Personality disorders Flashcards
what is the definition of personality
The tendency towards a pattern of behaviour, emotion, cognition and interaction that show through regardless of the situation we are in.
When does personality become a disorder?
When personality fits the situation - fine
but when it doesnt this could cause a problem
Socio political perspective
A way of saying that person is not diagnosable but is pretty close and probably will have a problem soon
Issues with socio- political perspective
Medio- legal perspective: Are we entitled to jail/ detain people based on what they might do.
What if we dont and then they do offend
Categories vs. dimensions
Personality varies along dimensions
Statustical approach: extreme clumps at either end?
Mixture of DSM5 and personality dimension approach.
Definition of PD 1994
Inner experience and behaviour that deviates markedly from the expectations of the individuals culture
Definition
Impairments in personality functioning and presence of pathological personality traits.
Impairments in self (identity or self direction) and interpersonal (empathy or intimacy) functioning
Considerations when making a diagnosis
Stable across time and situations
Developmental stage or socio cultural environment
Not due to direct effects of substance medical condition or state.
Must be independent of biological factors (drug misuse),
Not in children or adolsecents
Cannot be made in a single meeting.
What are the three groups in the categorical approach to personality disorders?
- Odd/ eccentric personality disorders
- Dramatic/ emotional personality disorders
- Anxious/ fearful personality disorders
What are the three diagnoses in odd/ eccentric PD?
- Paranoid PD
- Schizotypal - phoebe
- Schozoid - separation/ limited emotions (Autistic)
WHat are the 4 diagnoses in dramatic/ emotional
- Antisocial PD- disregard for others, lack of remorse.
- Borderline PD- instable in relationships, impulsive
- Narcisistic PD-
- . Histrionic - centre of attention
what are the 3 diagnoses in anxious/ fearful?
- Avoidant PD- avoidin social situations, feel inadequate
- Dependent PD- need to be taken care of
- obsessive compulsive PD- ocd without consequence
Limitations of categorical model (4)
- Costa and Macrae (1990) believe personality shouldnt be defined in categories but dimensions
- Extreme scores on the FFM is associated with PD (Costa and MAcrae, 1990)
- Exsisting PDs are very rare in population especially Histrionic and Dependent PD (Brown et al., 2002)
- Definitions arent stable, someone diagnosed wont be diagnosed 2 years later (Shea et al., 2002)
what are the three discrete types of the DSM5 alternative model (Skodal et al, 2011)
- Level of personality functioning
- Personality disorder types
- personality trait domains and facets
Issues with prevalence estimates
- Reliability in diagnosis (Paris, 2010)
- Gender bias in diagnosis- histrionic, BPD and dependent
- Poor stability of PD over time (Zimmerman, 1994)
Prevalence of PD in population
10-14% Sansone and Sansone, (2011).
What are risk factors of developing a PD
- Low SES
- inner city
- Young adult
- Divorced, separated, never married.
- childhood abuse
Aetiology points for Cluster A (odd/ eccentric disorders)
- Genetic links between A and schizophrenia suggest they be part of a broader schizophrenia spectrum disorder
- Psychodynamic approaches suggest that parents may have been demanding, rigid and regecting givign rise to a lack of trust in others (paranoid)
- risk for all three types of A is increased in relatives of individuals diagnosed with schizophrenia suggesting a genetic link between schizophrenia and type a
Aetiology points for cluster b (Dramatic/ emotional)
- One of the best predictors for APD is conduct disorder
- Adolescent smoking, alcohol use, drug use, police and sex predicts antisocial PD
- psychodynamic approaches suggest lack of parental love and affection with inconsistent parenting leading to child failing to learn trust
- heritability of APD moderate, 40-69%
- possess dysfunctional cognitive schema
- individuals with BPD have higher rates of childhood abuse (60-90%)
- twin studies of BPD 35% MZ 7% DZ
Object relations theory of BPD
individuals with BPD recieve inadequate support and love from others and this results in an insecure ego which is likely to lead to lack of self esteem and fear of rejection
Aetiology of cluster c (Anxious)
- Family member diagnosed with social anxiety or avoidant personality increases risk
- Dependent PD many features similar to depression and drugs used for depression also aleviate symtoms
- regularly comorbid with social anxiety. panic and ocd
- COmorbidity of OCPD in individuals with OCD is low as 22% suggesting not related.
