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Personality & Individual Differences > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

ABNORMAL: STATISTICALLY

A
  • stat definition = ^ simplistic
  • whatever is dif from normal = abnormal
  • can be statistically determined how often something occur; abnormal when rare
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2
Q

ABNORMAL: SOCIAL

A
  • define abnormal according to society tolerance
  • beh deemed socially acceptable = abnormal
  • socially unacceptable in 1 society may be acceptable in another; reflects dif way of life/orientation
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3
Q

ABNORMAL: EVALUATION

A
  • stat/social approaches suffer from changing social/cultural norms over time/between cultures
  • beh thought offensive/socially inappropriate in past = acceptable today (ie. homosexuality)
  • stat definitions need further caution as “rare” NOT abnormal ie. ^ IQ = statistically rare; could be abnormal BUT desirable
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4
Q

ABNORMAL: BROADER APPROACH

A
  • given issues w/statistical/social approaches, broader approach = needed
  • abnormal beh definition considers psych criteria + stat/social aspects ie:
  • distress levels/functioning impairment/subjective feelings/emotional effect/thought patterns
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5
Q

METHODS OF ASSESSING PERSONALITY DISORDERS: SCID

A
  • Structured Clinical Interview (SCID); 3 versions BUT only SCID-5-PD (Personality Disorders) = applicable here
  • used to diagnose PD categorically (present/absent)/dimensionally
  • SCID-5-PD = updated SCID for DSM-5 Axis II PD (SCID-II); designed to assess 10 DSM-5 PDs across A/B/C Clusters
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6
Q

METHODS OF ASSESSING PERSONALITY DISORDERS: CLINICAL ASSESSMENT

A
  • clinical observations by qualified professionals
  • may be corroborated by additional info from self-reported experiences/beh/peer observations
  • self-report scales also used to diagnose PD:
    1. Minnesota Multiphasic Personality Inventory (MMPI)
    2. Personality Diagnostic Questionnaire (Revised PDQ-R)
  • ask whether people experience disorder signs
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7
Q

TYPE VS TRAIT/DIMENSIONAL APPROACH

A

LIVESLEY ET AL (1998)
- diagnostic systems use disorder categories to describe people BUT evidence suggests dimensional approach to PD = ^ appropriate

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8
Q

TYPE/CATEGORIAL APPROACH

A
  • person diagnosed w/disorder or not
  • qualitative break between people w/w/o PD
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9
Q

TRAIT/DIMENSIONAL APPROACH

A
  • each disorder viewed as continuum ranging from normality-severe disturbance
  • people w/disorder dif in degree only from those w/o disorder
    MOREY ET AL (2000)
  • diverse methodology range research supports it
    TRULL & DURRETT (2005)
  • PD = one extreme; normal = same continuum
    FLETT (2007)
  • PD = extremes of characteristics we already have OTHER THAN psychopathy (Skilling et al (2002))
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10
Q

PERSONALITY DISORDER

A
  • extreme/severe disturbance in overall character/behs of individual; affects various personality aspects
    MALTLBT EY AL (2010)
  • always involves personal/social disruption; affects person & those around them
    PARIS (2003)
  • disruption present over life; some symptoms develop in childhood
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11
Q

PERSONALITY DISORDERS: CHARACTERISTICS

A
  • early life onset; lifelong issue
  • most reluctant to ask for/accept help
  • challenging to therapist; unresponsive to input
  • referred by family/friends/colleagues
  • difficult to treat
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12
Q

PSYCHOLOGICAL DISORDERS/MENTAL ILLNESS: CHARACTERISTICS

A
  • clear start/onset
  • clear recovery trajectory
  • oft associated w/cause in environment (ie. bereavement/job loss)
  • seek therapy; work w/therapist to recover
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13
Q

PD VS PSYCH D

A

KENDELL (2002)
- distinction ^ challenged
- tenuous divide; overlap w/symptoms
- recent moves towards trait approach recognises PD lie on continuum/represent extreme common trait ends
- DSM-4 revised; DSM-5 recognises further research examining PD = continuous traits > absolute categories need
- hierarchical model/Axis 3 drives research > diagnosis

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14
Q

LABELLING

A
  • mentioning PD diagnosis = powerful effect on clinician’s views
  • vital for PD concepts to refer to real entities
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15
Q

APPLEBY (1988)

A

APPLEBY (1988)
- receiving PD label effect observed by psychiatrists
- 1/6 vignettes sent to 240 practicing psychiatrists
- 1 mentioned patient diagnosed w/PD
- rate patient against statement number
- large effect; judgements ALWAYS less favourable

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16
Q

APPLEBY (1988): PD CLINCIAN’S VIEWS

A
  • manipulate admission
  • overdose for attention
  • NOT suicide risk
  • unwanted in doctors clinic
  • annoying
  • unlikely to improve
  • NOT mentally ill; unlikely to warrant NHS time
  • not suitable for anti-depressants
  • unlikely to comply w/treatment
  • in debt of own fault
  • management problem
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17
Q

