Cognition (ways of interpreting self, others & events)
- Affect (range, intensity, stability & appropriateness of emotional response)
- Interpersonal functioning
- Impulse control
Others:
- Early onset during early childhood (e.g. lack of empathy)
- Tend to externalise their mistakes (hold others accountable for their mistakes, instead of themselves)
3
Q
Core features of Personality Disorder
A
-
Functional inflexibility
- Failure to adapt to situations: rigid response -
Self-defeating
- Behavioural responses damaging -
Unstable in response to stress
- Emotional, behavioural & cognitive instability -
Lack of insight
- failure to recognise dysfuntional aspect of personality
4
Q
DSM-5 Personality Disorder Cluster A
A
Odd/eccentric
- Paranoid
- Schizoid
- Schizotypal
All typified by high levels of introversion (i.e., low extroversion)
5
Q
DSM-5 Personality Disorder Cluster B
A
Dramatic/emotional/erratic
- Antisocial
- Corderline
- Distonic
- Narcissistic
6
Q
DSM-5 Personality Disorder Cluster C
A
Anxious/fearful
- Avoidant
- Dependent
- Obsessive-Compulsive
7
Q
Categorical vs. dimensional approach in classifying Personality Disorders
A
- DSM-5 represents a categorical approach
- assumes that personality disorders represent distinct clinical syndromes
- Advantages: clarity and ease of communicating information
- Disadvantages: difficult to distinguish the threshold where the person goes from a ‘normal’ personality traits through to meeting criteria for a personality disorder
- A gradual move towards a dimensional approach to classifying personality disorders
8
Q
DSM-IV: AXIS I vs. AXIS II
A
- AXIS I: Major clinical disorders with acute symptoms that need treatment
-
AXIS II: Personality disorders (& intellectual disabilities)
- early age of onset
- enduring and more pervasive effects on daily functioning
- involvement of self & identity
- presumed poorer self-awareness
- lower treatment response
- BUT high degree of co-occurrence of symptoms
- heterogeneity within diagnoses
- diagnostic unreliability
- lack of robust scientific evidence
- DSM-5: single-axial model
9
Q
Paranoid PD
A
Consistent & pervasive pattern of distrust, suspiciousness and prolonged grudges held:
- Believes others intentionally exploit, harm or deceive them
- Reluctance to disclose personal information for fear it may be used against them
- Severely sensitive to criticism & threat => hypervigilant for signs of others to harm them
- Misinterprets comments to indicate concealed, hidden or malevolent intent or motivation
- Hostility, aggression & anger to perceived insults
- Jealousy (distrust & misinterpretation)
Two thirds meet criteria for other PDs
- e.g., Schizotypal, Narcissistic, Borderline & Avoidant
10
Q
Schizoid PD
A
-
Detachment and disinterest in social relationships
- withdrawal into internal world to avoid affect and maintain distance from others
- Sees others as intrusive and controlling
- Flatness of affect: coldness, aloofness, self-absorption, social ineptitude or conceit
- Unresponsive to social criticism: sexually apathetic reflecting incapacity to form interpersonal bonds
- Anhedonia
- Comorbid with schizotypal and avoidant PDs
11
Q
Schizotypal PD
A
- Marked interpersonal deficits, behavioural eccentricities and distortions in perception & thinking
- Manifest a number of positive and negative psychotic symptoms,
- BUT do not meet criteria for schizophrenia
- e.g. magical thinking, extreme superstition, belief in paranormal phenomenon, bodily illusions, sensory alterations
- Odd thoughts & speech patterns: vague, abstract but retains coherence
- Often seek treatment for anxiety, depression & affective dysphoria (constricted or inappropriate affect)
- Comorbid with borderline, avoidant, paranoid and schizoid PDs
12
Q
Antisocial PD
A
- Repeated reckless disregard for others
- Victimising& blaming others for inadequacies
- Shallow & manipulative interpersonal relationships
- Self-centered focus & failure to adhere to regulations
- Impulsive, aggressive, charismatic, deceitful
- Experience guilt & depression but lack capacity to empathize
- Anti-social behaviour: criminal behaviours may or may not be present
- Co-morbidity with borderline, narcissistic, histrionic & schizotypal PDs
13
Q
Histrionic PD
A
- Roots in the concept of hysteria: conversion disorders, emotional instability, anxiety & phobias
- Excessive emotionality, attention-seeking, ego-centric, flirtatious, seductiveness (focus on grooming),
- Denial of anger and hostility
- Gregarious, manipulative, low frustration tolerance, suggestibility, somatization
- Displays of emotions: shallow and fickle in interpersonal relationships
- Comorbid: narcissistic, borderline, anti-social PDs & psychoactive substance abuse
14
Q
Narcissistic PD
A
- Personalities organised around maintenance of self-esteem by eliciting external adulation to compensate for internal sense of falseness
- Fragile self-esteem, envy, self-consciousness, & vulnerability: “image replaces substance”
- Compensatory reaction: self-righteousness, pride, contempt, vanity & superiority
- Pervasive pattern of grandiosity, sense of entitlement, privilege, or expectation of preferential treatment, exaggerated sense of self-importance, arrogant behaviour & attitudes
- Focus on own issues with insensitivity or impatience to problem of others: cold, disinterested, snobbish, patronising
- Comorbid with: anti-social, histrionic, borderline PDs & substance abuse
15
Q
Avoidant PD
A
- Pervasive social inhibition, discomfort in social situations, feelings of inadequacy, low self-esteem, hypersensitivity to criticism, disapproval, shame, ridicule & rejection
- Avoidance of activities involving personal contact & groups
- Socially inept/incompetent, personally unappealing, inferior to others
- Comorbid with dependent PD & Axis I mood, anxiety, & eating disorders
