Personality Disorders

Question 1

History of personality

Answer 1

Word appeared in the 14th century, distinguishing humans from inanimate objects. Comes from Ancient Roman ‘persona’ Refers to mask worn by actors to portray a character, archetypes in Greek dramas. Stable ‘character’ traits that exert themselves.

Question 2

Definition of personality

Answer 2

an individuals enduring pattern of responses and interactions with others and the environment (Boys and Bee, 2010) Trait- an enduring characteristic that reveals itself in a pattern of behaviour in a variety of situations. Characteristics central to who we are as people and how we percieve other people and experiences. Stereotypes we hold about others are linked with personality attributes.

Question 3

Key concepts in personality psychology

Answer 3

1. What are the major enduring commonalities among people in action, motivation, and cognition. 2. Key ways individuals differ in action, motivation and cognition and establish criteria to see the most important ways. 3. How can the relations between major commonalities and major individual differences be conceptualized.

Question 4

Example of personality and individual differences

Answer 4

high IQ may make someone more susceptible to depression.

Question 5

Disordered personality

Answer 5

Class of personality types that deviate from contemporary societal expectations (Berrios 1993) Studies such as Grilo et al. (2004) (Figure 1) compared Major Depression Disorder people with PDSs after a two year period showed below clinical levels of the disorder at 23% (schizotypal) to 38% (OCD) 20-60% of people will show no change in their symptoms, as hard to treat, as individual believes their thoughts are normal.

Question 6

General criteria for a PD in DSM-V

Answer 6

A. significant impairments in self and interpersonal functioning. B. One or more pathological personality trait domains or trait facets. C. Impairments in individuals personality are shown across all time and situations. D. The impairments not better understood as normative for the individuals developmental stage or sociocultural environment. E. The impairments are not due to physiological effects.

Question 7

Development of a PD disorder

Answer 7

Cant be diagnosed till 18. 73% of adult patients reported various forms of child abuse. In a review by Tackett et al found such as parental conflict, low socioeconomic status, parental psychopathology and maternal over-control can increase risk. Genetic liability found by Distel et al.

Question 8

Cluster A disorders

Answer 8

Schizotypal, Schizoid, Paranoid

Question 9

Schizotypal disorder

Answer 9

severe anxiety, paranoid ideation, derealization, transient psychosis, peculiar speech mannerisms and odd modes of dress. 3-45 population.

Question 10

Schizoid disorder

Answer 10

rare condition, avoidance of social activities and consistently shy away from interaction with others and limited range of emotional expression. 2-4% population.

Question 11

Paranoid

Answer 11

very suspicious of others, believing they will harm them. Reluctant to confide in others, bearing grudges and finding demeaning comments even in the most innocent comments. Hard to treat as need to build trust with therapist. 2-4% population.

Question 12

Further info on paranoid

Answer 12

Suspiciousness is due to anticipated mistreatment and exploitation by others who are seen as devious, deceptive and manipulative. Generally experience anger over presumed abuse, anxiety over perceived threats and a heightened sense of fear that is often perceived by others as argumentative, stubborn and uncompromising.

Question 13

PPD and conspiracy theories

Answer 13

overlap between paranoid and a general political attitude vs paranoia about harm to the individual self. Both paranoia and belief in conspiracy theories are related to beliefs in authoritarianism (powerful systems controlling things behind the scenes) Also both linked to low perceived benevolence of social groups (the world is an unkind place)

Question 14

Cluster B PDs

Answer 14

Dramatic cluster: Borderline Personality Disorder, Anti-social (sociopaths), Narcissistic, histrionic

Question 15

Borderline Personality Disorder

Answer 15

Psychological term is affective dysregulation, disturbed patterns of thinking or perception, cognitive or perceptual distortions, impulsive behaviour, intense but unstable relationship with others. More common in women.

Question 16

Anti-social (sociopaths)

Answer 16

impulsive, irresponsible and often criminal behaviour, manipulative, deceitful and reckless no care for other peoples feelings, has a goal they will reach no matter what.

