Personality Disorders Flashcards
The DSM describes general personality disorder as (criterion A) an ________ pattern of _____ _______ and behaviour that ______ markedly from the individuals culture. This is manifested in ____ or more of the following:
- _______
- _______
- _______ _____
- _____ _______
enduring
inner experience
deviates
2
Cognition - perceiving and interpreting self/others
Affectivity - appropriateness of emotional response
Interpersonal Functioning
Impulse Control
DSM Personality Disorder Criterion B:
Enduring pattern which is
- inflexible
- pervasive
across a broad range of personal and social situations
DSM Personality Disorder Criterion C:
Pattern is stable, and can be traced back to adolescence or early adulthood
Millon (1981) describes the 3 core features as:
- Functional inflexibility - failure to adapt to situations, rigidity - always respond in the same way
- Self-defeating - damaging behavioural responses
- Unstable in response to stress - emotional, behavioural, cognitive instability
What is ONE important element common to personality disorders that affects treatment-seeking, and response to treatment?
LACK OF INSIGHT - failure to recognise these aspects of their personality - blame others - never their fault
Name the clusters in personality disorders
A - odd - eccentric
B - dramatic - emotional
C - anxious - fearful
List the personality disorders in cluster A
Schizoid
Schizotypal
Paranoid
List the personality disorders in cluster B
Histrionic
Anti-social
Narcissistic
Borderline
List the personality disorders in cluster C
Avoidant
Dependent
Obsessive-compulsive
Schizoid PD….
Are simply not interested in ________ _______; have a _______/_______ in them. Prefer to be ______. Physical contact is _____ _________ for them, so they have little interest in _____ _______.
They have a _______ range of _______ expression - ______ of affect, cold, ______. Very self-______, doesn’t care about social _______.
Sees others as _____ and ______
social relationships
detachment/disinterest
alone
not pleasurable, sexual relationships.
restricted range of emotional expression
- flatness, cold, aloof,
- self-absorbed, does not care about social criticism
intrusive and controlling
Schizotypal PD
Many ______ and _______ in ______ and thinking
E.g: ______ thinking, ideas of _______ - so everything that happens in the world is related to one’s own destiny, ______ and belief in the _______.
Overly ______ in how in touch they are with others, have strong _____ for _______, yet their speech pattern can be ______ and awkward. Also very _____ at gaging how others _____ _____.
eccentricities and distortions in perceptions
magical thinking, ideas of reference
superstitious and belief in the paranormal
confident
desire for relationships
vague
bad, perceive them
Paranoid PD
Pervasive _______ and _______ of others. Assumes others will _______, _______ and talk ___ ____ ______. People’s motives are interpreted to be _______.
Hence, they want to ______ the loyalty of friends/family.
This manifests in behaving severely if they think they’ve been ______ to, or ______ in anyway, and results in them holding _____ for long periods.
It can be a self-fulfilling prophecy, however, as their behaviour can cause people to talk behind your back. Also, relationships are often very _______, as they do not disclose ______ _______, are constantly ______ of others’ motives and are very _______.
They are very sensitive to ______, and often ________ statements/actions as having hidden malicious meanings. They are also very ______ of partners.
- pervasive distrust and suspicion of others
- assumes others will disappoint, manipulate and talk behind their backs
- People’s motives are interpreted to be malicious
- Hence they want to ensure the loyalty of friends/family
- lied to, wronged, grudges
superficial
personal information
suspicious
hypervigilant
criticism, misinterpret
jealous
2/3 meet criteria for another PD
Avoidant PD
Strong _____ and feeling of _____ in social situations. See themselves as ________ and ______ inept. Hence, have very low self-______, are shy and timid.
They desire ____ _________, but rarely take ____ _____.
They are also _____ to criticism, _______ and negative _________. This leads them to be more socially withdrawn.
discomfort and feelings of inadequacy
unappealing, socially inept
low self-esteem
close relationships,
social risks
hypersensitive, rejection and negative feedback
The DSM-IV featured a mult-axial system where axis I included _______, reflecting those requiring ______ ____ and axis II included _________, reflecting _______ disorders.
anxiety, mood, eating, substance, etc
personality disorders and developmental disorders
immediate action, pervasive
Does this DSM have an axial system now? Why/why not?
No, it is a single axial system. This is due to diagnostic unreliability and lack of clear evidence for this distinction - lots of co-occurrence with other disorders
Elaborate on the categorical/dimensional model for classifying PDs
Currently, PDs classified using categorical system. This reflects medical model that each PD is symptomatically, causally and treatability different.
