personality disorders Flashcards
importance of personal experience with personality disorder study
- understand diversity of experience
- stop stereotyping
- stop stigmatising representations (e.g. dangerous, wilful, self-obsessed
- consideration
diagnosis of personality disorders as a paradox
- diagnosis can feel like being written off as a “problem” or having no prospect of change
- diagnosis can be a relief - recognition there is a problem, access to therapy
- lack of clarity about diagnosis and treatment can be frustrating
emotional and interpersonal sensitivity
the ability to accurately assess others’ abilities, states, and traits from nonverbal cues
can be diminished in personality disorders
maladaptive beliefs in personality disorders - 2
conditional beliefs - e.g. if i do this they will hate me
core beliefs - e.g. no matter what i do they will hate me
interpersonal relationships and lack of trust in personality disorders
come from past experiences
maintained by current behaviours
e.g. faced rejection in the past and then act in ways to push people away in the present
define personality
tendency towards patterns of behaviour, emotion, cognition, and interaction that show regardless of the situation we are in
trait not state –> not context dependent
under 18 = temperament, not personality –> as people change and develop, becomes more stable with age
implications of personality types/differences
positive - if it fits the demands of the world and its rules
negative - if it does not
hard to define when it tips from one to the other
does it not fit a specific context? or just any context?
e.g. nuns are not aggressive - would be a problem due to the context
socio-political perspective of personality disorders (4)
labelling a person as:
- “weird” –> who decides this? not everyone would agree
- “not acceptable” –> people disagree on this too
- “not within social bounds” –> when views differ, this can be called wrong
- not diagnosable, but probs will have an issue soon, so do something now –> e.g. early definitions of borderline personality disorders were about being borderline psychotic - idea of not quite being there but their personality was not seen as normal
socio-political perspective of personality disorders –> medico-legal perspective
can we detain people on the basis of what they might do
idea of responsibility if nothing is done and they go on to cause harm
levels of caution and politics can get in the way
dimensions of personality - + extremes
personality varies along dimensions e.g. extraversion, neuroticism
are personality disorders just extremes on these dimensions?
- need to establish a cut off
- are these at the top and bottom end of each dimension - e.g. extreme introversion or extraversion could be seen as a problem
- are these at just one end of a dimension - e.g. might see extreme neuroticism as a problem, but not extreme stability
categorical vs dimension approach to personality disorders
definitions used to assume it was simple categories - you do or you don’t have a disorder
now in DSM-V its more of a mixture - uses different dimensions to reflect the complexity
DSM-IV definition of personality disorder (1994)
“an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture”
this is vague
could include unusual belief systems (e.g. flat earthers) which would have been normal at other points in history
DSM-V definition of personality disorder (2013)
“the essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits”
quite similar to DSM-IV - still categorical
contains suggestions of using a dimensional approach
DSM-V diagnosis of personality disorder requires following criteria (2 overall, 3 sub)
- significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning
- one or more pathological personality trait domains or trait facets
impairments in personality functioning and the individual’s personality trait expression are:
- relatively stable across time and across situations
- not better understood as normative for the individual’s developmental stage or socio-cultural environment
- not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma)
issues with DSM-V definition of personality disorder
“significant” and “normative” are vague and not defined - what counts as significant, what is normal?
clinicians tend to use diagnosis regardless of substance use, nutrition issues, injury