APPLEBY (1988): RESULTS

A
  • just mentioning PD diagnoses powerfully affects clinicians views
  • pervasive PD nature/widely accepted belief in limited treatment effectiveness -> development/management emphasis > aetiology/treatment
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18
Q

LABELLING & CRIME/JUSTICE

A
  • stigma/discrimination resulting from PD/psych D diagnosis highlights evidence based diagnosis importance
  • further highlighted as evidence suggests relationships between some PD/criminal beh
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19
Q

CLASSIFICATION SYSTEMS: ICD-11

A
  • 11th revised International Classification of Diseases and Related Health Problems adopted by 72nd World Health Assembly (2019)
  • info effect January 2022; WHO may use ICD-10 until then
  • PD section completely overhauled; just 1PD diagnosis based on severity
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20
Q

CLASSIFICATION SYSTEMS: DSM-5

A
  • Diagnostic/Statistical Manual of Mental Disorders (2013)
  • taxonomic/diagnostic tool published by APA; used by mental health professionals in USA/UK
  • 10 PD categories
  • DSM-5 Alternative PD Model (AMPD) = further research trait model
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21
Q

CLASSIFICATION SYSTEMS: DSM-5

A
  • Diagnostic/Statistical Manual of Mental Disorders (2013)
  • taxonomic/diagnostic tool published by APA; used by mental health professionals in USA/UK
  • 10 PD categories
  • DSM-5 Alternative PD Model (AMPD) = further research trait model
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22
Q

ICD-11

A
  • moving away from categorical typology approach > making primary PD classification 1/5 severity lvls
    SEVERITY
  • 3 lvls: mild/moderate/severe PD
    PROMINANT TRAIT QUALIFIER
  • negative affectivity/detachment/disinhibition/dissociality/anankastia (rigid perfectionism; emotional/beh constraint)
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23
Q

DSM-5

A
  • retains categorical approach w/10 PDs
  • unaccepted revisions approved as alternative hybrid dimensional-categorical model; included Section III for further work
  • using alternative methodology -> PD diagnosis based on individual’s particular personality functioning difficulties/pathological trait patterns
  • hybrid retains 6 PD types each defined by specific impairment/trait pattern
24
Q

DSM-5: HYBRID

A
  1. Borderline PD
  2. Obsessive-Compulsive PD
  3. Avoidant PD
  4. Schizotypal PD
  5. Antisocial PD
  6. Narcissistic PD
25
Q

DSM-5: PERSONALITY DISORDER-TRAIT SPECIFIED (PD-TS)

A
  • part of hybrid approach
  • PD present BUT specific criteria not met
  • personality functioning impairment severity/problematic personality traits assessed
  • attempts to address existing issues w/categorical approach; APA specifically encourages research supporting this model in patient diagnosis/cure/treatments/causes
26
Q

ICD-11 VS DSM-5

A
  • trait domains used as specifiers contributing to individual personality disturbance expression + overall severity classification
  • specifiers inform clinical management of diagnosed patients incl. choosing intervention target
  • both describe 4 trait domains (negative affectivity/detachment/antagonism/disinhibition)
  • DSM-5 AMPD incl. separate psychoticism domain
  • ICD-11 incl. separate anankastia domain
27
Q

CLASSIFYING PD

A

DSM-5
- lists 250 dif disorders
- PD represent small possible psychopathologies detailed in DSM-5
- 10 dif PDs included/grouped in 3 clusters
- recognises considerable PD/psych D overlap

28
Q

APA: PERSONALITY DISORDER

A
  • enduring pattern of inner experience/beh that deviates markedly from cultural expectations of exhibiting individual
  • DSM-5 detail several general/specific criteria
28
Q

APA: PERSONALITY DISORDER

A
  • enduring pattern of inner experience/beh that deviates markedly from cultural expectations of exhibiting individual
  • DSM-5 detail several general/specific criteria
29
Q

DSM-5: GENERAL CRITERIA

A
  • deviation from expectations needs to manifest in at least 2 of following ways:
30
Q

DSM-5: FIRST GENERAL CRITERIA

A
  1. deviation from expectations needs to manifest in at least 2 of following ways:
    COGNITIONS
    - ie. thinking ways; perceiving/interpreting things/events/situations/people
    AFFECT
    - ie individual emotions
    - may include emotional intensity/lability/appropriateness range
    INTERPERSONAL FUNCTIONING
    - how individual relates to/interacts w/others
    IMPULSE CONTROL
    - lack of control; need gratification
31
Q

