Personality disorders (week 11) Flashcards

Question

Dependent personality disorder clinical description

Answer 1

* Interpersonally dependent, anxious * Submissive, timid, and passive * Feelings of inadequacy, sensitive to criticism, and need reassurance * Cling to relationships

Answer 2

A) A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, as indicated by 5+: * Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others * Needs others to assume responsibility for most major areas of his or her life * Has difficulty expressing disagreement with others because of fear of loss of support or approval (Note: Do not include realistic fears of retribution.) * Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy) * Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant * Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself * Urgently seeks another relationship as a source of care and support when a close relationship ends * Is unrealistically preoccupied with fears of being left to take care of himself or herself

Answer 3

* Disruptions in early childhood lead to fears of abandonment * High in sociotropic traits * Low on individualistic achievement traits

Answer 4

- developing confidence; ensuring patient does not depend on therapist

Answer 5

* Preoccupied with rules, lists, order, organization, or schedules * Overconscientious and inflexible * Excessively devoted to work and productivity to the exclusion of leisure * Rigid * Poor interpersonal relationships due to rigidity * Quest for perfectionism, which interferes with functioning

Answer 6

A) A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, as indicated by 4+: * Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost * Shows perfectionism that interferes with task completion (e.g. - is unable to complete a project because his or her own overly strict standards are not met) * Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) * Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) * Is unable to discard worn-out or worthless objects even when they have no sentimental value * Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things * Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes * Shows rigidity and stubbornness

Answer 7

- Relaxation techniques - CBT to reframe compulsive thoughts

Answer 8

Dramatic and Emotional

Answer 9

* Dramatic, theatrical, self-centred, vain, seek constant reassurance, impulsive * View situations in global, black-and-white terms * Speech is often vague, lacking in detail

Answer 10

Women: might be overdiagnosed (Stereotypical female is considered overdramatic, seductive, over-concerned with physical appearance

Answer 11

A) A pervasive pattern of excessive emotionality and attention-seeking, indicated by 5 +: * Is uncomfortable in situations in which he or she is not the center of attention * Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior * Displays rapidly shifting and shallow expression of emotions * Consistently uses physical appearance to draw attention to self * Has a style of speech that is excessively impressionistic and lacking in detail * Shows self-dramatization, theatricality, and exaggerated expression of emotion * Is suggestible (i.e. - easily influenced by others or circumstances) * Considers relationships to be more intimate than they actually are

Answer 12

- Historically blamed on hysteria - co-occurs with antisocial personality disorder

Answer 13

* Improving problematic interpersonal relationships * Teaching appropriate ways of negotiating their wants and needs * Little treatment success

Answer 14

* Unreasonable sense of self-importance, grandiosity * No compassion for others, envious, arrogant * Frequently depressed

Answer 15

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy, as indicated by 5 +: * Has a grandiose sense of self-importance (e.g. - exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) * Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love * Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) * Requires excessive admiration * Has a sense of entitlement (i.e. - unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations) * Is interpersonally exploitative (i.e. - takes advantage of others to achieve his or her own ends) * Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others * Is often envious of others or believes that others are envious of him or her * Shows arrogant, haughty behaviours or attitudes

Answer 16

* Failure of empathetic “mirroring” from parents * Child remains fixated at self-centred, grandiose stage of development * Increasing prevalence? Parenting?

Answer 17

* CBT, coping strategies (relaxation training, accepting criticism), empathizing, treatment for depression * Focus on feelings of others * Very limited research and success

Answer 18

one of the most common diagnosed personality disorders

Answer 19

1-2% of the population

Answer 20

* Turbulent relationships, fear abandonment, self-mutilating behaviours, no control over emotions, high rates of substance use * Impulsivity is a core feature * Often engage in suicidal or self-mutilating behaviours

Answer 21

10% die by suicide

Answer 22

A) A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, as indicated by 5+: 1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.) 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 3. Identity disturbance: Markedly and persistently unstable self-image or sense of self. 4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.) 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms

Answer 23

* Genetics, high rates in twins * Changes in the limbic system in the brain * Memory bias (for negative cognitions typical of this disorder) * Early trauma and biological predisposition * Childhood sexual abuse; similarities with PTSD, DTD * Experienced rapid cultural changes

Answer 24

- Antipsychotics and antidepressants - Dialectical behaviour therapy (DBT) - effective in reducing suicide attempts *** - Traditional components: individual outpatient therapy, skills training, phone consultation, case consultation for therapists

Answer 25

- individual DBT therapy - Phone coaching - therapist consults with team - skills group

