Personality Disorders Flashcards
Define personality.
- Emotional and behavioral traits that characterize the person in day-to-day living under ordinary conditions
- Cognition, affect, behavior (impulse control) and interpersonal style
- Relatively stable and predictable
Define personality disorder.
Longstanding pervasive and inflexible patterns of behavior
- Depart from cultural expectation
- Impair social and occupational functioning
- Cause emotional distress
- Coded as Axis II and can be co-morbid with Axis I
When can personality disorder generally be diagnosed?
Personality disorder cannot generally be diagnosed until after puberty (i.e. around early 20s)
What is negative affectivity?
- Involves experiencing negative emotions frequently and intensely.
- Trait facets: Emotional lability, anxiousness, separation insecurity, perseveration, submissiveness, hostility, depressivity, suspiciousness, restricted affectvity (-).
Define detachment in personality disorder.
- Involves withdrawal from other people and from social interactions.
- Trait facets: Restricted affectivity, depressivity, suspiciousness, withdrawal, anhedonia, intimacy avoidance,
Define antagonism in personality disorder.
- Involves behaviors that put the person at odds with other people.
- Trait facets: Manipulativeness, deceitfulness, grandiosity, attention seeking, callousness, hostility
Define disinhibition in personality disorder.
- Involves engaging in behaviors on impulse, without reflecting on potential future consequences.
- Compulsivity is the opposite pole of this domain.
- Trait facets: Irresponsibility, impulsivity, distractibility, risk taking, rigid perfectionism (-).
Define psychoticism in personality disorder.
- Involves unusual and bizarre experiences.
- Trait facets: Unusual beliefs & experiences, eccentricity, cognitive & perceptual dysregulation
What is cluster A personality disorder?
- Odd and Eccentric (Schizophrenia spectrum)
- ie: Paranoid, Schizotypal & Schizoid
What is cluster B personality disorder?
- Dramatic, Emotional and Erratic
- ie: Borderline, Histrionic, Narcissistic & Antisocial
What is cluster C personality disorder?
- Cluster C – Anxious & Fearful
- Avoidant, Dependent and Obsessive-Compulsive
What are the demographics of paranoid personality? (cluster A)
- 0.5-2.5% of the population.
- Men > Women.
What is the relationship with paranoid personality with schizophrenia?
- Paranoid personality may be on the Schizophrenia spectrum
- Lacks hallucinations
- Disturbance of cognitive organization & info processing
What are the main characteristics of paranoid personality?
- Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
- Doubts about the loyalty or trustworthiness of friends or associates.
- Reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
- Reads hidden meaning or threatening meanings into benign remarks or events.
- Persistently bears grudges
- Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
- Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
What is the prevalence of schizotypal disorder? (Cluster A)
- 3%
- M>F
What is the relationship of schizotypal disorder with schizophrenia?
- May be on the spectrum of schizophrenia
What are the main characteristics of schizotypal disorder?
- Ideas of reference
- Odd beliefs/magical thinking that influences behavior and is inconsistent with subcultural norms (6th sense)
- Unusual perceptual experiences, including bodily illusions.
- Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped).
- Suspiciousness or paranoid ideation.
- Lack of close friends or confidants
- Excessive social anxiety
What is the prevalence of schizoid personality? (Cluster A)
- Prevalence F
What are the main characteristics of schizoid personality?
- Neither desires nor enjoys close relationships, including being part of a family.
- Almost always chooses solitary activities.
- Has little, if any, interest in having sexual experiences with another person.
- Takes pleasure in few, if any, activities.
- Lacks close friends or confidants other than first-degree relatives.
- Appears indifferent to the praise and criticism of others.
- Shows emotional coldness, detachment, or flattened affectivity.
What is the prevalence of borderline personality? (Cluster B)
- 1-2% of the population
- 2x women> men
What disorders are increased in borderline personality?
- increased prevalence of major depressive disorder
- alcohol abuse/dependence
- substance abuse found in first degree relatives
- border of psychosis/neurosis (where name is from)
- abuse or “invalidating” family environment
What therapy is used in borderline personality?
