PERSONALITY DISORDERS Flashcards
what are personality disorders?
- disorders marked by persistent, inflexible, maladaptive patterns of thought and behaviour
- develops in early adulthood/adolescence
- impairs ability to function
trait domains PD is based on
negative affectivity detachment antagonism disinhibition psychotism
individual PD - DSM-5
- shcizotypal PD
- antisocial PD
- BPD
- narcissistic PD
- obsessive compulsive PD
- avoidant PD
prevalence of PD
- most common –> schizoid, avoidant and paranoid
- worldwide estimates - 4-15%
history of diagnosis of PD
- diagnosis of exclusion
- label used for those difficult to help
difficulties with diagnosis of PD
- clinicians bypass general diagnostic requirements
- types = subjective
criteria for general PD
ongoing rigid pattern of though and behaviour with 2 or more: - cognition - affectivity - interpersonal functioning - impulse control consistent and long lasting pattern
cluster A of PD
- schizotypal PD
- schizoid PD
- dilutional disorder
- schizoaffective disorder
cluster B of PD
anti social PD
cluster C of PD
obsessive compulsive PD
cluster A aetiology
- genetic link
- neurobiological evidence - similarity in abnormal brain development and physiological evidence
Cluster B aetiology
- MZ > DZ
- genetics likely to interact with environment
physiological evidence for cluster B
- lower reactivity levels of skin conductance
- no startle response
- slow automatic arousal to emotional/distressting stimuli
cluster C aetiology
- low comorbidity with OCD (22%)
- linked to manipulation/guilt induction parenting style (Aycicegi et al., 2002)
- not a lot of research
maintenance factors of PD
- emotion dysregulation - mediated associationg between BPD symptom severity at baseline and affective instability and identity disturbance at 12 month follow up, consistent with emotional dysregulation as maintenance factor
- not seeking support/help (Lenzenweger, 2006)
pharmocotherapy intervention
- mood stabilisers - help mood swings
- anti psychotics - alleviate psychotic symptoms
- only used in cases of comorbidity with mood disorders
psychosocial interventions
- behaviour therapy
- traditional psychoanalytic
- individual or group treatment
- guidelines suggest these should be paired with other support (e.g. social or employment)
aims of interventions
- reduce life threatening symptoms
- improve distressing mental state symptoms
- aid in advocacy issues (e.g. employment)
- improve life outcomes
- acute symptoms generally met but more complex needs are not (Bateman et al., 2015).
cluster A interventions: psychosocial
- cognitive therapy - effects change in cognitive/social disabilities
- nature of paranoid PD –> suspicion means interventions are difficult to implement
cluster A interventions: pharmacological
- antipsychotics - improvement in symptom severity/risk to benefit ratio unclear
- no RCT —> lack of evidence
cluster B interventions - psychosocial
- CBT - schema specific
- transference focused psychotherapy
- mentalisation based therapy
- systems training emotional predictability therapy
- cognitive analytical therapy
- social skills training
cluster B interventions: pharmacological
- SSRIs
- low dose antipsychotics
- mood stabilisers
cluster C interventions: psychosocial
- cognitive therapy
- CBT
- schema focused therapy
clsuter C interventions: pharmacological
antidepressants