Answer 26

- Mindfulness - rational, emotional and wise mind * Interpersonal effectiveness skills (e.g., balancing priorities vs. demands, building mastery and self-respect) * Emotion regulation (e.g., identifying and labelling emotions) * Distress tolerance (e.g., distraction, self- soothe, improve the moment)

Answer 27

Meta-analysis found moderate decreases in suicidal and parasuicidal behaviour in adults with BPD

Answer 28

* Aggressive, lying, cheating, no remorse, substance abuse, unnatural death in boys with this disorder * Psychopathy : 30% of those ASPD (Abdalla-Filho & Vollm, 2020) * 50% to 80% of male offenders diagnosed with this disorder

Answer 29

* Need history of conduct disorder earlier in development * Conduct problems lie on a spectrum * Oppositional Defiant Disorder * Conduct Disorder

Answer 30

* at least 4 symptoms, >6 months, with at l One person that is not a sibling Angry/ Irritable Mood * Often loses temper * Is often touchy or easily annoyed * Angry and resentful Argumentative/ Defiant * Argues with authority figures (adults) * Defies or refuses to comply with requests from adults * Deliberately annoys others * Blames others for their mistakes Vindictiveness * Spiteful or vindictive at least 2 x in the last 6 months

Answer 31

A) A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months: * Aggression to People and Animals * Destruction of Property * Deceitfulness or Theft * Serious Violations of Rules B) The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. C) If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

Answer 32

* Often bullies, threatens, or intimidates others * Often initiates physical fights * Has used a weapon that can cause physical harm to others (e.g., a bat) * Has been physically cruel to people * Has been physically cruel to animals * Has stolen while confronting a victim * Has forced someone into sexual activity

Answer 33

Destruction of Property * Has deliberately engaged in fire setting with the intention of causing serious damage * Has deliberately destroyed others property Deceitfulness or Theft * Has broken into someone else’s house, building or car * Often lies to obtain goods or favors to avoid obligations (e.g., “cons” others) * Has stolen items of nontrivial values without confronting a victim

Answer 34

* Often stays out at night despite parental prohibitions, beginning < 13 years * Has run away from home overnight at least twice while living in the caregivers home, or once without returning for a lengthy period * Is often truant from school, beginning before age 13 years

Answer 35

* Is causing significant distress in the individual or others * Impacts social, educations, occupational, or other important areas of functioning * The symptoms do not happen only during the course of Schizophrenia, or other Psychotic Disorder. * Subtypes * Childhood onset (symptoms began <10 years old) * Adolescent onset (symptoms began >10 years old) * Unspecified onset * Specifier: with Limited Prosocial Emotion otherwise known as Callous-Unemotional Traits or “CU traits”

Answer 36

* Delinquent friends influence teens * Dual Failure model * Less structure can lead to more deviance * Parents: monitoring or relationship? * Single parent family * SES and Indigenous youth

Answer 37

* Genetics? * Under aroused amygdala * Sensation seeking boosts activation * Hare’s cortical immaturity hypothesis- related to impulsive/ childlike behaviour * Fearlessness hypothesis * Maltreatment

Answer 38

genetically based diminished sensitivity to others Hypo-aroused/ low anxiety

Answer 39

Relationally based develops "mask" of callousness Hyper - aroused / high anxiety

Answer 40

* Prevention is key * Parent training for diagnosed children * Parent-Child Interaction Therapy * Mostly behavioural-focused * Multifaceted for juvenile offenders * CBT has limited impact * For adults * CBT limited effectiveness

Answer 41

* Assumes all behaviour is learned and can be changed * Positive and negative reinforcement * Communication skills * Home rules * Effect limit setting * Time outs * Example: Incredible Years, Triple P COPE

Answer 42

* Developed for parents of aggressive adolescence * Attachment Based * Psycho-education * Learn attachment principle each week * E.g., Empathy is the heartbeat of attachment; attachment through the lifespan * Roleplays * Processing of role plays

Answer 43

* Impulsive, Failure to conform to social norms, aggression, lack of remorse, reckless, evidence of CD before age 15 * Need 3 symptoms

Answer 44

* 3 facets: Irresponsible behaviour, Interpersonal style (manipulative, charming, boastful), and “Affective factor”/ CU traits (lack of empathy, callousness) * Need to be high on all three

Answer 45

* Lack of empathy, callousness, uncaring attitude * Same as “affective” factor of psychopathy * Tends to have higher levels of CD compared to low CU traits * Ends therapy with more symptoms than non-CU peers