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Personality disorders Flashcards

1
Q

How is personality disorder chronic?

A

has early onset (childhood or adolescence); is stable, long-lasting, and pervasive across life areas

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1
Q

Characteristics of personality disorder

A

chronic, inflexible, deviates from cultural expectations, and leads to clinical distress or impaired functioning

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2
Q

Kinds of impaired functioning caused by personality disorder

A

cognition, affect, interpersonal functioning, impulse control

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3
Q

Disorders in cluster A

A

paranoid, schizoid, schizotypal

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4
Q

Characteristics of cluster A

A

odd, eccentric, avoid social contact

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5
Q

Disorders in cluster B

A

antisocial, histrionic, borderline, narcissistic

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6
Q

Characteristics of cluster B

A

dramatic, erratic, punitive, hostile

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7
Q

Disorders in cluster C

A

avoidant, dependent, obsessive-compulsive

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8
Q

Characteristics of cluster c

A

anxious and fearful

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9
Q

Characteristics of paranoid disorder

A

suspicious, mistrustful, and expects attacks

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10
Q

Characteristics of schizoid disorder

A

inability of and no interest in forming attachments

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11
Q

Characteristics of schizotypal disorder

A

strange or magical thinking; perception and speech interferes with communication

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12
Q

Characteristics of histrionic disorder

A

dramatic, attention-seeking (otherwise have temper outbursts); emphasis on attractiveness

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13
Q

Characteristics of narcissistic disorder

A

grandiosity, attention-seeking, lack of empathy, self-promoting

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14
Q

Characteristics of antisocial disorder

A

disregard and violation of others’ rights; serious violation of social norms; deceitful and manipulative; conduct disorder in childhood

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15
Q

Characteristics of borderline disorder

A

impulsive; extreme emotional reactivity; drastic mood changes; self-injury/suicide attempts

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16
Q

Characteristics of avoidant disorder

A

shy, hypersensitive to rejection, extreme social insecurity, self-conscious and self-critical

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17
Q

Characteristics of dependent disorder

A

extreme discomfort being alone; suppress needs to keep relationships; indecision

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18
Q

Characteristics of obsessive-compulsive personality disorder

A

excessive concern with order, rules, and trivial details; rigidity; perfectionism; lack of warmth

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19
Q

4 diagnostic issues in studying PDs

A

criteria not sharply defined; categories not mutually exclusive; personality characteristics are dimensional; lack of agreement on assessment measures

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20
Q

Openness

A

openness to experience (e.g. feelings, ideas, actions, ideas)

