Test 3 Flashcards
beck’s cognitive distortions: selective abstraction
hyper-focusing on a small detail and ignoring the bigger context of a situation.
E.g., at a party, talk to a lot of ppl but one person left the group right after you started to talk to them.
Your view of the party is influenced by this which leads to an inaccurate & negative self-assessment
beck’s cognitive distortions: arbitrary inference
interpretation drawn from an event w/out any factual evidence to support the conclusion, or in spite of evidence that contradicts that conclusion.
E.g., bereaved spouse convinced that the family of their deceased spouse is upset w/ them, despite no evidence that points to that conclusion, or in spite of evidence that shows otherwise.
beck’s cognitive distortions: overgeneralization
similar to selective abstraction (takes sm. sample & unduly generalizes from it). Often involves words such as always, never, nobody, & everybody; takes a rare occurrence & paints it as a much bigger & much more regularly-occurring problem.
E.g., someone who has recently lost a handful of ppl in their life may think that everybody around them is dying.
beck’s cognitive distortions: Magnification & Minimization
Both are considered errors in evaluation, namely in over-or under-estimating the significance of an event.
Magnification: making a mountain out of a molehill, worst-case-scenario, jumping to conclusions.
E.g., assuming that a neck lump is terminal cancer.
Minimization: down-playing of the significance of things, such as one’s achievements, & is often accompanied by magnification, such as the magnification of one’s flaws.
what is personality?
Personality refers to one’s stable, consistent,
& distinctive way of thinking about, feeling,
acting, & relating to the world.
There are hundreds of diff personality
traits which can be organized into the broad
dimensions referred to as the Five-Factor Model
* OCEAN
HEXACO Model
* Honesty-Humility
* Emotionality
* Extraversion
* Agreeableness (versus Anger)
* Conscientiousness
* Openness to experience
OCEAN personality model (low - high score)
Openness (imagination, feelings, actions, ideas)
- low: practical, conventional, prefers routine
- high: curious, wide range of interests, independent
Conscientiousness (competence, self-discipline, thoughtfulness, goal-driven)
- low: impulsive, careless, disorganized
- high: hardworking, dependable, organized
Extroversion (sociability, assertiveness, emotional expression)
- low: quiet, reserved, withdrawn
- high: outgoing, warm, seeks adventure
Agreeableness (cooperative, trustworthy, good-natured)
- low: critical, uncooperative, suspicious
- high: helpful, trusting, empathetic
Neuroticism (tendency toward unstable emotions)
- low: calm, even-tempered, secure
- high: anxious, unhappy, prone to negative emotions
what makes a personality disordered?
According to the perspective of Livesley & colleagues
*Personality disorders occur when there is a failure to manage these three life tasks:
1. To form stable, integrated & coherent
representations of self & others (to see your self
& others as they really are)
2. To develop capacity for intimacy (to have positive
inter-relationships)
3. To engage in pro-social & cooperative behaviours (to function adaptively in society)
normal vs disordered
According to Millon, criteria that distinguish ‘normal’ versus ‘disordered’ personality:
* Rigid & inflexible
* Self defeating, vicious cycle that perpetuate troubled ways of thinking & behaving
* Structural instability, fragility, ‘cracking’ under stress
Personality Disorders: DSM 5TR Clusters
Cluster A (Odd/Eccentric Cluster): Paranoid PD, Schizoid PD, Schizotypal PD *social awkwardness & social withdrawal
Cluster B (Dramatic, Emotional, or Erratic Cluster): Antisocial PD, Histrionic PD, Narcissistic PD, Borderline PD *problems w/ impulse control &
emotional regulation
Cluster C (Anxious/Fearful Cluster): Avoidant PD, Obsessive-compulsive PD, Dependent PD *overlap w/ symptoms of anxiety & depressive disorders
Cluster A: Paranoid personality disorder
“delusional/paranoid”
guarded, defensive, distrustful, & suspicious; hypervigilant to the motives of others to undermine or do harm; seek confirmatory evidence of schemes; feel righteous but persecuted; hard to work w/ & form relationships.
*Paranoid PD must be diagnosed to the exclusion of schizophrenia, or any other psychotic disorder including psychosis (mood disorder)
Cluster A: Schizoid personality disorder
“social withdrawal”
apathetic, indifferent, solitary, distant, humourless, contempt, & odd fantasies; no desire or need for human attachments, withdrawn from relationships; affects more males than females; restricted range of
expression of emotions in interpersonal settings
Cluster A: Schizotypal personality disorder
“distorted reality”
eccentric, self-estranged, bizarre, & exhibit peculiar mannerisms/behaviours; think they can read others’ thoughts; preoccupied w/ odd daydreams/beliefs (blurred line between reality & fantasy); few close relationships.
