Personality Disorders Flashcards
Exam 4 (on 5/9)
In Cleckley’s The Mask of Sanity, what are the criteria for psychopathy (Table 15.1) and which six had the strongest influence on current conceptualizations of the disorder?
6 strongest influence + 6 others
Top 6: superficial charm (good initial first impression), lacking remorse/shame, antisocial or devious behavior while lacking an apparent goal, failure to learn from experiences or mistakes, inability to connect emotionally with others (love), deficit in major affective reactions
Others: absence of delusions or nervousness, unreliability, lying, unresponsiveness, uninviting, failure to carry out a life plan
What are the elements of Gray’s BIS/BAS model?
There are 3
Fight/Flight System (FFS) = reacts to unconditioned aversive stimuli
Behavioral Activation System (BAS) = sensitive to reward
Behavioral Inhibition System (BIS) = sensitive to goal conflict
What element of the BIS/BAS model seems most related to psychopathy?
What experimental and physiological evidence supports this notion?
Psychopathy is associated with deficits in the BIS
Experiments: show that psychopaths are more likely to make passive avoidance errors
Physiology: have reduced startle responses and electrodermal activity when exposed to aversive stimuli
What area of the brain figures most prominently in Blair’s conceptualization of learning deficits in psychopathy? What is it responsible for?
Does the research literature support that structural brain differences in psychopathy are limited to this area?
Psychopaths have reduced amygdala activation during aversive conditioning tasks and passive avoidance tasks
The amygdala is responsible for modulating the startle response and for learning about aversive stimuli
We also see abnormalities in other brain regions responsible for empathy, such as the insula and anterior cingulate cortex
What is the response modulation hypothesis?
That abnormalities in selective attention undermine the ability of psychopaths to consider contextual information (especially when it comes to goal-directed behavior)
What is the main difference between low-fear and punishment-learning based models of psychopathy?
Low-fear focuses on fearlessness as a factor while punishment-learning focuses on reduced amygdala activation
Both focus on aversive stimuli, while the RMH focuses on attention processing of stimuli overall
What is the attention bottleneck?
Once attention is given to a specific goal, they are less able to process outside stimuli and their meanings, which interferes with their ability to consider context when evaluating their goals
What findings from Newman & Baskin-Sommers (2011) support the attention bottleneck hypothesis?
How do findings using the fear-potentiated startle paradigm also support this conclusion?
Studies further confirmed that they commit more passive avoidance errors
They used fear-potentiated startle (FPS) and found that they responded with normal fear responses when the attention was focused on fear-related information (color), but they had a fear deficit when the threat cues were peripheral and their attention was focused on goal-directed activity
I.e. insensitivity to punishment occurs when cues are peripheral in comparison to their goal-directed focus of attention
What do findings suggest about the relative genetic and environmental contributions to psychopathy?
Moderate contribution of each
Genetic and non-shared environmental factors seem to account for variance in twin studies (no gender differences were found in terms of heritability)
Seems to be a negligible influence of shared environmental factors
What is a potentially potent non-shared environmental factor in the development of psychopathy?
What findings, in particular, highlight this factor?
Peer relationships
Studies find that levels of psychopathic traits exhibited by an individual are correlated with the levels of psychopathic traits exhibited by their peer group (they’re similar)
What does research suggest about the genetic influences on the development of callous-unemotional traits in psychopathy?
Provides strong evidence for a genetic influence in the development of those traits, with an estimated 40 to 78% of variation attributed to genetic factors
What does it mean that BPD has been referred to as a disorder of “stable instability”?
In what ways are individuals with BPD “unstable”?
3 main areas of instability are listed here
Instability of mood (rapidly changing negative emotions), self-image (difficulty maintaining sense of self and goals), and interpersonal relationships
They are also dangerously impulsive and engage in self-harm behaviors to regulate negative emotions
“Stable” meaning consistent and profound (emotional pain)
What are the clinical features of BPD as per Table 14.1?
There are 9 symptoms
- Profound fears of abandonment
- Intense and unstable interpersonal relationships (switching between idolizing and devaluing)
- Identity disturbance
- Impulsive behavior that is potentially self-damaging or harmful
- Recurrent self-mutilating or suicidal behavior
- Highly reactive mood
- Persistent feelings of emptiness
- Intense or inappropriate anger
- Brief periods of paranoid ideation or dissociative symptoms
From where does the term borderline come from?
Be familiar with the types of patients that Stern (1938) and Knight (1953) were working with and how this informed their choice of the term
Borderline: at the time, it didn’t fit well within the existing classification system, which mainly focused on neurosis vs psychosis
Types of patients: hypersensitivity, impaired ego, trouble with reality testing, negative reactions to therapy, etc.
These patients didn’t seem to fit well in either category, but were still problematic
According to APA, approximately what percentage of patients with BPD are women?
What are some theories about why this might be (other than that a genuine difference exists across gender)?
75% of cases are women
Might be because women are more likely to seek treatment and thus be diagnosed
What did Torgersen et al. (2001) and Lenzenweger et al. (2007) find about gender differences in BPD?
Reported no gender differences in the prevalence of BPD in both the US and Norway
BPD may even be more prevalent in men in the UK
What do the authors of the chapter ultimately conclude with respect to gender differences in BPD?
The authors conclude that there is no real evidence to support the commonly held assumption that BPD has a 3:1 ratio of women to men
What do Linehan (1993) and Gunderson (1996) consider to be the core features of BPD?
They have two differing opinions (2 answers)
Linehan: affective instability (rapid mood changes, extreme reactivity, and depressed baseline mood)
Gunderson: Fear and intolerance of aloneness (extreme fear of abandonment and accompanying “frantic” efforts to avoid it)
What are the main components of Linehan’s (1993) biosocial theory?
What does she consider the key environmental factor in the development of the disorder?
BPD results from the interaction of biological or temperamental vulnerabilities with a family environment that does not provide said emotionally vulnerable child with the skills necessary to emotionally regulate
In other words, the key environmental factor is an invalidating family environment
What types of negative life events characterize the youth of those later diagnosed with BPD?
There are 4 listed here
Early trauma and adversity, such as neglect or parental absence, physical/sexual abuse, frequent arguments between parents, or being raised by a relative or in foster home
What is the main problem with almost all of the studies that examine the early life experiences of BPD patients? Why is this a problem?
They rely on retrospective reporting, which may be inaccurate due to problems with recall and reporting bias
What is attachment theory and how has it been used to understand BPD?
Interactions with caregivers are the basis for a child’s understanding of themselves and interpersonal relationships (it sets expectations for future relationships and impacts the quality of those bonds)
Most people with BPD are assessed as insecurely attached to their caregivers
What specific styles of insecure attachment appear linked to BPD in empirical studies?
Be familiar with Bateman and Fonagay’s notions of what links attachment style and BPD.
No specific style of insecure attachment appears linked to BPD
It’s found that failures in early attachment may be linked to an inability to mentalize (interpret the mental state of oneself or others)
What is executive neurocognition?
The ability to delay or terminate an action in favor of another goal or less immediate reward