Advantages - clarity and ease of communicating
Disadvantages - difficult to see the boundary b/w “normal” personality and “abnormal” disorder
Gradual move towards dimensional approach - significant overlap b/w PDs and 60% don’t fit into one category.
Obsessive Compulsive PD
Pervasive pattern of orderliness, _______ and having complete _______. Very adherent to _____, _____ and schedules.
They are seen as _____, rigid, and _______. This can be also in regards to beliefs and ______ issues.
They are surprisingly _______ and they spend so much time ______ and ______ about tasks. They are also very reluctant to _______
Views others as irresponsible, ____ and _______. They also have a lot of _______ and anger towards themselves because of their high standards
Pervasive pattern of orderliness and perfectionism and having complete control
Rules, details, schedules
inflexible, rigid, stubbornness, moral
inefficient, planning, worrying, delegate
- responsible for themselves, driven by “shoulds”
- views others as irresponsible, lazy, incompetent
disappointments and anger towards self
Narcissistic PD
Have a ______ self-image, strong sense of ______, privilege or expectation of ____ treatment. They believe they have special _____ or ______. They think their ideas are the _____ and that others should support them. They come across as _____ and patronising.
However, deep down they have a very low ___-_____, fragile _____ and lack of intact ____-___-_____. They have a ____ _____ of what other’s think of them, and very sensitive to _____ or ______.
They lack ______ and are _____ and ______ with the problems of others. However, they have relationships if it helps build them up, so they can get ______, and advance their ______ ______
grandiose entitlement VIP treatment special skills/abilities best snobbish
low self-esteem
lack of intact sense of self
deep concern
criticism or defeat
empathy, insensitive and impatient with the problems of others
admiration
personal agenda
Dependent PD
Have a pervasive need to be _____ ____ of, needing others to take ______ for most/all areas of their life. Hence, they have an intense fear of ______ and _______. They also constantly seek ______ from others.
They lack self-_______, and believe they cannot _____ for themselves. See themselves as _____ and _______.
They can often find it very difficult to make even the ______ decisions, and are ______ to have someone who can completely ____ ____ of them.
taken care of
responsibility
abandonment and rejection
reassurance
confidence
care
needy, weak, incompetent, vulnerable
smallest
desperate
take care
Histrionic PD
Key features are _______ _______ and excessive _______, very lively, dramatic, and always wants to be _____ of ________.
Hence, they will act out to remain the centre of attention, telling ______ or ______ stories, or act in a ______ or ______ manner.
However, this display of emotions is _______, and whilst they might say to someone “you’re a wonderful person”, they have issues coming up with concrete ______
- excessive emotionality and attention-seeking, lively, dramatic, always wants to be the centre of attention
dramatic, inappropriate
flirtatious, seductive - uses physical attractiveness to their advantage
- superficial display of emotions - shallow and fickle underneath - not much there. E.g: “you’re a wonderful person” but cannot then say what is wonderful about them
Antisocial PD
Disregard for ______, societal _____ and ______. Little ________, but can experience _____ and ________. Very _________, and ________, with little regard for the _______ of their actions.
Can have relationships, but only for their own ____ _____. Often quite ____ in relationships, self-______, and _______. They never take _______ for their actions, and can be ______, and ________ to get what they want.
others
societal values/norms
empathy
guilt, depression
- impulsive and irresponsible - spur of the moment decisions with little regard for the consequences or rights of others
self-gain
charming, self-assured, manipulative.
responsibility, deceptive, and aggressive
Borderline PD
Have ______ moods.
They use a defence mechanism called _______ - where people or a job, etc, is either completely ____ or completely ______.
They are also ______ of ________, and often do extreme things to avoid this such as threaten ________, or self_______.
Often called _____ ______ - because they only consistent thing is instability
unstable
Splitting, good bad
terrified of abandonment, threaten suicide or self-harm
stable instability
Name three assumptions in borderline PD and their related cognitions
- The world is dangerous –> vigilance, anxiety, avoidance
- I am weak and vulnerable –> low self-efficacy, fear of being alone
- My feelings are unacceptable –> dependency, lack of clear goals, inconsistency, anticipates rejection
No 3. is what leads to many of the bx such as impulsiveness, manipulative bx, and extreme attempts to escape emotions
Name three assumptions in antisocial PD and their related cognitions
- Everyone is out for themselves –> I have to protect myself –> insecurity –> do not show weakness –> deception of others –> avoidance of pro-social and close relationships
- Rules don’t apply to me –> I can bend them –> conforming does not succeed –> lack of planning which can lead to impulsive acts
- If you’re smart you can beat the system –> decisions with little regard for consequences –> no point being pro-social