*These symptoms must not occur only during the course of a disorder w/ similar symptoms (such as schizophrenia or autism spectrum disorder).
Cluster B: Antisocial personality disorder
violates rights of others; history of antisocial tendencies before 15; often lies, fights, & has problems w/ the law; impulsive & fails to think ahead, can be deceitful & manipulative; irresponsible w/ life (job/financials); lacks feelings for others & remorse over misdeeds.
*Psychopathy is related to ASPD but emphasizes psychological (thoughts & feelings) not just behavioural aspects; All psychopaths are diagnosed w/ ASPD but many w/ ASPD do not meet the criteria for psychopathy
related to ASPD: Psychopathy
*Not a formal DSM diagnosis
Psychopathy is related to ASPD but emphasizes psychological (thoughts & feelings) not just behavioural aspects:
- lack of remorse (‘without conscience’), no sense of shame
- superficially charming
- manipulates others for personal gain, exploits ppl
- thrill seeking
All psychopaths are diagnosed w/ ASPD but many w/ ASPD do not meet the criteria for psychopathy
Prevalence, Comorbidity, & Etiology: Antisocial PD
Estimates 1% - 4% of general population have ASPD
- More common in folks assigned male at birth
- May be underdiagnosed in folks assigned female at birth (focus on aggressive symptoms)
- High comorbidity w/ substance use disorder
- Studies found that your risk increases if you have a biological relative w/ ASPD
Environmental influences: increased parental conflict & negativity along w/ decreased parental warmth predict antisocial behaviours
Emotion and Psychopathy: unresponsive to punishments / no conditioned fear responses; decreased skin conductance in resting situations; normal heart rate under resting conditions but higher heart rate when anticipating intense or aversive stimuli
Response Modulation, Impulsivity, and Psychopathy:
slow brain waves & spikes in the temporal area; less activity in the amygdala/hippocampal formation; decreased prefrontal activity
Cluster B: Histrionic Personality Disorder
excessively over-dramatic, emotional, & theatrical; feels uncomfortable when not the center of attention; behaviour often inappropriately seductive or provocative; speech is highly emotional but often vague; emotions are shallow & often shift rapidly; *may alienate friends w/ demands for constant attention
Prevalence, Comorbidity, & Etiology: Histrionic PD
Prevalence 2 to 3%
- More common among ppl who are assigned female at birth w/ an onset in adolescence & early 20s
- Comorbid w/ depression & BPD
Etiology
- Tends to run in families indicating a possible genetic link
- May result from childhood trauma
- Parenting styles lacking boundaries or are overindulgent or inconsistent parenting
Cluster B: Narcissistic personality disorder
overinflated & unjustified sense of self-importance & preoccupied w/ fantasies of success; feels entitled to special treatment from others; shows arrogant attitudes & behaviours; takes advantage of others; lacks empathy
Prevalence, Comorbidity, & Etiology: Narcissistic PD
Prevalence < 1%
- Between 50%-75% of cases affect men
Etiology
- Causes of are unknown, but theorized to be linked to certain types of traumas.
- A combo of genetic, environmental, & social factors are involved in narcissistic PD.
- Kohut view of emerging self: immature grandiosity & dependent over-idealization of others – failure to develop healthy self-esteem
- Product of our times & system of values?
Cluster B: Borderline personality disorder
unstable in self-image, mood, & behaviour; cannot tolerate being alone & experiences chronic feelings of emptiness; unstable & intense relationships w/ others; behaviour is impulsive, unpredictable, & sometimes self-damaging; shows inappropriate & intense anger; makes suicidal gestures
Prevalence, Comorbidity, & Etiology: Borderline PD
Prevalence 1 to 2%
- More common in folks assigned female at birth
about 3 times
- Comorbid w/ mood disorder, substance abuse, PTSD, eating disorders, & Cluster A PDs
Object-relations theory:
- inconsistent parental love causes insecure ego development
- Childhood abuse & trauma
- up to 70% of ppl w/ BPD experienced abuse as a child
Biological factors:
- runs in families - genetics
- dysfunction in dorsolateral prefrontal & limbic brain regions
Cluster C: Avoidant personality disorder
socially inhibited & oversensitive to negative evaluation; avoids occupations that involve interpersonal contact b/c of fears of criticism or rejection; avoids relationships w/ others unless guaranteed to be accepted unconditionally; feels inadequate & views self as socially inept & unappealing; unwilling to take risks or engage in new activities to take risks or engage in new activities if they may prove embarrassing.
Prevalence, Comorbidity, & Etiology: Avoidant PD
Estimated prevalence between 1.5% to 2.5%
- Usually begins in late teens or early 20s
- More common in ppl w/ a range of mental health conditions (depression, social anxiety disorder, OCD)
Etiology
- Genetics - genetics account for about 64% of the likelihood of developing AVPD
- possible links to temperament in infancy
- Fearful attachment style
- Childhood rejection & maltreatment
Cluster C: Dependent personality disorder
allows other to take over & run their life; is submissive, clingy, & fears separation; cannot make decisions w/out advice & reassurance from others; lacks self-confidence; cannot do things on their own; feels uncomfortable or helpless when alone.