DSM-5: SECOND GENERAL CRITERIA

A
  1. experience/beh patterns have to be:
    - enduring/flexible/maladaptive/dysfunctional; constant across broad personal/social situation range (aka. not limited to a specific triggering)
    - -> personal distress/clinically sig impairment to individual’s personal/social/occupational life
    - stable/present over long time periods; onset traced back to adolescence/early adulthood
    - cannot be explained as manifestation/consequence of other mental disorder
    - cannot be attributed to substance/medical condition physiological effects (ie. drugs/TBI)
32
Q

DSM-5: 10 PERSONALITY DISORDERS

A
  • grouped in 3 clusters; each shares common thread:
    CLUSTER A (schizoid/schizotypical/paranoid)
  • tendency to be odd/eccentric; most to do w/interaction w/others
    CLUSTER B (antisocial/borderline/histrionic/narcissistic)
  • dramatic/emotional/erratic
    CLUSTER C (avoidanct/dependent/OCD)
  • anxious/fearful
33
Q

DSM-5: CLUSTER A

A
  • schizotypal NOT = schizophrenia despite clear symptom/cause overlaps
  • schizophrenia = clinical/psychological diagnosis; serious mental illness w/hallucinations/delusions/perceptual aberrations
  • schizoid/schizotypal PDs show low nonpsychotic schizophrenia symptoms
  • likely to possess genotype making them ^ vulnerable to schizophrenia
34
Q

CLUSTER A: PARANOID PD

A
  • extreme distrust/irrational suspicions of others
  • 0.5-2.5% prevalence of general pop
  • “get them before they get you”
35
Q

CLUSTER A: PARANOID CRITERIA

A
  • 4+ required for DSM-5 diagnosis:
    1. suspicious others truing to exploit/deceive them
    2. preoccupied w/unjustified doubts about trustworthiness of friends/family
    3. pathological jealousy; recurring fidelity suspicions
    4. reluctance to confide; concerned info used maliciously
    5. misinterprets social events; innocent/benign remarks = threatening/demeaning
    6. persistently holds grudges against people; rigid views; unforgiving to those who insulted/hurt them
    7. hypersensitive; innocent comments = attacks
36
Q

CLUSTER A: SCHIZOID PD

A
  • restricted emotions
  • detachment/disconnection/indifference to interpersonal/social relations pattern
  • don’t respond to social cues; may be inept/socially clumsy (1.7% general pop)
  • “I hate being tied to others”
37
Q

CLUSTER A: SCHIZOID CRITERIA

A
  • 4+ required for diagnosis:
    1. won’t seek/enjoy close personal relations ie. family
    2. nearly always choose solitary pursuits/jobs
    3. little/no interest in sexual experiences
    4. few/no close friends
    5. indifferent to praise/critique of others
    6. flattened emotions; cold; low/no attachment
38
Q

CLUSTER A: SCHIZOTYPAL PD

A
  • extreme discomfort w/close relations
  • thinking/feeling/perception distortions
  • sometimes eccentric beh (0.6% in general pop)
39
Q

CLUSTER A: SCHIZOTYPAL CRITERIA

A
  • 5+ required for diagnosis:
    1. reference ideas aka. world revolves around them
    2. magical thinking/odd beliefs (ie. clairvoyance/telepathy)
    3. unusual perceptions/distortions/bodily experiences
    4. odd thinking/speech (ie. confusing/abstract)
    5. suspicious/paranoid world ideas
    6. inappropriate/lacking emotional expression/close friends/relations
    7. extreme social discomfort
    8. general social anxiety via paranoia
40
Q

CLUSTER B

A
  • exhibit hostile interpersonal beliefs; others =
    1. existing primarily to use/take advantage of (antisocial/borderline)
    2. admirers for attention/adoration (narcissistic/histronic)
  • psychopathy related to antisocial PD BUT not it
  • only subset w/antisocial PD meet psychopathy crit
41
Q

CLUSTER B: ANTISOCIAL PD

A
  • general disregard of others
  • little care for feelings/rights/happiness
  • 0.7-3% general pop
  • beh shown must NOT result from other disorder (ie. schizophrenia)
  • “I’m different; laws don’t apply to me”
42
Q

CLUSTER B: ANTISOCIAL CRITERIA

A
  • 3+ required for diagnosis:
    1. failure to socially conform (ie. repeatedly breaking law)
    2. repeatedly lying/conning for profit/pleasure
    3. impulsivity/repeated failures to plan
    4. irritability/aggressive beh (ie. repeatedly fighting)
    5. reckless disregard for others safety
    6. repeated irresponsible acts (ie. not holding job/financial obligations)
    7. lack of remorse (indifferent to others’ pain/hurt)
43
Q

CLUSTER B: BORDERLINE PD

A
  • instability in relations/beh/emotions/self-image
  • 0.7-2% general pop
  • “if you leave me I’ll kill myself”
44
Q

