Problem 5 Flashcards
Personality
Refers to all the ways we act, think, believe and feel that make each of us unique
Personality trait
Refers to a complex pattern of
a) behavior
b) thought
c) feeling
that is stable across time + situations
5-factor model of personality
Suggests that everyones personality is organized along 5 broad dimensions/factors of personality (The big 5)
- Emotionality
- Extraversion
- Openness to experience
- Agreeableness
- Conscientiousness
–> each has a number of facets/dimensions
The DSM 4 treats personally disorders as if they were entirely different from “normal” personality traits.
How ?
Name the main differences to DSM 5.
- Lists 10 personality disorders which are grouped into 3 Clusters
- PDs are placed on Axis II of the diagnostic disorders
- -> instead of acute disorders - Categorical, not dimensional
e. g.: Cluster A,B,C and NOS
Cluster A
odd + eccentric
Contains the
a) Schizoid
b) Schizotypal
c) Paranoid
personality disorders, suggesting that these peoples behaviors are strange + unusual
Cluster B
dramatic + erratic
Contains the
a) Antisocial
b) Borderline
c) Histrionic
d) Narcissistic
personality disorders, suggesting that these peoples behaviors are impulsive + unstable
Cluster C
anxious + fearful
Contains the
a) Avoidant
b) Dependent
c) Obsessive-compulsive
Personality disorders, suggesting that these peoples behaviors are nervous + worried
Cluster NOS
Not otherwise specified
Contains
a) Depression
b) Passive-Aggressiveness
–> most prevalent personality disorders
Narcissistic personality disorder
NPD
Involves acting in a grandiose manner + seeking admiration from others, while depending on ones self evaluation (=never relying on others)
–> shallow in emotional expression + relationships with others, combined with a lack of concern for others
Prevalence of Narcissistic PD ?
Gender differences ?
- Very rare, with a lifetime prevalence of 1%
2. More prevalent in men
Cognitive theory/approach of NPD
Narcissistic PD develops as a result of indulgence + overvaluation by significant others during childhood
Treatment options for Narcissistic PD ?
Exploratory collaborative approach (Cognitive technique)
- to develop more realistic expectations of ones abilities
- Identifying patients regulatory patterns
- -> range between healthy + pathological patterns - Challenging ones self-aggrandizing ways of interpreting situations
BUT: Usually don’t seek treatment except for when they develop depression or interpersonal problems
Comorbidity of NPD
- Substance abuse
- Mood disorder
- Suicidality
–> can obscure the regular signs of NPD
Multifactural Etiology of NPD
- Inheritance (40%)
- Temperament
- Psychological trauma
- Age-inappropriate role assignments
Is NPD treatable ?
- Narcissistic traits can be changed over time, but change is only temporal
- Patients usually tend to drop out as soon as mood swings or depressions lessen
–> no enduring change (50% remission)
Psychodynamic approach
Symptoms of NPD are maladaptive strategies for managing emotions + self views
–> individuals did not develop realistically positive view of themselves + adaptive strategies for handling stress as children and thus rely on praise + domination of others for their self esteem
AND: as a result, they rely on praise and domination of others for their self-esteem
What factors can influence narcissistic self regulation + competence in social interactions ?
- Deficiencies in emotion processing + recognition
- -> less accurate - Comprised emphatic functioning
- -> losing sight of whose feelings belong to whom - Motivation/ Agency + self-regulation
Are therapeutic treatments effective ?
No, due to disconnect between own feelings and feelings perceived in others
–> talk and relate in ways that control interaction
e.g.: “speak at clinician not to”, thus clinician can’t reach them
Alexithymia
Refers to the inability to
a) identify + describe feelings in words
b) differentiating feelings from bodily sensations caused by emotional arousal
What do narcissists gain from relationships ?
Positive attention + sexual satisfaction
–> finding a way to receive the benefits of a relationship without enduring the costs
How do narcissists maintain/lead relationships ?
- Maintaining a relationship with a partner by using charm, extraversion + confidence
- -> gives narc positive attention, esteem + sexual resources - Not letting the relationship become too intimate instead they disengaging in
- Covertly seeking out other potential romantic partners
- -> thus maintaining power + freedom in existing relationship, gain esteem and sexual access from additional partners + easy transition to another relationship
=> Corresponds to ludus
(game-playing love style)
Narcissism
Refers to a normal personality trait that differs between people
–> associated with high unstable self-esteem + relying on several strategies to minion the inflated self beliefs
Narcissism is a crucial moderator of … ?
Agressiveness + angry reactions to rejection
–> violence is a strategy for gaining respect, thus NPDs have a lower threshold for social rejection
Difference between high vs low self esteem individuals when it comes to love ?
- HSI
- -> less likely to experience manic love + associated to eros (love style) - LSI
- -> experience love more intensely/ manic
There are 6 distinct love styles.
Name them and their meaning.
- Eros (Non-NPD)
- -> physical passion + desire for rapidly escalating romantic involvement - Ludus (NPD)
- -> game-playing, aversion to partner dependence - Storge
- -> emphasis on companionship and trust in relationships - Pragma
- -> pragmatic/practical approach to romantic relationships - Mania
- -> painful obsession with love object - Agape
- -> selfless regard for the well-being of the romantic partner
Biological theory of NPD
Prefrontal gray matter (GM) volume differences suggest deficits in
- empathic functioning
b) emotion regulation + processing
c) development of self-referential processing bias
–> indifference to fearful + sad stimuli
In early versions of the hybrid model, NPD was not included as a specific personality disorder type.
Why was that ?
- It has extensive comorbidity with other mental disorders
2. Narcissism is a trait that appears in many other conditions
What are the differences between the DSM 5 section II NPD vs section III NPD ?
- Section III explicitly acknowledges both grandiose (inflated) + deflated (vulnerable) presentations
–> Section II only presents grandiose presentation
- Section III recognizes grandiosity and feelings of entitlement may be either overt or covert
–> Section II only focuses on overt presentation
Limitations of DSM 4
- Some symptoms do not really show much tendency to co-occur
–> 2 persons diagnosed with the same disorder might not have any symptoms in common
- Two disorders might have overlapping symptoms and may be diagnosed together
–> people might me diagnosed with 2 or more disorders
- “Clusters” of disorders do not match factor analysis results
- A personality disorder should be seen as a continuum, not as a category
=> because having it is a matter of degree
Principle of least interest
Suggests that the person with the least interest has more control over the relationship
–> NPDs act on this
Narcissistic injury
Occurs when narcissists react negatively to perceived or real criticism or judgment, boundaries placed on them, and/or attempts to hold them accountable for harmful behavior
ex.: divorce, job firing
–> rejection
Narcissistic mirroring
Needing to be seen by their surrounding the same way they see themselves
ex.: admiration, attention
–> what they need
Narcs can usually be in 2 different states, meaning overt vs covert.
Specify these states and their meaning.
- Overt
Grandiosity - Covert
- -> Vulnerability
