Personality Disorders Flashcards
What is the big five?
Big Five Factors
- Neuroticism
- Extraversion→ assertive, talkative VS passive, reserved
- Openness to experience→ Imaginative, curious VS shallow, unperceptive
- Agreeableness→ kind , trusting, warmth VS selfishness, hostility
- Conscientiousness→ organized, careful VS careless, unreliable
What are the criteria characterizing personality disorders in the DSM-5?
DSM-5→ got rid of Axis II
- enduring pattern of inner experience and behavior
- deviates markedly from the expectations of the individual’s culture
- is pervasive and inflexible
- has an onset in adolescence or early adulthood (children only have temperament)
- is stable over time
- and leads to distress and impairment (egosyntonic VS egodystonic)
What is the difference between egosyntonic et ego dystonic?
Ego syntonic→ don’t cause distress to the person
Ego dystonic→ behaviour causes distress and the person does not want to engage in this behaviour
What are the three clusters of PDs and their corresponding PDs?
Cluster A→ Odd/ Eccentric
- social detachment
- Paranoid PD, schizoid, schizotypal
Cluster B→ Dramatic / Emotional / Erratic
- impulse behaviours
- antisocial activities
- attract attention
- Antisocial, borderline, histrionic, narcissistic
Cluster C→ Anxious / Fearful
- Avoidant PD , Dependent PD, Obsessive Compulsive PD
- look a lot like anxiety disorders
What is the epidemiology of PDs?
Life time prevalence→ 4-15% in general pop
- higher in inpatient settings
Gender
- Diagnose women with Antisocial PD→ because agression take different forms depending on culture and dont fit definition
- 80% of individuals with BPD are women
- Diagnose men with Histrionic PD→ explicitly gendered
- study with mental health professionals diagnose case with 50% described ad women and other men
- 76% of female cases dx HPD VS 49% male cases
What are the comorbidity rates of PDs?
Comorbidity→ very high
Norms to have multiples PDs
- Of people diagnosed with BPD
- 47% met criteria for APD
- 57% for histrionic
- APD has overlapping symptoms with both Schizoid and NPD
Major disorders→ mood, anxiety, substance use…
- Avoidant, dependent highly comorbid with anxiety and depression
- BPD comorbid with unipolar, bipolar, PTSD
- Substance use disorder comorbid with ASPD, BPD, NPD
- Avoidant comorbid with all Eating Disorders (ED)
- Highest comorbidity for AN-R (arenoxia) and BED (binge eating) = OCPD
What are the two criteria of the Alternative Model for Personality Disorders (AMPD)?
A→ Moderate or greater impariment in personality functioning with personality functionig being
- the degree to which there is an intact sense of self (involving a clear, coherent identity and effective self-directedness)
- interpersonal functioning (reflecting a good capacity for empathy and for mature, mutually rewarding intimacy with others)
B→ presence of pathological personality traits
- Negative affectivity, Detachment, Antagonism, Disinhibition and Psychoticism
—>moderate improvement is threshold ot indicate presence of PD
How does Paranoid Personality Disorder present itself?
Symptoms
- Pervasive suspiciousness
- see self as blameless
- on guard for perceived attacks by others
More common in families of person with schizophrenia
- different form schizophrenia with severity
Overlap with Avoidant and BPD
How does Schizoid Personality Disorder present itself?
Symptoms
- Near total lack of interest in intimate involvement with others
- Limited emotional responsiveness
- “Loners”→ Perceived as cold, indifferent
Overlap with Schizotypal
- but might be more related to asocial disorders like Autism spectrum
How does Schizotypal Personality Disorder present itself?
Symptoms
- Cognitive and perceptual distortions
- Want interpersonal relationships but difficult to connect with people
- Eccentricity of thought or behavior
- Odd beliefs, odd speech
- Magical thinking (lots of superstition)
- Telepathy, clairvoyance
- Ideas of reference
- Contact with reality maintained (know that it is irrational deep down)
Overlap with schizophrenia→ but less severe
- eccentric but not delusional
- could be a mild or prodromal schizophrenia
- familial co-aggregation
How does Histrionic Personality Disorder present itself?
Symptoms
- Highly dramatic, lively, extraverted personality
- high sensetion-seeking
- low on self-consciousness
- lot of over flirtation and preoccupation with physical appearance
- Irritability and temper outbursts if attention seeking is frustrated
Prevalence→ 2-3%
- proposed for removal
How does Narcissistic Personality Disorder present itself?
Symptoms
- Genuine grandiosity VS Vulnerable→ grandiosity can mask intense shame and terrible feeling about themselves
- Preoccupation with receiving attention
- Self-Promoting
- Lack Empathy
- Easily offended
- Highly variable clinical presentation
- hypercritical of others
Usually don’t come in therapy for that
- increase likelihood of dropout
- slow symptom change
- difficulty accepting the diagnosis
Prevalence→ less than 1%
Gender→ may be more common in males than females
Etiology
- Grandiose associated with parental overvaluation
- Vulnerable associated with emotional, physical, sexual abuse/ intrusive, controlling, cold parenting styles
How does Obsessive-Compulsive Personality Disorder present itself?
Symptoms
- Inflexibility and a desire for perfection
- Preoccupation with rules and order
- Often moralistic and judgmental
- Viewed by others as rigid, stubborn, cold
- Most stable features: rigidity, stubbornness, perfectionism, reluctance to delegate
How is OCD different from OCPD?
Very different from OCD
- not true obsessions and compulsions
- not always associated with anxiety
- only 20% of OCD have OCPD
- OCD more likely to be comorbid with avoidant and dependent