Question 17

Narcissistic

Answer 17

long term pattern of exaggerated feelings of self importance, excessive need for admiration, lack of empathy. Another type is incredibly insecure use narcissism to fill their self esteem

Question 18

Histrionic

Answer 18

excessive attention seeking, usually begins in early adulthood, inappropriate seduction and excessive approval.

Question 19

Zoom in on Antisocial Personality Disorder-

Answer 19

Egocentricity, absence of prosocial standards, need to control others. Need 6 of 7 traits: (Manipulativeness, Callousness, Deceitfulness, and Hostility) and Disinhibition (risk taking, impulsivity and irresponsibility) DSM-5 AMPD includes a psychopathy specifier, “lack of anxiety of fear and by a bold interpersonal style (thrill seeking)

Question 20

Antisocial Personality Disorder and ADHD

Answer 20

ADHD one of the most common childhood conditions (3-5%) Impulsiveness, attention deficits, difficult in social interactions. 65% of the ASPD measured by DSM-IV also met the DSM-IV criteria for ADHD. A history of childhood neglect, parental divorce, early maternal separation, and more common in ASPD participants with comorbid ADHD. 50% ADHD have another psychiatric disorder.

Question 21

Cluster C: Anxious Cluster

Answer 21

The Avoidant Personality Disorder, Dependent Personality Disorder, OCD/OCPD

Question 22

The Avoidant Personality Disorder

Answer 22

Characterised by a pervasive of pervasive pattern of social inhibition, feelings of inadequacy and a hypersensitivity to negative evaluation.

Question 23

Dependent personality disorder

Answer 23

A strong need to be taken care of by other people, this need and the associated fear of loosing the support of others often leads patients to behave in a “clingy manner”

Question 24

OCD/OCPD

Answer 24

Characterised by extreme perfectionism, order and neatness; finding it hard to express feelings, and difficulty forming and maintaining close relationships with others.

Question 25

Zoom in on Dependent Personality Disorder:

Answer 25

5% of the population, more common in females. Core element is a view of self as helpless and inept, along with a view of others who are seen as strong and contempt.

Question 26

8 characteristics needing to be met for DPD

Answer 26

Need to meet 5/8 Difficulty making decisions without reassurance from others, 2. others needing to assume their responsibilities, 3. fear of disagreeing with others, 4. Difficulty starting projects without others help, 5. Excessive need for others support, 6. Feels vulnerable when alone, 7. Desperately seeks another relationship when one ends. 8. Unrealistic fear of being left out.

Question 27

Dependent Personality Disorder and Physical Abuse:

Answer 27

305 subjects consecutively admitted to an outpatient department of legal medicine for physical abuse (Loas et al., 2011) Divided in 3 groups: without personality disorder with WPD, NDPD and with DPDs. Rate of spouses among the perpetrators was significantly different between the three groups: 44.4% of the perpetrators were the spouse for DPD subjects vs. 11.2% for WPD and 20.1% for NDPD

Question 28

Treatment (Beck et al., 2016) ideas

Answer 28

Those with PDs have likely struggled since childhood or adolescence. May not have defined goals or values, tend to distort reality in situations and have rigid and highly dysfunctional beliefs and rules. Have a smaller amount of coping strategies.

Question 29

CBT (Beck et al., 2016)

Answer 29

Therapist helps client feel safe and they can trust them. Offer positive reinforcement that contradicts clients’ core beliefs about themself. Change the behaviours that happen due to faulty thinking e.g., meta analysis of several PDs that included five RCTs found CBT resulted in improvements in symptoms and personality measures

Question 30

Dialectical behavioural therapy (DPT)

Answer 30

Common treatment for BPD. A dialectical philosophy that encourages the balance and synthesis of both acceptance and change The role of mindfulness acceptance and appraisal. Think of things you can do instead of the self harming behaviours.