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Semester 1 2024 > PSYU3337 Personality Disorders > Flashcards

PSYU3337 Personality Disorders Flashcards

1
Q

What does Cluster A include?

A

Paranoid, schizoid, schizotypal

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2
Q

What does cluster B include?

A

Antisocial, borderline, histrionic, narcissistic

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3
Q

What does cluster C include?

A

Avoidant, dependent, obsessive compulsive

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4
Q

What are the 5 personality trait dimensions?

A

Openness to experience
Conscientiousness
Extraversion
Agreeableness
Neuroticism

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5
Q

What is a personality disorder?

A

Persistent pattern of emotions, cognitions and behaviour that results in enduring emotional distress for the person affected or for others, and may cause difficulties with work and relationships.

Pervasive and inflexible traits, which are stable and maladaptive.

Ego-synotnic: feels consistent with one’s identity (barrier to treatment)

10-12 % of the population meet criteria for PD, but the measures we use to assess PD aren’t very reliable

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6
Q

How are they organized?

A

Cluster A = odd or eccentric cluster (4%)
Cluster B = dramatic, emotional, erratic cluster (4%)
Cluster C = fearful or anxious (7%)

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7
Q

Challenges of diagnosing

A
  • there are overlapping features across disorders and categories
  • high comorbidity with other disorders
  • symptoms are subjective
  • misdiagnosis is common
  • personality researchers can’t agree on a dimensional system for PDs
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8
Q

5 factor model - pathology

A

–> the 5 factor model is most used, but we need to create pathological measures from those

Is there a pathological version of openness? not really

Conscientiousness = disinhibition
Extraversion = extreme introversion
Agreeableness = antagonism
Neuroticism (pathological) = negative affectivity

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9
Q

Paranoid Personality Disorder

A

Pervasive and unjustified mistrust and suspicion
(bears grudges, reads threatening meaning into neutral events, recurrent suspicions about fidelity, unjustified doubts about loyalty)

The individual is not usually psychotic

Prevalence = 1-2%
1:1 ratio

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10
Q

Causes and treatment of Paranoid personality disorder

A

Not well studied
- might have a modest genetic transmission
- associated with parental neglect
- exposure to violent adults as children
- traumatic brain injury
- chronic coke use
Treatment
- cognitive therapy to counter negativistic thinking
- lack of RCTs

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11
Q

Schizoid personality disorder

A

Pervasive pattern of detachment from social relationships AND very limited range of emotions in interpersonal situations

(does not desire close relationships, little interest in sex, does not take pleasure in activities, lacks friends, appears indifferent to praise / criticism)

1%, more common in men

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12
Q

Causes of Cluster A schizoid personality disorder

A

Not well studied (PDD make them less likely to participate in studies)
- significant overlap with autism spectrum disorder
- may precede a psychotic illness
- modest genetic transmission in affiliative system

Treatment:
- value of interpersonal relationships
- build empathy and social skills
- lack of RCTs

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13
Q

Cluster A: schizotypal personality disorder

A

Pervasive pattern of social and interpersonal deficits - marked by acute discomfort with close relationships AND COGNITIVE/PERCEPTUAL distortions AND eccentricities in behaviour
- magical thinking
- paranoid ideation
- inappropriate or constricted affect
- lack of close friends
- excessive social anxiety that does not diminish with familiar people

1%, more common in males

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14
Q

Causes and treatment of schizotypal personality disorder

A

Most studied out of the Cluster A disorders
- appears to be part of the schizophrenia spectrum
- modest genetic transmission (often occurs in first degree relatives of people with schizophrenia), cihldhood maltreatment or trauma, low ses (bidirectional)

Treatment:
- low doses of antipsychotic s
- SSRIs
- address comorbid depression using CBT
- lack of RCTs

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15
Q

Cluster B: antisocial personality

A

Pervasive pattern of disregard for and violation of the rights of others by the age of 15
(failure to conform to social norms, deceitfulness, impulsivity, irritability and aggression, reckless disregard for safety, consistent irresponsibility, lack of remorse)
has to be at least 18 years old

Prevalence = 2-3% overall
5:1 ratio of men to women

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16
Q

Causes of Antisocial Personality Disorder

A
  • heavy emphasis on observable behaviours

Causal factors
- modest genetic transmisison
- having a young mother
- low family income
- single parent household
- delinquent siblings
- neglect
- large family size
- harsh discipline

