Personality Disorders Flashcards
1
Q
DSM-V
A
- pervasive pattern of instability in affect regulation
- impuls control
- interpersonal relationships
- self image
- emotional dysregulation
- impulsive aggression
- repeated self injury
- chronic suicidal tendencies
- feeling of emptiness
- need to have 5/9 symptoms for a substantial amount of time
2
Q
Costa and McCrae (1998)
A
- issues of diagnosis:
- many overlap
- comorbidity
- self report - may be biased
- may patients do not accept there is anything wrong with them
- hard to treat
3
Q
Coid
A
- comorbidity
- 40% anxiety
- 50-57% substance misuse
4
Q
Davey
A
- similar prevalence rates in the UK and USA
- 35% of the prison population
- 15-95% are in the mental health setting
- women>men = BPD
- men>women = antisocial PD
- 70% inpatients, 10% outpatients
5
Q
Torgeson et al (2000)
A
- 35% vs. 7%
- environment or genetics?
- few adoption studies
- short allele variant of 5HTTLPR
6
Q
Norra et al (2003)
A
- low 5HT impulsivity
7
Q
Smith and Blackwood
A
- 44% comorbid with bipolar
- SO could be the bipolar symptom and not BPD
- AND - cause and effect?
8
Q
Soloff (2001)
A
- differences in male and female serotonergic regulation
- dif in structural and functional neuroimaging
- used fMRI - differs in brain network and anterior cingulate cortex control
- may be reason why differences in prevalence of males and females
9
Q
Lyoo
A
- neuroanatomy
- reduction of frontal and orbitofrontal lobe volume - cause and effect?
10
Q
Donegan et al
A
- increased left amygdala activation in response to facial expressions of negative emotional
- fMRI
- BUT also reduced amygdala and hippocampal activation in PTSD
- hard to tell whether it is comorbidity
- many symptoms overlap… why is it they have BPD and not PTSD
– cannot look before and after onset of BPD… maybe identify individuals at risk? i.e. chose a patients who has a family history and a ‘bad’ upbringing
11
Q
Soloff et al (1986)
A
- double-blind placebo
- 61 patients tested over the course of 5 weeks
- found minimal effectiveness
- participants reported more self reported change compared to observer reported change
- high drop out rates (side effects, not believing they are ill - medication for type A to eliminate schizoid symptoms and medication fro type C to eliminate depressive symptoms - possibly fewer medications to aid with type B and BPD)
- gender bias - most research carried out on females
- remission rates are high - do not address the underlying causes.
- deterministic - i.e. this brain area is a cause of BPD. Therefore you will get it.
- costly
+ suicidal tendencies decrease
12
Q
Linehan’s biosocial theory
A
- suggest that some may have a biological predisposition, but an upbringing triggers it
- born with an emotional vulnerability
- inner challenging experiences are repeatedly validated
- might be reinforced by family members which triggers BPD
- VERY difficult to treat, as patients may go home to the validating area
- AND comorbid (McMurran) - 37% fail to complete the treatment
13
Q
Dialectal Behavioural Therapy
A
- multimodal programme
- increased behavioural control and reduced dysfunctional behavioural - make a personal feel empathy and validation
- distress tolerance - teach skills to regulate emotions
- interpersonal effectiveness
- typically therapy would last one year
- role play and meetings
- MUST have a good therapist-client relationship and must be stable
– high drop out rate as many do not believe what is wrong
14
Q
Soler et al (2015)
A
- good in conjunction with medication
- Linehan says that pharacotherapy should not be used as a treatment of choice but DBT should. Focuses more on coping mechanisms in daily life, and doesn’t just address the symptoms
15
Q
Bateman and Fanargy (1999)
A
- compared partially hospitalised and fully inpatients
partial was good - gave patients a greater sense of self efficacy and confidence. More likely to stick at the programme - after 18 months and 38 patients, there was less reported self harm, medication worked as well to lower depressive symptoms
