Personality Disorders

Question 1

Personality Disorders

Answer 1

Rigid, maladaptive patterns that cause personal distress or an inability to get along with others

Question 2

Narcissistic Personality Disorder

Answer 2

A disorder characterized by an exaggerated sense of self-importance and self-absorption

Question 3

Paranoid Personality Disorder

Answer 3

A disorder characterized by habitually unreasonable and excessive suspiciousness and jealousy

Question 4

Borderline Personality Disorder

Answer 4

-Intense but unstable relationships, fear of abandonment, unrealistic self-image, emotional volatility, self-destructive behavior
-controversial because of loose diagnostic criteria, possible overdiagnosis

Question 5

Antisocial Personality Disorder

Answer 5

A disorder characterized by antisocial behavior such as lying, stealing, manipulating others, and sometimes violence; and a lack of guilt, shame, and empathy
-From the DSM
deceitful, repeatedly break the law, irresponsible, lack remorse, physical, reckless, impulsive

Question 6

Dissociative Identity Disorder

Answer 6

-used to be called multiple personality disorder
-disorder marked by appearance within one person of two or more distinctive personalities, each with its own name and traits
-often has roots in intense childhood sexual abuse
—The identity splits (dissociates) in order to repress or confine the memory to one identity, while other identities remain happy and oblivious

highly controversial

Question 7

Sociocognitive Definition of DID

Answer 7

Disorder is not an actual fragmenting of the identity or multiple personalities, but is simply an extreme manifestation of the different roles we all hold
-Diagnosis rates have skyrocketed
-Media hype?
- Improved diagnostic criteria or overzealous therapists?
—Abusing suggestibility
—Rewarding patient by giving them an out for bad behavior
—Rewarding patients with a great deal of attention

Question 8

Schizophrenia

Answer 8

a group of psychotic disorders marked by positive and negative symptoms that indicate a distorted perception of reality
-positive symptoms- something abnormal is present
—delusions, hallucinations, incoherent speech, inappropriate behavior
-Negative symptoms- something normal is absent
—lack of affect, loss of motivation, social withdrawal
—may be grouped to form an overall state of catatonia (A neuropsychiatric disorder which affects behavioral and motor functions)

Question 9

Delusions

Answer 9

false beliefs that often accompany schizophrenia and other psychotic disorders

Question 10

Hallucinations

Answer 10

sensory experiences that occur in the absence of actual stimulation

Question 11

Diathesis-stress model

Answer 11

-possible theory of schizophrenia
-environmental stressors can trigger physical vulnerabilities
-vulnerability may be genetic
—strong correlation in twin studies
-vulnerability may be a brain abnormality
—research suggests prenatal neural differences
—synaptic pruning in adolescence may trigger early episodes
-vulnerability in neurotransmitter levels
—dopamine- can affect movement and emotion
—glutamate- major excitatory neurotransmitter

Question 12

Treatment and Therapy for Schizophrenia

Answer 12

biological treatments
talking cures
debated amongst doctors for which is best route

Question 13

Concerns with Biological Treatment with Schizophrenia

Answer 13

-treating problem or just symptoms?
-some effects overstated due to publication bias
-is there a placebo effect?
—Meta-analysis indicates for some drugs placebo equally effective
—this doesn’t mean drugs are ineffective, just that they may not be actually doing what they claim to be doing
-often used instead of costlier, but more effective non-drug options

Increasing off-label prescription: when an FDA-approved medication is used in a way that has not been approved by the FDA

Side effects may feel worse than the disorder symptoms
- especially bad with lithium and anti-psychotics, leading to high relapse and dropout rates

Long term Effects-
-Addiction
-Diabetes
-Tardive dyskinesia - (A neurological syndrome that results in involuntary and repetitive body movements.)

Question 14

Psychosurgery

Answer 14

any surgical procedure that destroys selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behavior

Question 15

Frontal lobotomy

Answer 15

-destroys or separates parts of the frontal lobe
-stops strong emotional reactions, leads to flat affect
-also can interfere with other frontal lobe functions planning, socially appropriate behavior
-18000 conducted 1939-51

Question 16

Antonio Moniz’ Method

Answer 16

won 1949 Nobel Prize
-drilling holes into the skull and pumping absolute alcohol into the frontal cortex

Question 17

Walter Freeman’s Method

Answer 17

By inserting a long, thin instrument—modeled after an icepick—to pierce the brain via the patient’s eye socket

called the transorbital lobotomy

Question 18

Electroconvulsive Therapy (ECT)

Answer 18

-Used in cases of severe major depression
-Ineffective for other conditions
- Initiated by Ugo Cerletti in 1937
- Produces retrograde amnesia for the procedure itself
- widely used today (100,000 + / year)
- criticized as a tool more of control than treatment