Gene-environment interaction:
- Monoamine Oxidase A gene (MAOA gene) is involved in breaking down NT –> low MAOA activity + maltreatment = higher risk of ASPD

17
Q

development of antisocial personality disorder

A
  • often see things going on before the age of 16
  • oppositional defiant disorder (children)
  • conduct disorder (>9 years)
  • ASPD

or ADHD and conduct disorder –> personality disorder

18
Q

Cluster B: borderline personality disorder

A

Pervasive pattern of instability of interpersonal relationships, self-image, affect, and marked impulsivity
–> abandonment issues
–> unstable and intense relationships
–> identity disturbance
–> impulsivity
–> recurrent suicidal behaviour
–> affective instability
–> inappropriate anger
Prevalence = 1-2% overall, making up 10% of outpatients and 20% of inpatients

19
Q

BPD causes and treatment

A

Lots of comorbidity
- 25% make a suicide attempt
- has high emphasis on past experience in emotional, physical and sexual abuse compared to other personality disorders
- most reserach of all PDs

Causes:
- modest genetic transmission
- childhood abuse and other bad childhood experiences

Treatment:
- antidepressants (little evidence to support their use other than helping with comorbid depression)
- dialectical behaviour therapy (dual reality of acceptance of difficulties and need for change), focus on interpersonal effectiveness, focus on distress tolerance

20
Q

Histrionic Personality Disorder

A
  • pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of settings
    (uncomfortable when not the focus of attention, inappropriate sexually seductive / provocative behaviours, rapidly shifting shallow expression of emotions, excessively impressionistic style of speech, theatrical, easily influenced by others)

1% overall
- more common in women

21
Q

Causes and treatment of Histrionic PD

A

causes = unknown
treatment
- focus on attention seeking and long-term conseqeunces
- problematic interpersonal behaviours
- little evidence treatment is effective

22
Q

Cluster B: narcissistic personality disorder

A
  • pervasive pattern of grandiosity, need for admiration, lack of empathy, beginning by early adulthood and present across contexts
    (sense of self importance, fantasises about unlimited success / power, believes they are special and can only be understood by other high status people, requires admiration, entitled, lacks empathy, envious of others)
    1%, more common in men
23
Q

Causes and treatment of narcissistic personality disorder

A
  • causal factors: parental overvaluation
  • emotional, physical and sexual abuse
  • intrusive, controlling and cold parenting styles

Treatment:
- focus on grandiosity, empathy, unrealistic thinking
- emphasize realistic goals and coping skills for dealing with criticism

24
Q

Cluster C: Avoidant personality disorder

A

Pervasive pattern of social inhibitiion, feelings of inadequacy, hypersensitivity to negative evaluation
(avoids interpersonal contact because of fears of criticism, disapproval, rejection - needs to be certain that they are liked, shows restraint with relationships for fear of being shamed, preoccupied with criticism, views self as socially inept, reluctant to take personal risks)

2-3% prevalence
more common in women

25
Q

Causes and treatments of Avoidant Personality Disorder

A

Causes:
- modest genetic contribution
- emotional abuse, rejection or humiliation from parents

Treatment: focus on social skills, entering anxiety provoking situations

26
Q

C: dependent personality disorder

A

Pervasive and excessive need to be taken care of that leads to submissive and clingy behaviours and fears of separation
- difficulty making decisions without reassurance from others
- needs others to assume responsibility
- difficulty expressing disagreement
- uncomfortable / helpless when alone
- urgently seeks another relationship as a source of care/support

1 % overall
more comomn in women

27
Q

Causes and treatments of DPD

A

lack of research
- small to moderate genetic contribution
- authoritarian and overprotective parents

Treatment:
lack of evidence that any treatment works

28
Q

C: obsessive compulsive personaity disorders

A

Pervasive pattern of preoccupation with orderliness, perfectionism, mental and interpersonal control, at the expense of flexibility, openness and efficiency

  • preoccupied with rules, lists, details
  • perfectionism
  • devoted to productivity at the exclusion of leisure activities
  • overconscientious, scrupulous and inflexible about morals, ethics, values
  • unable to discard worthless objects
  • reluctant to delgate work to others
  • miserly spending stye

2% overall
more common in men

29
Q

cause and treatment of Obsessive Compulsive PD

A

treatment: targeting rumination, procrastination and feelings of inadequacy

Semester 1 2024 (13 decks)

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