CLUSTER B: BORDERLINE CRITERIA

A
  • 5+ required:
    1. repeated suicidal beh/threats/self-harm/self-mutilating beh
    2. abandonment fear
    3. impulsivity in at least 2 damaging areas (ie. financial/sexual beh; substance abuse; reckless driving)
    4. unstable/intense relations (ie. idealisation/devaluation)
    5. disturbances in identity characterised by persistent unstable self-image
    6. unstable emotions/feelings; marked mood/irritability/anxiety changes
    7. persistent emptiness/worthlessness feelings
    8. aggressiveness/difficulty in controlling anger (ie. frequent fight/tempers)
    9. paranoia/delusions/dissociation under stress
45
Q

CLUSTER B: HISTRIONIC PD

A
  • attention seeking beh to be at attention centre
  • overly dramatic mood swings
  • excessive approval need
  • “I’m so interesting/attractive; everyone likes me”
46
Q

CLUSTER B: HISTRIONIC CRITERIA

A
  • 5+ required for DSM-5 diagnosis:
    1. excessive attention seeking (constant need to be at its centre)
    2. sexually provocative/seductive interactions
    3. excessive/exaggerated/changeable/lacking depth emotions
    4. physical appearance used to draw attention
    5. impressions > facts/rationale; shallow opinions dramatically expressed BUT v suggestible
    6. over-dramatic about themselves
    7. exaggerates personal relations intimacy
47
Q

CLUSTER B: NARCISSISTIC PD

A
  • strong need to be admired
  • pervasive grandiosity pattern
  • inflated self-importance
  • lack of empathy
  • ^ self-esteem BUT fragile w/criticism; rage when admiration = absent
  • “I’m more important than you, I don’t need to listen to you”
48
Q

CLUSTER B: NARCISSISTIC CRITERIA

A
  • 5+ required for DSM-5 diagnosis:
    1. excessive admiration need
    2. inflated self-importance/grandiosity
    3. self = unique/special
    4. prosperity/power/influence/adoration daydream preoccupation
    5. strong entitlement sense
    6. exploitative in intimate relations
    7. lacks insight in others needs/feelings
    8. envious/believes others are envious of them
    9. superiority/arrogance tendency
49
Q

CLUSTER C

A
  • fear causes = rejection (avoidant)/being along (dependent)
    BRENNAN & SHAVER (1998)
  • PD symptoms links w/anxious/fearful/preoccupied attachment style
  • beh patterns aimed at avoiding anxiety/fear
  • certain beh patterns may solve certain issues BUT also create issues (ie. avoidant beh -> isolation/^ social situation fear)
50
Q

CLUSTER C: AVOIDANT PD

A
  • social inhibition/inadequacy
  • criticism/judgement fear
  • low self-esteem/shyness tendency
  • avoid criticism situations
  • 0.8% general pop
  • “I wish you’d like me but I’m sure you don’t as I’m so inept”
51
Q

CLUSTER C: AVOIDANT CRITERIA

A
  • 4+ required for DSM-5 diagnosis:
    1. restricts personal/occupational activities to avoid criticism/negative appraisal
    2. inadequacy/inferiority feelings in social situations/complete avoidance
    3. rejection fear; inadequacy restrains new relations
    4. new activity avoidance for criticism/embarrassment fear
    5. preoccupied w/rejection/criticism fear in social situations
52
Q

CLUSTER C: DEPENDENT PD

A
  • pervasive psychological dependence on others
  • lack of self-confidence; others take responsibility for major life aspects
  • 1.5% pop affected
  • “my worst nightmare is being abandoned/alone”
53
Q

CLUSTER C: DEPENDENT CRITERIA

A
  • 5+ required for DSM-5 diagnosis:
    1. pervasive need to be cared for due; concerned about not doing it themselves
    2. ^ difficulty making normal everyday decisions; seek out reassurance
    3. needs others to take responsibility for major life areas
    4. rare initiative/disagreement w/others for fear of losing support/approval
    5. independent work = difficult
    6. excessive lengths to gain others’ support (ie. horrible tasks)
    7. hates being along; preoccupied w/fears of it/not being able to cope
    8. swiftly seeks other relation post break-up
54
Q

CLUSTER C: OBSESSIVE COMPULSSIVE PD

A
  • preoccupation w/order/perfectionism
  • strong rule conformity/moral code
  • 2% general pop
  • “the only right way to do it is my way”
55
Q

CLUSTER C: OCPD CRITERIA

A
  • 4+ required for DSM-5 diagnosis:
    1. detail/rule preoccupation overshadows task purpose
    2. high perfectionism interferes w/task completion
    3. excessive devotion to work leaves little personal/social life time
    4. inflexible beliefs/values/morals
    5. thing MUST be done the way they want them to
    6. oft miserly w/money
    7. rigid/stubborn attitudes/beh
56
Q

CLUSTER C: OCPD IS NOT OCD

A

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