Question 19

Antipsychotic Drugs

Answer 19

-block or reduce sensitivity of brain receptors that respond to dopamine
-some increase levels of serotonin, a neurotransmitter that inhibits dopamine activity
- can relieve positive symptoms of schizophrenia but are ineffective for or even worsen negative symptoms
- side effects include weight gain, diabetes
- increasingly prescribed off-label (seroquel)

Question 20

Monoamine oxidase inhibitors

Answer 20

Antidepressant
(Nardil, Parnate)
- Elevate norepinephrine / serotonin in brain by blocking an enzyme that deactivates them

Question 21

Tricyclic

Answer 21

Antidepressant
Elavil, Tofranil
-Boost norepinephrine and serotonin in brain by preventing normal reuptake of these substances

Question 22

Selective serotonin reuptake inhibitors (SSRIs)

Answer 22

-also inhibit re-uptake of serotonin to boost levels
-examples- Prozac, Zoloft, Paxil

Question 23

Anti-Anxiety (Tranquilizers)

Answer 23

Developed for treatment of anxiety
-Increase levels of hamma0aminobutyric acid (GABA), an inhibitory neurotransmitter
-Developed for shorter-term use, with high relapse rates when people stop taking them
-Often overprescribed by general Phyicians for patients who complain of any mood problems
—overprescription or long-term use can lead to addiction
-examples: valium, xanax

Question 24

For many of drugs

Answer 24

not really known how they work
-includes the widely prescribed SSRIs
-From the ad for the bipolar med Abilify:

Question 25

How Abilify is thought to work

Answer 25

Abilify may work by adjusting dopamine activity, instead of completely blocking it and by adjusting serotonin activity. However, the exact way any medicine for bipolar disorder works is unknown

Question 26

Approaches to Therapy

Answer 26

-psychodynamic
behavioral therapy
cognitive therapy
humanistic therapy
sociocultural methods (family and group therapy)

Question 27

Psychodynamic Theory

Answer 27

Uses various techniques to explore the unconscious as a route to identifying and solving problems
-Dream analysis
-Free Association
—A method of uncovering unconscious conflicts by saying freely whatever comes to mind
-Transference
—A critical step in which the client transfers unconscious emotions or reactions onto therapist (e.g. conflicts about parents)

Question 28

Behavioral Methods

Answer 28

Apply principles and techniques of classical and operant conditioning to help people change self defeating or problematic behaviors
-examples
—systematic desensitization
—behavioral self-monitoring (e.g. via diaries)
-Aversive conditioning- punishing undesirable behaviors

Question 29

Cognitive Theory

Answer 29

-Aim is to have people identify and understand maladaptive thought patterns, then change them to improve their life
—Albert Ellis’s Rational Emotive Behavioral Therapy (REBT): therapist and client actively challenge existing beliefs
—Aaron Beck’s Cognitive Theory- examines interconnection of thoughts, feelings and behaviors

Question 30

Cognitive Behavioral Theory

Answer 30

integrative approach, with a goal of using behavioral methods to change cognitions
-Helps build self efficacy
-Self instructional methods, such as self-talk, can help restructure cognitive habits over time

Question 31

Humanistic Therapy

Answer 31

-emphasizes people’s free will to change
-Client-/ Person-Centered Therapy (Carl Rogers)
—Emphasizes empathy with client, seeing the world as client does, Unconditional Positive Regard
-Therapist may rephrase / repeats back what they client is saying via reflective listening, to guide toward insight
-Often is nondirective, with the goal that the client should solve the problems him/herself

Question 32

Family Therapy

Answer 32

-Many problems develop in the context of family, or are perpetuated by the dynamics of the family
-Any changes made will affect all members of the family
-Family-System Perspective-
—Therapy with individuals or families that focuses on how each member forms part of a larger interacting system

Question 33

Group Therapies

Answer 33

Advantages
-Can be led by a professional to show people that they are not alone in their problems
-People can learn from the growth of others
-Less expensive than one-on-one
-Most common type is that used in AA, NA, etc.
Disadvantages
-Lack of confidentiality
-Requires a skilled facilitator to avoid social issues such as groupthink

Question 34

Evaluating Therapies

Answer 34

success hinges on
-Getting the person into the most compatible type of therapy for their disorder and personality
-Client and therapist working together in a therapeutic alliance
-Therapist being culturally competent for client population
-Client being motivated to change
Improvement then has to be monitored up to the point where it levels off

Question 35

Scientist Practitioner Gap

Answer 35

-A substantial, serious disconnect between scientists who research and those who practice
-Practitioners often disregard scientific evidence as not relevant to their personalized approaches
—This leads to perpetuation of misdiagnoses and useless or harmful treatment methods
-Scientists may undervalue the individual human elements of therapy, overemphasize one-size-fits-all approaches