Personality Disorders Flashcards
1
Q
Personality disorder overview
A
- enduring inflexible predispositions
- Begin early childhood
- Chronic
- Poor prognosis
- Strong counterparts to the therapist
- Don’t feel the treatment is necessary: externalization common– problem is with everyone else
- 10 disorders into 3 clusters
- Distress or impairment in two or more areas
- self or cognition (identity/perception)
- affect
- interpersonal function (empathy)
- impuslve control (risky behavior)
2
Q
Clusters
A
- Cluster A: Odd or Eccentric
- Schizoid, paranoid, schizotypal
- Cluster B: dramatic, emotional, erratic
- Antisocial, histrionic, borderline and narcissistic
- Cluster C: anxious or fearful
- Obsessive compulsive, avoidant and dependent
3
Q
Paranoid
A
- Unjustified suspicion of everyone
- Misinterpret everyday occurrences e.g.wrong change at the store
- Overly cautious, find hostility in benign comment or criticism
- Cold and distant few relationships
- poor quality of life
- *
4
Q
Paranoid causes and treatment
A
- Causes
- Not well understood
- Could involve early learning that people can’t be trusted
- Treatment
- Few seek out professional help (mistrust of therapists)
- Developing trust
- CBT to counter negative thinking
- Lack of good outcome studies
5
Q
Schizoid
A
- No desire for close social relationships
- Come off as cold, distant
- Differs from paranoid
- no suspiciousness or fear of rejection
- flat affect
- Overlap with autism spectrum disorder
- Shared preference for social isolation
- ASD doesn’t understand emotions schizoid doesn’t care
- Causes
- Unclear
- Usually childhood shyness
- Childhood abuse sometimes
- Treatment
- Few seek professional help
- Establish the value of interpersonal relationships
- CBT to build empathy
- lack of good outcome studies
6
Q
Schizotypal
A
- Isolated and highly suspicious
- Exreme discomfort in social relationships
- Loose associations in conversation (Napolean dynamite monologue)
- Psychotic like symptoms: magical thinking (e.g. telepathy), ideas of reference (e.g. personalised commericals) and illusions (less severe than hallucinations)
7
Q
Schizotypal Causes and treatment
A
- Causes
- Mild expression of schizophrenia genes?
- Potentially more likely to develop after childhood trauma
- potentially other brain deficits
- Treatment options
- address comorbid depression (significantly increased chance)
- Combination of antispsychotic medication, CBT and social skills training
- poor prognosis
8
Q
Antisocial PD
A
- Failure to comply with social norms
- Men tend to be diagnoses
- Disregard for others
- Can be charming or manipulative (Ted Bundy)
- Larger proportion of criminals with antisocial than gen population
- “psychopathy” associated with personality traits associated with disorder
9
Q
Neurobiological & Antisocial
A
- Underarousal: reduced emotional response (sweating HR) to fear-inducing images
- Fearlessness: failure to respond to danger cues
- Cortical immaturity: cerebral cortex not fully developed
- Smaller frontal lobe: judgement and impulse control impaired
- Grays model: inhibition signals outweighed by pleasure signals i.e. dopamine high seratonin low
10
Q
Psychosocial Antipersonality
A
- Dont care about others needs
- Less likely to give up when goal is unattainable, why they continue with crime after being punished
- Genetic/family
- Parents have antisocial (genes and modeling)
- Inconsistent discipline and support
- neglect/abuse some cases
- may not learn to fear consequences
- Low SES and urban settings
11
Q
Antisocial development
A
- Early history of behavioral problem e.g. skipping school, aggression towards people and animals
- previous diagnosis of conduct disoder
- Aggression, destructiveness and/or rule violations before age 13
- “Callous-unemotional type:
- Mutual bio-environmental influence
- antisocial tendencies alienate peers that could be postive role models
- family stress and antisocial behavior
12
Q
Treatment APD
A
- Few seek out treatment
- Poor prognosis
- prevention and rehabilitation
- e.g. school programs targeting aggression; parents not accidentally reinforcing behavior
- Often prison
- focus on selfish consequences (if you assault someone you go to prison)
13
Q
Borderline (and comorbidity)
A
- Hallmark: emotional instability
- Intense and unstable relationships & moods
- Impulsivity, fear of abandonment, unstable sense of identity, feelings of emptiness
- Self-destructive behavior to relieve emotional suffering: mutilation, suicidal behavior, unsafe sex, drug use
- Comorbidity rates high with other disorders
- 80% bipolar patients also hhave
- 67% substance use
- 25% bulimia patients have
14
Q
Borderline causes
A
- strongly inherited
- emotional reactivity: impairment of the limbic system and amygdala
- Early trauma/abuse increases risk
- High levels of shame and low self-esteem
- Biopsychosocial: genetic risks + tendency to experience intense emotions + bad family environment = BPD
15
Q
Borderline Treatment
A
- No medication but antidepressants used
- psychotherapy: difficult patients
- seek out therapy but drop out
- quick to open up then shut down
- violate boundaries (call the emergency line for non-emergency situations)
- Small provocation = anger towards helpers
- Use relationship with therapist as model for other relationships