Prevalence, Comorbidity, & Etiology: Dependent PD
Estimated prevalence between .5% to 1%
- More folks assigned female at birth
- Usually begins by early adulthood
- Comorbid w/ mood, anxiety, & other personality disorders
Etiology
- Cause is generally unknown
- Genetics plays a strong role
- Abuse & childhood trauma are potential causes
Cluster C: Obsessive-compulsive personality disorder
pervasive needs for perfectionism that interferes w/ ability to complete tasks; preoccupied w/ details, rules, order, & schedules; excessively devoted to work at the expense of leisure & friendships; rigid, inflexible, & stubborn; insists things be done a certain way.
*different from OCD (smtg bad happening if you don’t fulfill compulsions - distress they’re aware of) -> OCPD don’t have obsessions & compulsions, just things having to be done by rules, they also have awareness
OCPD: prevalence, comorbidity, & etiology
- Estimated prevalence ranging from 2.1% to 7.9%.
- More folks assigned male at birth (2x)
- Usually begins by early adulthood
- Comorbid w/ OCD (20%), panic disorder, depression, & avoidant personality disorder
Etiology - Cause is generally unknown
- Parent-child attachment
- Genetics: Scientists have identified a malfunctioning gene that may be a factor in OCPD.
treating personality disorders
Therapy for personality disorders
- schema therapy for PD uses CBT approach to examine logical errors & dysfunctional attitudes
Therapies for borderline personality disorder (BPD)
- ppl w/ borderline personality disorder have troubles establishing trust
- alternatively idealize then vilify therapist
Two main therapy approaches are used for BPD:
- object-relations therapy for BPD: strengthening client’s weak ego, reducing ‘splitting’, combines client-centred acceptance w/ a cognitive-behavioural focus
Dialectical behaviour therapy (DBT) for BPD
- challenge dichotomous (‘black whi&te’) thinking
- teach assertiveness and emotion regulation
Schizophrenia
A psychotic disorder characterized by major
disturbances in thought, emotion, & behaviour
* Disordered thinking in which ideas are not logically related
* Faulty perception & attention
* Flat or inappropriate affect
* Bizarre disturbances in motor activity
* Usually appears in late adolescence or
early adulthood
* Appears earlier for men than for women
* More frequent in men than women
⚬ 1 to 4 ratio
* 50% suffer from a comorbid disorder
⚬ most frequently substance use & depression
course of schizophrenia (how it develops & hospitalization)
- sometimes begins in childhood; however, it usually appears in late adolescence or early adulthood.
- ppl w/ schizophrenia typically have a number of acute episodes of their symptoms.
- between episodes, they often have less severe but still very debilitating symptoms.
- accounts for 19.9% of hospitalizations in general
hospitals. - accounts for 30.9% of hospitalizations in
psychiatric hospitals.
*Despite recent advances in treatment, many people with schizophrenia remain chronically disabled.
Schizophrenia: Positive & Negative Symptoms
Positive Symptoms (the presence of too much of a behaviour that’s not apparent in most ppl):
* Disorganized speech (also called thought disorder)
* Problems in organizing ideas & in speaking so that a listener can understand
* Loose associations
* Derailment
* Delusions
* Hallucinations
Negative Symptoms (the absence of a behaviour that should be evident in most ppl):
* Avolition - Lack of energy
* Alogia - Poverty of speech, amount of speech, poverty of content of speech etc.
* Anhedonia - Lack of interest in recreational activities, relationships w/ others, & sex.
* Flat affect - a lack of emotional expressiveness
* Asociality - Few friends, poor social skills, & little interest in being w/ others
positive symptoms: disorganized speech
Can also include disorganized thoughts; refers to disjointed thought processes where the person
thinks & speaks in a way that seems as though they are randomly combining words, is very difficult to follow, or is very illogical; ppl w/ disorganized speech might speak incoherently, respond to questions w/ unrelated answers, say illogical things, or shift topics frequently; it may also include loose associations such as rapidly shifting between unrelated topics
positive symptoms: delusions
Beliefs that are contrary to reality & are firmly held even in the face of contradictory evidence; more than half of ppl w/ schizophrenia have delusions.
* Paranoid delusions - ie the FBI is following you or
your neighbour is a spy
* Grandiose delusions - ie you are the richest person in the world, are Jesus Christ, or have knowledge no one else posesses
* Somatic delusions - that smtg highly abnormal &
improbable is happening to your body ie - you’re infested by insect or parasites
