Personality Disorders and Defense Mechanisms Flashcards
Dependent
Cluster C
Submissive and clinging behavior related to an excessive need to be taken care of
low self confidence
females>males
Obsessive Compulsive Personality
Cluster C
Preoccupation with orderliness, perfectionism and control
Ego-syntonic
Behavior consistent with one’s own beliefs and attitudes (vs OCD)
Passive aggression
immature defense mechanism
expressing aggression towards others by passively refusing to meet their needs
Personality Disorder
inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning, person is usually not aware of the problem
Usually presents by early adulthood
Sublimation
mature defense mechanism
Replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system (vs reaction formation)
not harmful to society
Primary goal is to convert negative emotions into productive activity not to benefit others
Cluster B personality disorders
dramatic and erratic
Characteristics: labile, unpredictable, impulsive, difficulty establishing and maintaining relationships
Interpersonal crisis, depression, anxiety-bring to clinical presentation
Genetic association with mood disorders and substance abuse
Co-morbidity: substance abuse
Histrionic
Cluster B excessive emotionality and attention seeking Excessive excitability Sexually provocative Overly concerned with appearance Females>males
Cluster C
anxious and fearful
Characteristics: anxious, timid, perfectionist, conflict avoidant
Presentation: depression, anxiety, somatic complaints
Co-morbidity: anxiety and social avoidance
When to consider borderline personality
Adolescence: cutting, eating disorder, depression, suicide attempts
Young Adult: multiple crises, hospitalizations
Later adult: diminished impulsivity but identity disturbance persists
Environmental convergence
Abuse and maltreatment in cluster B
Histrionic
dependent
Avoidant
Cluster C
Social inhibition,
feelings of inadequacy and hypersensitivity to negative evaluation
Timid,
desires relationships with others (vs schizoid)
Fear of being judged, avoids interactions, no intimate relationships, believes self to be inept
Psychopaths and crimes
65% of offenders are antisocial
25% are psychopaths
tend to engage in predatory, dispassionate, and instrumental violence,
Motivated by greed, vengenance, anger, retribution, sadism, and money
Non-psychopaths tend to engage in reactive violence: they batter, sexually assault or use weapons against female relatives
Motivated by anger, jealousy, or sexual arousal
Fixation
immature defense mechanism
partially remaining at a more childish level of development (vs regression)
defense mechanism associated with antisocial
rationalization
Schizotypal
Cluster A
Acute discomfort in close relationships
cognitive or perceptual distortions and eccentricities of behavior
eccentric appearance, odd beliefs or magical thinking
Interpersonal awkwardness
Paranoid
Cluster A
Distrust and suspiciousness such that others’ motivves are interpreted as malevolent
More than 1 hour
Projection is major defense mechanism
Suppression
Mature defense mechanism
Intentional withholding of an idea or feeling from conscious awareness (vs. repression)
Projection
Immature defense mechanism
attributing an unacceptable internal impulse to an external source (vs. displacement)
Repression
immature defense mechanism
Involuntary withholding an idea or feeling from conscious
awareness (vs. suppression)
Person cannot remember past traumatic event
Altruism
Mature defense mechanism
Alleviating guilty feelings by unsolicited generosity toward others
Borderline
Cluster B
instability in interpersonal relationshiops, self image and affects
Abandonment fears
Marked impulsivity (sex, spending, substances, reckless driving, binge eating)
Unstable mood
Self mutilation, boredom, sense of emptiness
Females>males
Splitting is major defense mechanism
PTSD common co-morbidity
Structural Brain imaging: chagnes in anterior cingulate gyrus and orbital frontal cortex in both brain volume and white matter coherence
Amygdala hyper responds to emotion
Schizoid
Cluster A
voluntary social withdrawal
Restricted range of emotional expression
Content with social isolation (vs avoidant)
Reaction formation
immature defense mechanism
replacing a warded-off idea or feeling by an (unconsciously derived) emphasis on its opposite (vs. sublimation)
isolation of affect
immature defense mechanism
separating feelings from ideas and events
Denial
immature defense mechanism
avoiding the awareness of some painful reality
Projective identification
immature defense mechanism
modeling behavior after another person who is more powerful (not always admirable person)
Splitting
immature defense mechanism
believing that people are either all good or all bad at different times due to intolerance of ambiguity. commonly seen in borderline personality disorder
increase in suicide
Very high and very low
Undoing
immature defense mechanism
symbolically nullifying or guilt provoking thought or feeling by confession or atonement
Dissociation
immature defense mechanism
immature defense mechanism
temporary, drastic change in personality, memory, consciousness or motor behavior to avoid emotional
Acting out
immature defense mechanism
expressing unacceptable feelings and thought through actions
rationalization
immature defense mechanism
proclaiming logical reasons for actions actually performed fro other reasons, usually to avoid self-blame
Regression
immature defense mechanism
turning back the maturational clock and going back t earlier modes of dealing with the world (vs fixation)
defense mechanism associated with obsessive
isolation of affect
defense mechanism associated with borderline
splitting
Defense mechanism associated with histrionic
repression
defense mechanism associated with paranoid
projection
Humor
mature defense mechanism
Appreciating the amusing nature of an anxiety provoking or adverse situation
Intellectualization
immature defense mechanism
suppressing a feeling by using facts and figures
Passive Aggression
Expressing aggression towards others by passively refusing to meet their needs
Fantasy
Substitution of an imaginary scenario to protect oneself from overwhelming feelings
Cluster A personality
odd and eccentric
Characteristics: distrusting, misinterpret others, odd and idiosyncratic beliefs, social isolation-inability to develop meaningful social relationships
No psychosis
Genetic association with Schizophrenia
Presentation: do not generally self present for treatment; family members encourage, hostility, suspiciousness, conflict with others
Co-morbidity: transient psychotic symptoms
Antisocial
Disregard for and violation of rights of others
Failure to conform to social norms
Deceitful, repeated lying, conning behavior
Reckless disregard for safety of others or self
Lack of remorse and rationalization of inappropriate behavior
criminality, impulsivity
Males>females
Must be >18 years old and have history of conduct disorder before age of 15
Reductions in structure and function have right orbitofrontal cortex, left dorsolateral prefrontal cortex and right anterior cingulate cortex
OFC region results in poor response inhibition and poor decision making
Dysfunctin in dorsolateral region results in executive deficiencies
Dysfunction in medial prefrontal cortex affect emotions of guilt, embarrassment, and compassion
Structural function disruptions in amygdala associated with impaired processing of emotions (associating harmful actions with pain and distress)
Displacement
immature defense mechanism
transferring avoided ideas and feelings to some neutral person or object (vs projection)
Narcissistic
Cluster B grandiosity, need for admiration, and lack of empathy Sense of entitlement Often demands the best reacts to criticism with rage
Classical conditioning
Previously neutral stimulus elicits response after association with a natural unlearned stimulus
Operant conditioning
Behavior becomes associated with an environmental consequence
Positive punishment
Giving a punishment decreases behavior
Negative punishment
Removal of reward decreases behavior
Positive reinforcement
Giving a reward increases behavior
Negative reinforcement
Removal of consequence increases behavior
