Personality Disorders Flashcards
Personality
Characteristic way a person behaves and thinks.
Pervasive - influences all aspects of our lives
BIG 5
Openness
Conscientiousness
Agreeableness
Extraversion
Neuroticism
Openness
fantasy, aesthetics, feelings, actions, ideas, values
opposite: closedness
concrete, disinterest, alexithymia, routine, close-minded, dogmatic
Conscientiousness
competence, order, dutifulness, achievement stivining, self-discipline, deliberation
opposite: disinhibition
irresponsibility, negligence, rashness, disordered
Extraversion
warmth, assertiveness, activity, excitement seeking, positive emotionality
opposite: introversion - coldness, dullnes, submissiveness
Agreeableness
trust, straightforwardness, altruism, compliance, modesty, tender-minded
opposite: antagonism
mistrust, deceptopn, exploitation, aggression
Neuroticism
anxiousness, angry hostility, depressiveness, self-consciousness, impulsivity, vulnerability
opposite: emotional stability
unconcerned, dispassionate, optimistic, shameless, restrained, fearless
Personality Disorder
DSM 5: “Inflexible and maladaptive, and cause
significant impairment or subjective distress”
Chronic & pervasive – see evidence in most aspects
of someone’s life
General Personality Disorder
A) Enduring pattern of inner experience and behaviour that deviates markedly from what is expected of the individual’s culture. Manifests in
two or more of the following:
1) Cognition (i.e., ways of perceiving and interpreting self, others, and events).
2) Affectivity (i.e., range, intensity, lability, and appropriateness of emotion response).
3) Interpersonal functioning.
4) Impulse control.
B) The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
C) The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
D) The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
E) The enduring pattern is not better explained as a manifestation or
consequence of another mental disorder.
F) The enduring pattern is not attributable to the physiological effects of a
substance or another medical condition.
PD Criterion A
a 0–4 scale of personality functioning in self
identity and self-direction and interpersonal domains
(empathy and intimacy)
PD Criterion B
a dimensional system in which 25 traits are organized into five overarching domains (antagonism vs agreeableness; detachment vs extraversion; disinhibition vs conscientiousness; negative affectivity vs emotional
stability; and psychoticism vs lucidity)
PD Criterion C
A prototypal system of six personality disorder types (vs current 10)
Avoidant, schizotypal, antisocial, narcissistic, obsessive-compulsive, and
borderline
Dropped schizoid, paranoid, histrionic, dependent
PD Cluster A
Odd-Eccnetric Personality Disorders: symptoms similar to schizophrenia (ex. odd speech patterns + paranoia) but maintain grasp on reality
PD Cluster B
Dramatic-Erratic Personality Disorders: manipulative, volatile + uncaring in social relationships. Prone to impulsive + violent behaviours.
PD Cluster C
Anxious-Fearful Personality Disorders: extremely concerned about being criticized or abandoned by others, therefore have dysfunctional relationships.
Boderline Personality Disorder (BPD)
A pervasive pattern of instability of interpersonal relationships, self-image, and
affects, marked impulsivity beginning by early adulthood and present in a
variety of contexts, as indicated by five or more of the following criteria..
1) Frantic efforts to avoid real or imagined abandonment
2) A pattern of unstable and intense interpersonal relationships characterized
by alternating between extremes of idealization and devaluation; splitting
3) Identity disturbance; markedly and persistently unstable self-image or sense
of self
4) Impulsivity in two areas that are potentially self-damaging (e.g., spending,
sex, substance abuse, reckless driving, binge eating)
5) Recurrent suicidal behaviour, threats, gestures, or self-mutilating behaviour
6) Affective instability due to a marked reactivity of mood (e.g., intense
episodic dysphoria, irritability, or anxiety usually last a few hours, rarely
more than a few days)
7) Chronic feelings of emptiness
8) Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical
fights)
9) Transient stress-related paranoid ideation or severe dissociative symptoms DSM 5 Criteria
BPD Commorbidities
25%-75% have MDD
4-20% biopolar
65% substance use
eating disorders
40% men committing violence against partners
diagnosed more frequently in women
“Borderline”
in between neurotic and psychotic
Etiology of BPD
unresolved PTSD?
Childhood abuse - higher rates by those with BPD
Reduced hippocampal & amygdalar volumes in
BPD – a consequence of PTSD?
No specificity in abuse-disorder relationship
Respondent behaviour
Behaviour is a habitual
response/reaction to circumstance
E.g., every time person perceives rejection, there are
overwhelming feelings of panic, followed by suicide gestures
Operant behaviour
behaviour that is
learned/maintained by consequences
every time person makes suicide gesture, personal and
professional supports increase, demands decrease, emotional
pain decreases
Treating BPD
CBT invalidating for people in acute distress
Fundamental difference – assume that cognitions
are not distorted
Radical acceptance/nonjudgmental stance
Being a “perfect” BPD client
Dialectical?
Dialectic = an interpretive method routed in the
practice of dialogue between two people with
different ideas and trying to persuade one
another of their position
3 Basic Tents of Dialectics
1) Interrelatedness and Wholeness
“Everything is connected to everything else”
2) Reality is composed of opposing forces
(“thesis” and “antithesis”).
These opposites
can be integrated (“synthesis”) to form a closer approximation of “the truth”
3) Change is constant and inevitable; tension between opposing forces in a system is
what produces change
The Central Dialectic of DBT
Acceptance - synthesis & new way of being - change.
Individual therapy
Conduct a behavioural analysis to address:
a) suicidal behaviour;
b) therapy-interfering behaviours;
c) quality of life interfering behaviour;
d) increasing skills
Group therapy
Mindfulness – being in the moment
Emotion-regulation – identifying emotions;
changing emotional state through behaviour
Distress tolerance – distracting, self-soothing
Interpersonal skills – effective communication
