Personality disorders Flashcards
What is the five factor model of personality?
1: openness: open minded
2: conscientiousness: desire to do a task well
3: extraversion: outgoing
4: agreeableness: polite
5: neuroticism: difficulty controlling/regulating emotions
What is a personality disorder (definition)?
enduring pattern of inner experience and behavior that deviates markedly from expectations in individuals culture
What are the areas that personality disorders can manifest in? How many areas must be affected?
Patterns must manifest in 2+ areas:
1: cognition - ways of percieving and interpreting self/other people/events
2: affectivity - range, intensity, lability and appropriateness of emotional response
3: interpersonal functioning - difficulty getting into and being in a relationship
4: impulse control
what 5 features of the personality abnormality are needed to diagnose a personality disorder?
- The enduring pattern is inflexible and pervasive across a broad range of personal and social situations
- The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood
- The enduring pattern isn’t better explained as a manifestation or consequence of another mental disorder
- The enduring pattern is not attributable to the physiological effects of a substance (e.g. drug of abuse/medication) or another medical condition (e.g. head trauma)
what three different types of personality disorder exist? Which disorders are classifed into these types?
Odd and eccentric (cluster A): paranoid/schizoid/schizotypal
Dramatic, emotional, erratic (cluster B): antisocial, histrionic/borderline/narcissistic
Anxious and fearful (cluster C): avoident, dependant, obsessive-compulsive
How many people in the general population have a personality disorder? what is the heritability in general for personality disorders?
1 in 10 people
60% heritability
What is the prognosis for personality disorders?
most stable over time but many people do show improvement
How can personality disorders be treated?
- psychological therapies
- topiramate - some evidence for anger/aggression
- Antidepressants
- phenelzine for hostility
- olanzapine but wt gain
- treatment of co-morbidity important
Describe paranoid PD: what are the features (7)
A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
- Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
- Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
- Reads hidden demeaning or threatening meanings into benign remarks or events.
- Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
- 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 schizoid PD? What are the features? (7)
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- 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 or criticism of others.
- Shows emotional coldness, detachment, or flattened affectivity.
What is antisocial PD? What are the features? (7)
A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:
- Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
- Deceitfulness, as indicated by repeated lying, 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, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
- Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
What is borderline PD? What are the features? (9)
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- 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).
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation or severe dissociative symptoms
What is histrionic PD? What are the features? (8)
pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Is uncomfortable in situations in which he or she is not the center of attention.
- Interaction with others is often characterized by 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 of emotion.
- Is suggestible (i.e., easily influenced by others or circumstances).
- Considers relationships to be more intimate than they actually are
What is avoidant PD? What are the features? (7)
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
- 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.
- 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 dependant PD? What are the features? (8)
A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- 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. (Note: Do not include realistic fears of retribution.)
- 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, to the point of volunteering to do things that are unpleasant.
- 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
