Personality Disorders

Question 1

Personality

Answer 1

Characteristic way a person behaves and thinks.

Pervasive - influences all aspects of our lives

Question 2

BIG 5

Answer 2

Openness
Conscientiousness
Agreeableness
Extraversion
Neuroticism

Question 3

Openness

Answer 3

fantasy, aesthetics, feelings, actions, ideas, values

opposite: closedness
concrete, disinterest, alexithymia, routine, close-minded, dogmatic

Question 4

Conscientiousness

Answer 4

competence, order, dutifulness, achievement stivining, self-discipline, deliberation

opposite: disinhibition
irresponsibility, negligence, rashness, disordered

Question 5

Extraversion

Answer 5

warmth, assertiveness, activity, excitement seeking, positive emotionality

opposite: introversion - coldness, dullnes, submissiveness

Question 6

Agreeableness

Answer 6

trust, straightforwardness, altruism, compliance, modesty, tender-minded

opposite: antagonism
mistrust, deceptopn, exploitation, aggression

Question 7

Neuroticism

Answer 7

anxiousness, angry hostility, depressiveness, self-consciousness, impulsivity, vulnerability

opposite: emotional stability
unconcerned, dispassionate, optimistic, shameless, restrained, fearless

Question 8

Personality Disorder

Answer 8

DSM 5: “Inflexible and maladaptive, and cause
significant impairment or subjective distress”

Chronic & pervasive – see evidence in most aspects
of someone’s life

Question 9

General Personality Disorder

Answer 9

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.

Question 10

PD Criterion A

Answer 10

a 0–4 scale of personality functioning in self
identity and self-direction and interpersonal domains
(empathy and intimacy)

Question 11

PD Criterion B

Answer 11

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)

Question 12

PD Criterion C

Answer 12

A prototypal system of six personality disorder types (vs current 10)

Avoidant, schizotypal, antisocial, narcissistic, obsessive-compulsive, and
borderline

Dropped schizoid, paranoid, histrionic, dependent

Question 13

PD Cluster A

Answer 13

Odd-Eccnetric Personality Disorders: symptoms similar to schizophrenia (ex. odd speech patterns + paranoia) but maintain grasp on reality

Question 14

PD Cluster B

Answer 14

Dramatic-Erratic Personality Disorders: manipulative, volatile + uncaring in social relationships. Prone to impulsive + violent behaviours.

Question 15

PD Cluster C

Answer 15

Anxious-Fearful Personality Disorders: extremely concerned about being criticized or abandoned by others, therefore have dysfunctional relationships.

Question 16

Boderline Personality Disorder (BPD)

Answer 16

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

Question 17

BPD Commorbidities

Answer 17

25%-75% have MDD
4-20% biopolar
65% substance use
eating disorders
40% men committing violence against partners

diagnosed more frequently in women

Question 18

“Borderline”

Answer 18

in between neurotic and psychotic

Question 19

Etiology of BPD

Answer 19

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

Question 20

Respondent behaviour

Answer 20

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

Question 21

Operant behaviour

Answer 21

behaviour that is
learned/maintained by consequences

every time person makes suicide gesture, personal and
professional supports increase, demands decrease, emotional
pain decreases

Question 22

Treating BPD

Answer 22

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

Question 23

3 Basic Tents of Dialectics

Answer 23

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

Question 24

The Central Dialectic of DBT

Answer 24

Acceptance - synthesis & new way of being - change.

Question 25

Individual therapy

Answer 25

Conduct a behavioural analysis to address:
a) suicidal behaviour;
b) therapy-interfering behaviours;
c) quality of life interfering behaviour;
d) increasing skills

Question 26

Group therapy

Answer 26

Mindfulness – being in the moment

Emotion-regulation – identifying emotions;
changing emotional state through behaviour

Distress tolerance – distracting, self-soothing

Interpersonal skills – effective communication