Personality Disorders Flashcards
What are personality disorders?
A persistent pattern of emotions, cognitions and behaviours that result in pervasive problems in personal and interpersonal functioning
Whan are personality disorders recognisable and how long do they last for
In adolescence or early adulthood
Symptoms usually last for years
What is the prevalence of personality disorders
10 percent of adults
40 percent of mental health outpatients
what are the 3 clusters of personality disorders?
Odd/Eccentric
Anxious/fearful
Dramatic/Erratic
What are the subcategories of avoidant/fearful?
Avoidant
Dependent -DSM said to remove
Obsessive compulsive
What is Avoidant Personality Disorder?
- Extreme sensitivity to others opinions
- one becomes highly avoidant of interpersonal relationships
- Fears rejection and criticism
- Has a low self esteem
- 80 percent of patients have co-morbid depression
What is avoidant personality disorder often compared to?
A more chronic, but less severe form of Social Anxiety Disorder- SAD
Why is avoidant personality disorder often compared to with social anxiety?
They have shared genetic vulnerability
their treatments are similar
- challenge low self esteem
Expose to social situations
Whats the difference between avoidant personality disorder and social anxiety disorder?
SAD patients are afraid of negative social evaluation but its more intense and limited to fewer settings
Avoidant is linked to more pervasive and strongly held views of inadequacy- hypersensitive to criticism
Avoidant symptoms present for lower,ie. from early adulthood.
Whats obsessive compulsive personality disorder?
- Perfection which ends up in tasks not getting completed
- Preoccupation w rules, details and organisation that goals get lost
- Excessive devotion to work which results in an exclusion of social life
- Being stubborn and rigid thinking
- Reluctance to delegate tasks- loves being in control
- Difficulty throwing things away- mild hoarding and miserly
What are the similarities between OCD and OCPD
OCD is rarer to could be the more extreme cases
They are both marked by ritualised and rigid behaviours
Differences between OCD and OCPD
OCPD- ego-syntonic (harmonise)
The desires for perfection are wanted
OCD- Dystonic
They are unwanted and intrusive and the person tries to suppress them
The majority of ppl with OCD do not have OCPD
Whats dependent personality disorder
- Deep reliance on others
-fear of separation
-clingy and submisssive
- feeling of helplessness when alone
-need to be taken care of - Difficulty asserting disagreement- won’t speak up, don’t want to anger others
- Relies on others to make major and minor life decisions
- Vulnerable to exploitation and abuse
What are the subcategories of odd/eccentric?
Paranoid-DSM said to remove
Schizoid-DSM said to remove
Schizotypal
Whats paranoid personality disorder?
- mistrust and suspicion of others
- Hypervigilance to exploitation
- Preoccupied w doubts of suspicion and trustworthiness
- Extremely hostile
- Holds grudges and always gets involved in conflict
- Often isolated and has a poor quality of life
Whats schizoid personality disorder
- detachment from social relationships
- Very limited range of emotions- flat affect
- indifference to approval and criticism
- Not interested in pleasurable activities
Whats schizotypal personality disorder?
- Eccentric behaviour
- Socially isolated
- Highly suspicious of others
- Strange beliefs/theories
- Disorganised speech
Whats schizophrenia light?
- Similar (but milder) cognitive deficits
- Similar (but milder) brain changes
- Genetically-related to schizophrenia
- Treatment same- antipsychotics
What are the subcategories of dramatic/erratic?
Antisocial
borderline
Histrionic -DSM said to remove
Narcissistic -DSM said to remove
Whats antisocial personality disorder?
- Violation of rights of others
- Being irresponsible, aggressive, deceitful
- Lack of conscience, empathy or regret
- May be very charming but manipulative
- Law breaking is common- 75% meet criteria
What is antisocial personality disorder usually referred to as?
Sociopathy/ psychopathy
Whats the under arousal hypothesis for antisocial personality disorder?
That they have lower arousal to stimulation, ie. reduced startle
reduced fear response
Why are Antisocial personality ppl more likely to commit crime
Because they’re less sensitive to punishment and are less scared
How was the term narcissistic personality disorder coined?
From Greek figure Narcissus
Whats narcissistic personality disorder?
- Exaggerated or unreasonable sense of self-importance,ie. grandiose delusions.
- Preoccupation with receiving attention
- Lack compassion for others
- Highly sensitive to criticism
- Arrogant and envious
What are some theories behind why narcissism exists?
Parenting styles- you are so special
Low self-esteem
Whats borderline personality disorder?
- Unstable moods
- Fear of abandonment
- Impulsivity - gambling, suicidal gestures
- Poor self image
- 80% comorbidity with depression
- 70% self har,
Whats the prevalence of BPD?
Most prevalent personality disorder
20% of inpatient population
What is the genetic aetiology of BPD
50 %
Whats the environmental aetiology of BPD
Trauma and abuse
Whats the neurological aetiology of BPD
High emotional reactivity
Morte reactive amygdyla
Less reactive prefrontal cortex
This causes more functional impairment than depression.
What is Histrionic personality disorder?
- Dramatic/melodramatic behaviour
- Emotions are very shallow
- Sexually provocative
- Attention seeking- use their appearance to stand out
- Suggestible
Difference between Histrionic personality disorder and hysteria?
Hysteria is true, deep-felt uncontrollable emotion
What personality disorders are more common in men?
antisocial (5 times more)
Narcissistic
Schizotypal
What personality disorders are more common in women?
Avoidant
dependant
paranoid
What personality disorders are equally common in both genders?
Schizoid
Obsessie compulsie
histrionic
BPD- but more women are diagnosed
How are personality disorders treated
Most people with personality disorders are seeking treatment for another disorder
Personality disorders make treatment more difficult
Psychotherapy for personality disorders
Become aware of negative beliefs (e.g., everyone out to get me)
Try to challenge maladaptive ideas (e.g., around perfectionism)
Dialectical Behavior therapy for BPD (e.g., acceptance, emotional regulation, mindfulness, coping)
But treatments have limited efficacy (…except Dialectical for BPD)
What are the main problems with DSM 5 diagnoses for personality disorders?
- Assessment practices are poor- most clinicians don’t used structured interviews
- Personality disorders are not stable over time
- Personality disorders are highly co-morbid
- Assessment practices are poor- most clinicians don’t used structured interviews
Antisocial and obsessive-compulsive personality
disorders had questionable reliability
Narcissistic and schizotypal personality disorder were
seen too infrequently to be assessed
EXCEPTION: Borderline was a notable exception though.
- Personality disorders are not stable over time
After 16 years 99% of diagnoses get remitted
- Personality disorders are highly co-morbid
50% of people diagnosed with a personality disorder
meet the diagnostic criteria for another personality
disorder
Many patients with serious personality problems don’t
fit neatly into a personality disorder diagnosis - affects experiments where they want to make an independent variable
Why are psych disorders messy?
The line between healthy and“abnormal” is blurred
The lines between different
diagnoses are blurred
No two individuals are alike