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21
Q

Conscientiousness

A

order, duty, achievement, self-discipline

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22
Q

Extraversion

A

warmth, excitement-seeking, positive emotions

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23
Q

Agreeableness

A

trust, compliance, altruism

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24
Neuroticism
anxiety, anger-hostility, depression, self-consciousness
25
Traits expressed in extreme levels in antisocial PD
negative affectivity/neuroticism, detachment/extreme introversion, antagonism/extremely low agreeableness; disinhibition/extremely low conscientiousness
26
Controversy in diagnosing PDs
reliability of diagnoses is decent but the stability over time is iffy
27
6 factors that make PDs difficult to treat
varied goals; client's belief in need to change; client response; relationships hard to develop; clinician motivation/patience; tendency to drop out early (37%)
28
Treatment for PDs
CBT/cognitive therapy, techniques adapted based on disorder, antipsychotic/antidepressant medication (for schizotypal), CBT/antidepressant medication (for avoidant)
29
2 types of specific personality disorders
borderline personality disorder, antisocial personality disorder and psychopathy
30
3 main characteristics of BPD
combination of neurosis and psychosis; impulsive reaction to dysphoria leading to self-injury and substance abuse; affective instability or rapid mood changes
31
3 main differences between BPD and bipolar disorder
baseline mood; highly responsive to environment in BPD; mood changes in weeks-months for BPD and minutes-hours for bipolar disorder
32
Baseline mood for BPD
dysthymia (negative affect), emptiness, anxiety, anger
33
Symptoms of emotional dysregulation in BPD
high emotional reactivity, unstable mood (e.g. depression, anxiety, irritability, anger)
34
Symptoms of interpersonal dysregulation in BPD
fears of abandonment, unstable and intense relationships
35
Symptoms of behavioral dysregulation in BPD
extreme impulsivity or recklessness, NSSI, suicidal behavior
36
Symptoms of dysregulation of sense of self in BPD
feelings of emptiness, unstable sense of self, stress-related paranoia or dissociation
37
When does BPD have the greatest impairment and suicide risk?
young adulthood (then more stability in 30s and 40s)
38
Comorbidity of BPD
mood disorders, anxiety disorders, substance abuse, eating disorders, PTSD, other cluster B personality disorders
39
Biological factors of BPD
genes for the traits of neuroticism and impulsivity; 5x more common among 1st degree relatives along with impulse spectrum disorders (e.g. ASPD, substance abuse); more impulsivity and affective instability among identical twins
40
Effects of BPD on the brain
reduced orbitofrontal volume and hippocampal volume, amygdala hyperactivity, lower 5-HT
41
Effect of reduced orbitofrontal volume in BPD
impulsivity, aggression, mood instability
42
Effect of reduced hippocampal volume in BPD
stress overreactivity and increased fear response
43
Effect of lower 5-HT in BPD
impulsive behavior and disinhibition
44
Effect of amygdala hyperactivity in BPD
hypervigilance, emotional dysregulation
45
Psychological factors/symptoms of BPD
perceived rejection leading to intense rage; misperception of anger; thinking mistakes (e.g. dichotomous thinking, catastrophizing) due to fear of abandonment and rejection
46
Social factors of BPD
invalidating environment; early adverse events (e.g. trauma/maltreatment, early separation/loss, abnormal bonding with parent, neglectful and overprotective parent)
47
Invalidating environment
efforts to communicate inner experience is disrespected or punished
48
Cycle of an invalidating environment
child suppresses emotions > explodes > gets parents' attention > attention reinforces outburst
49
Biosocial theory of BPD
a biological diathesis for emotional reactivity and an invalidating environment leads (stress) to BPD
50
Biological treatment for BPD
SSRIs and mood stabilizers (since comorbid with mood disorders); antipsychotics for psychotic/dissociative symptoms
51
Psychological treatments for BPD
dialectical behavior therapy (DBT), mentalization, transference-based psychodynamic psychotherapy
52
Limitations of DBT treatment for BPD
intensive and expensive
53
Principles of DBT
acceptance and change
54
2 assumptions for acceptance in DBT
individuals are doing the best they can and they want to improve
55
4 assumptions for change in DBT
need to be motivated to change; may not have caused their problems but have to solve them anyway; lives are unbearable; must learn new behaviors in new contexts
56
3 components of DBT
CBT (change), validation (acceptance), dialectics (finding the middle path)
57
2 procedures involved in DBT
individual therapy and skills group
58
What is learned in the skills group in DBT?
mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness, dialectics
59
Radical acceptance
acknowledging a distressing situation, enduring, and working to change the situation when effective
60
3 main characteristics of antisocial personality disorder (ASPD)
inadequate conscience development; irresponsible and impulsive behavior; ability to impress and exploit others
61
Symptoms of ASPD
disregard for and violation of the rights of others, deceitfulness, impulsivity, aggressiveness, reckless disregard for safety of self or others, consistent irresponsibility, lack of remorse
62
Comorbidity of ASPD
substance abuse and other cluster B PDs
63
Biological factors of ASPD
PFC dysfunction causing poor executive control; genes (low MAOA); traits (e.g. aggressiveness, impulsivity, low anxiety)
64
MAOA or "warrior" gene
enzyme on the X chromosome that breaks down 5-HT, NE, DA causing structural and functional changes in the brain
65
Psychosocial factors of ASPD
low income, low parental supervision, parent psychopathology, delinquent siblings/peers, neglect, abuse, harsh discipline
66
2 developmental courses of ASPD
ODD by age 6 > CD by age 9 > ASPD; ADHD and CD > ASPD and possibly psychopathy
67
Interpersonal traits of psychopaths
superficial charm and pathological lying
68
Affective traits of psychopaths
lack of remorse, guilty, and empathy
69
Lifestyle traits of psychopaths
need for stimulation and impulsivity
70
Antisocial traits of psychopaths
poor behavioral control and criminality
71
Biological factors of psychopathy
genes (e.g. callous/unemotional traits), PFC dysfunction, and reduced amygdala volume
72
Psychological factors of psychopathy
callous/unemotional traits, low levels of fear or poor conditioning of fear, high reward sensitivity, attentional directedness or tunnel vision
73
Social factors of psychopathy
early parental loss, rejection, negative parenting responses due to callous/unemotional traits
73
Goals of early intervention for psychopathy
reduce hostile attributions; prevent development of resentment and shame; increase closeness in relationships, kind responses to self/others, softer emotions, compassion for caregivers, and predictable limits
73
Principles of treatment for psychopathy
work toward redirecting their skills toward prosocial goals rather than focusing on changing their social skills

PSYC 300A (11 decks)

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