personality disorders Flashcards
What is a personality disorder?
It is:
Persistent pattern of emotions, cognitions, behavior resulting in enduring emotional distress for affected person and others
Distress may (or may not) be subjective
Causes difficulties with work and relationships
Create distress for the individual but also those around them, interpersonal relationships (intimate, personal, work, etc.)
The DSM-5 lists 10 specific personality disorders
What is the nature of personality and personality disorders
Personality is an enduring and relatively stable predispositions (i.e. ways of relating and thinking)
Predispositions are inflexible and maladaptive, causing distress and/or impairment
A personality disorder typically becomes recognizable in adolescence or early adulthood
- these are among the most difficult psychological disorders to treat
- many sufferers are not even aware of their personality disorder
Have it’s roots in childhood, hints towards disordered personality in elementary school (very emotionally intense person)
Very hesitant to diagnosis at a young age but the signs are usually there
People with personality disorders are not always given insight, not so self-aware (especially narcissism)
Human personality is not that mailable, treating personality disorders takes a long time for little movement
As time goes on and people ages, some of the traits age out
What are the personality disorder clusters?
the DSM-5 divides personality disorders into three groups (clusters). It holds the criteria for diagnosis and it is a useful system to help identify different types:
Cluster A: Odd or eccentric
Cluster B: dramatic, emotional, erratic
Cluster C: anxious, fearful
What are the Cluster A Disorders and what category are they in?
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Odd personality disorders. People with these disorders display behaviors similar to, but not extensive as, schizophrenia
-Behaviors include extreme suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving things
Much less likely to seek the help of the therapist
High isolation
Suspicion
No social life
Not full on schizophrenia but a precursor state or on the scale
People who are odd and strange in an off putting way
What is Paranoid Personality Disorder?
Clinical Descriptions:
Argumentative, may complain,, quiet, hostile toward others, suicidal, aloof
Bears relationship to:
paranoid type of schizophrenia
Delusional disorder
A person is typically suspicious, mistrustful of others without justification. They are very intense, angry, assume you are plotting against them, preemptive behavior and can find offense and distrust in anyone
What causes paranoid personality disorder and what is the treatment like?
Causes:
Genetics
relatives with schizophrenia
mistreatment or traumatic childhood experiences
cognitive cultural factors
quite likely genetics
socio-economic factors
Treatments:
cognitive therapy to change mistaken assumptions about others
At the extreme, it would be very hard to treat, at the less extreme, it may be possible
People with paranoid personality disorder do not typically see themselves as need helping
- few come to treatment willingly
- those who are in treatment often distrust and rebel against their therapists
as a result, therapy for this disorder, as for most of the other personality disorders, has limited effect and moves slowly.
Therapy is a group, alliance, working together to get help so they must trust the therapist, something that paranoid personality cannot do
they don’t see themselves as needing help
Aileen Wuornos as example
What is Schizoid Personality Disorder?
Clinical Description:
Detachment from social relationships, no desire to enjoy closeness with others, cold, aloof
Often less to homelessness
Extreme social deficiencies
Social isolation, poor rapport, and constricted affect
It is characterized by persistent avoidance of social relationships and limited emotional expression
- Withdrawn and reclusive, people with this disorder do not have close ties with other people; they genuinely prefer to be alone
- People with schizoid personality disorder focus mainly on themselves and are often seen as flat, cold, humorless, and dull
- the disorder is estimated to affect fewer than 1% of the popular (m>f)
What causes Schizoid Personality disorder?
Causes:
Childhood shyness, abuse, neglect, low-density dopamine receptors
Treatment:
Their extreme social withdrawal prevents most people with this disorder from entering therapy unless some other disorder makes treatment necessary
- Even then, patient are likely to remain emotionally distant from the therapist, seem not to care about treatment, and make limited progress
Not motivated to approach and figure it out
Social Skills training - role-playing
Limited outcomes
What is Schizotypal Personality Disorder?
Clinical Description:
Social deficits, psychotic-like symptoms, cognitive impairments/paranoia
“Magical thinking”, delusional thinking, ideas of reference, and illusions are common
report unusual perceptual experiences
hypersensitive to criticism as children
Behavior and dress is odd and unusual
Most are socially isolated and may be highly suspicious of others
Risk for developing schizophrenia is high in this group
many also meet criteria for major depression
How do theorists explain schizotypal personality disorder?
Because the symptoms of schizotypal personality disorder so often resemble those of schizophrenia, resesarchers have hypothesized that similar factors are at work in both disorders
-Schizotypal symptoms are often linked to family conflicts and to psychological disorders in parents
- Researchers have also begun to link schizotypal personality disorder to some of the same biological factors found in schizophrenia, such as high dopamine activity
What causes schizotypal personality disorder and what is the treatment?
Causes:
Genetics, prevalence of disorder in relatives
left hemisphere damage; brain abnormalities
abnormalities in semantic association abilities
- may be cause of magical ideation
Treatment:
Antipsychotic medication, community treatment, social skills training, CBT
Therapy doesn’t seem to help
Most therapists agree on the need to help clients ‘reconnect’ and recognize the limit of their thinking and powers
- Cognitive-behavioral therapists further try to teach client to objectively evaluate their thoughts and perceptions and provide speech lessons and social skills training
Antipsychotic drugs appear to be somewhat helpful in reducing certain thought problems
What are the Cluster B disorders and what category are they in?
Antisocial Personality Disorder (Psychopathy)
Borderline Personality Disorder
Histrionic Personality Disorder
Dramatic personality disorders:
the behaviors of people with these disorders are so dramatic, emotional, or erratic that it is almost impossible for them to have relationships that are truly giving and satisfying
The causes of the disorders are not well understood
Treatments range from ineffective to moderately effective
What is Antisocial Personality Disorder?
Clinical Description:
Aggressive, lying, cheating, no remorse, substance abuse, unnatural death in boys with this disorder
moral insanity, egopathy, sociopathy, and psychopathy
50-80% of male offenders diagnosed with this disorder
Conduct disorder in children
Not social avoidance but a pattern of criminal behavior, lying, cheating, stealing, and manipulation, big egos
Big hint for an adult antisocial is a childhood conduct disorder - a childhood person who has the same behavior but as a child
Predominant in men
What causes Antisocial personality disorder and what does treatment look like?
Causes:
Born into the world with a predisposition then the environment develops these traits
Gene-enviornment interaction
Chronic stress in family
Academic difficulty, peer problems, low family income, neglect and harsh discipline from parents
underarousal of cortex, fearlessness
An integrative model:
Genetic vulnerability to antisocial behaviors and personality traits
- leads to underarousal and fearlessness
Weak inhibition system and overactive reward system
- differences in emotions and cognitions
Treatment:
Multifaceted, CBT, prevention better approach
What are neurobiological influences to antisocial personality disorder?
Executive cognitive function deficits in psychopaths
- underarousal hypothesis: abnormally low levels of cortical arousal, which causes fearlessness
- fearlessness hypothesis: antisocial and risk-taking behaviors
insufficiently developed cortices
deficient MAOA due to defective gene producing it
