Personality Disorders Flashcards

Question

Clusters B Personality Disorders Antisocial personality disorder and criminality Arousal theories / contributions / causes Discussed p 462 (Neurobiological)

Answer 1

According to the fearlessness hypothesis, psychopaths posses a higher threshold for experiencing fear. Things that greatly frighten the rest of us have little effect on the psychopath

Answer 2

Several theorists have applied Gray’s model of brain functioning to people with antisocial personality disorder, especially those with psychopathy. According to Gray, three major brain systems influence emotional behaviour and learning; the BIS, the reward system and the fight/flight system. The BIS is responsible for ability to stop or slow down when we are faced with impending punishment, nonreward, or novel situations. Activation of this system leads to anxiety and frustration. The reward system is responsible for how we behave, in particular our approach to positive rewards and is associated with hope and relief. An imbalance between BIS and the reward system may make the fear and anxiety produced by the BIS less apparent and the positive feelings associated with the reward system more prominent.

Answer 3

Discusses a card game where psychopathic criminals were more likely to continue playing and not be deterred despite feedback that reward was no longer forthcoming. Aggression in children with antisocial personality disorder may escalate partly as a result of their interactions with their parents. … Child learns to fight and not give up (to get what they want) when parents give in to demands in order to restore calm.

Answer 4

40 Non psychopath incarceration rates remain relatively stable

Answer 5

Takes into account the gene environment interactions such as the potential role of fear conditioning in children. If this learning is impaired how does a child learn to avoid things that can harm you. Deficits in amygdala are thought to make individuals unable to recognise cues that signal threat, making these people relatively fearless Biological influences further interact with other environmental experiences such as early childhood adversity. In a family that may already be under stress because of divorce or substance use disorder there may be an interaction style that encourages antisocial behaviour on the part of the child.

Answer 6

Issue is that these people rarely identify as needing treatment. In general, therapists agree with incarcerating to deter future antisocial acts, At risk children identified so treatment can be attempted before these children become adults. A large study of violent offenders found CBT could reduce likelihood of violence 5 years after treatment, but success was negatively correlated with PCL-R ratings (traits like self, callous and remorseless use of others) - high scores on these trait’s related to psychopathy The most common treatment strategy for children is parent training where parents are taught to recognise behaviour problems early and to use praise and privileged to encourage pro social behaviour.

Answer 7

Mood disorder are common with one study showing 80% also had major depression and approximately 10% had bipolar II disorder. Eating disorders are also common with 65% having some form of eating or feeding disorder , 25% with bulimia, 20% anorexia. Up to 64% are also diagnosed with at least one substance use disorder.

Answer 8

No currently accepted integrative model at this time but tempting to borrow from work on anxiety disorders. (Chapter five discusses the triple vulnerability theory) The first vulnerability (or diathesis) is a generalised biological vulnerability. We can see the genetic vulnerability to emotional reactivity and the way it affects specific brain function. Second - is a generalised psychological vulnerability- tend to view the world as threatening and to react strongly to real and perceived threats. Third - specific vulnerability learned from childhood experiences where trauma or abuse may advance this sensitivity to threats ..

Answer 9

These individuals are more likely than say antisocial personality disorder people to seek help due to marked distress, even more likely than people with anxiety and mood disorders. Efforts to provide successful treatment are complicated by drug misuse, none compliance with treatment and attempts to take their own lives. Clinicians are generally reluctant to work with these people. Dialectic Behaviour Therapy involves helping people with the stressors that seem to trigger suicidal behaviour and other maladaptive responses. Priority is first given to addressing behaviour that may result in harm then behaviour that interfere with therapy, and then those behaviours that interfere with quality of life… Final stage clients learn to trust their own responses rather than depend on the validation of others ….

Answer 10

Antisocial personality disorder.

Answer 11

Little research demonstrates success. A large part of therapy usually focuses on the problematic interpersonal relationships. They often manipulate others through emotional crises, using charm, sex, seductiveness or complaining. Often need to be shown short term gains result in long term costs.

Answer 12

True on both accounts

Answer 13

We start out as self-centred, demanding infants which is part of our struggle for survival. Part of the socialisation process, however, involves teaching children empathy and altruism. Some believe this disorder arises largely as a failure by parents to successfully model empathy in the child’s development. Consequently the child remains fixated at a self-centred grandiose stage of development. In addition, the child and later the adult becomes involved in an essentially endless and fruitless search for the ideal person who will meet their unfulfilled empathic needs. In a sociological view, prevalence in western societies is on a rise due to consequence of large scale social change including greater emphasis on short term hedonism, individualism, competitiveness snd success. However this apparent increase could be due to an increased interest in the disorder.

Answer 14

Research is extremely limited. When treatment is attempted, it often focuses on their grandiosity, hypersensitivity to evaluation and their lack of empathy toward others. Cognitive therapy strives to replace fantasies with a focus on the day to day pleasurable experiences truly attainable. Coping strategies such as relaxation training to help cope with accepting criticism. Helping them focus on the feelings of others. Due to vulnerability in developing severe depression, particularly in middle age, treatment is often initiated for the depression.

Answer 15

Some evidence suggests that it is related to other schizophrenia related disorders, occurring more often in relatives of people who have schizophrenia. A number of theories proposed that integrate biological and psychological influences as the cause. For example, may be born with a difficult temperament or personality characteristics and as a result, parents may reject them or not provide enough early uncritical love. This in turn results in low self esteem and social isolation , conditions that persist into adulthood …

Answer 16

There are a number of well controlled studies. Behavioural interventions techniques for anxiety and social skills problems have had some success. Due to similarity with social phobia, research had looked at medical interventions for anxiety (selective serotonin etc) and found to be effective. Therapeutic alliance appears to be an important predictor for success.

Answer 17

Part of the socialisation process in most cultures involves helping us live independently. It was thought early childhood experiences such as death of a parent, neglect or rejection by caregivers could cause people to grow up fearing abandonment. Also clear that genetic influences are important yet it is not yet clear on the interaction between genetic and environmental influences

Answer 18

There seems to be a moderate genetic component, some people being predisposed to favour structure in their lives but reaching level considered distressing and impaired may require reinforcement by caregivers etc. Therapy often attacks the fears that seem to underlie the need for orderliness. These individuals are often afraid of inadequacy so procrastinate and excessively ruminate about important issues and minor details alike. Therapist help with relaxation or use cognitive reappraisal techniques to reframe compulsive thoughts.