- DBT => dialectical behavior therapy
What are the main characteristics of borderline personality?
- Frantic efforts to avoid real or imagined abandonment.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
- Chronic feelings of emptiness.
- Can take on the emotions that are in their environment
- Recurrent suicidal behavior ( or self-mutilating behavior)
- Affective instability due to a marked reactivity of mood (within minutes/hours)
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
- Tends to split groups (antagonize individuals against another)
- Can also have many vague symptoms/diganosis
What is the prevalence histrionic personality disorder? (Cluster B)
- 2-3%.
- Diagnosed more frequently in women than in men
What are the main characteristics of histrionic personality disorder?
- Is uncomfortable in situations in which he or she is not the center of attention.
- Inappropriate sexually seductive or provocative behavior.
- Displays rapidly shifting and shallow expression of emotions.
- Consistently uses physical appearance to draw attention to self.
- Has a style of speech that is excessively impressionistic and lacking in detail.
- Shows self-dramatization, theatricality, and exaggerated expression.
- Easily influenced by others or circumstances.
- Considers relationships to be more intimate that they actually are
Describe Narcissistic Personality characteristics.
- Has a grandiose sense of self-importance
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
- Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
- Requires excessive admiration.
- Has a sense of entitlement
- Is interpersonally exploitative =>takes advantage of others to achieve his or her own ends.
- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
- Is often envious of others or believes that others are envious of him or her.
- Shows arrogant, haughty behavior or attitudes.
- Serious/”successful” suicide attempts
What is the prevalence of narcisstic personality disorder?
1%
What is the prevalence of antisocial personality (dyssocial)? (Cluster B)
- 3% in men
- 1% in women
- Familial pattern present
- High co-morbidity with etoh dependence
- High in prison populations.
What areas of the brain are generally affected in antisocial personality disorder?
- Low threshold of impulsive aggression
- Amygdala, reduced prefrontal
What are the main characteristics of antisocial personality disorder?
- Failure to conform to social norms with respect to lawful behaviors
- Deceitfulness, use of aliases, or conning others for personal profit or pleasure.
- Impulsivity or failure to plan ahead.
- Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
- Reckless disregard for safety of self or others.
- Consistent irresponsibility
- Lack of remorse
- The individual is at least age 18 years, and there is evidence of Conduct Disorder with onset before age 15 years.
What is the prevalence of avoidant disorder? (Cluster C)
1%
- Overlap with social phobia => but would LIKE to have relationships
- Treatment – exposure therapy
What are the main characteristics of avoidant disorder?
- Is unwilling to get involved with people unless certain of being liked.
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
- Is preoccupied with being criticized or rejected in social situations and avoids these situations
- Is inhibited in new interpersonal situations because of feelings of inadequacy.
- Views self as socially inept, personally unappealing, or inferior to others.
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
What is the prevalence of dependent disorder? (Cluster C)
- 1.5%
- F>M
- High medical interactions/obesity
What are the main characteristics of dependent disorder?
- Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
- Needs others to assume responsibility for most major areas of his or her life.
- Has difficulty expressing disagreement with others because of fear of loss of support or approval.
- Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
- Goes to excessive lengths to obtain nurturance and support from others
- Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
- Urgently seeks another relationship as a source of care and support when a close relationship ends.
- Is unrealistically preoccupied with fears of being left to take care of himself or herself.
What is the prevalence of Obsessive Compulsive PERSONALITY Disorder? (Cluster C)
- 1%
- NOT THE SAME AS OCD
What are the main characteristics of OCPD?
- Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
- Shows perfectionism that interferes with task completion
- Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships.
- Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values.
- Is unable to discard worn-out or worthless objects even when they have no sentimental value.
- Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
- Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
- Shows rigidity and stubbornness
How are personality disorders generally treated?
- Symptomatic
- Psychotherapy – change disorder into traits
- Psychodynamic, CBT, DBT
- Social skills training
- Medications (generally for related depression)
