Topic 4: Personality Disorders & Mood Flashcards
What is the DSM-IV?
A classification of 5 categories for personality disorders.
What is axis I of the DSM-IV?
Clinical Psychological Disorders.
What is axis II of the DSM-IV?
Personality Disorders + Intellectual Disabilities. (These could worsen the axis I disorder prognosis).
What is axis III of the DSM-IV?
Medical conditions and physical disorders. E.g., this could mean that they are not able to have certain medication.
What is axis IV of the DSM-IV?
Psychosocial and environmental factors.
What is axis V of the DSM-IV?
Functional level. (Looking at their capabilities of working/looking after themselves).
What did DSM 5 (2013) group together?
Grouped 1-3 together to remove the qualitative distinction between personality disorders and other psychological disorders.
Since the DSM 5 (2013) groups together axis 1-3, what does this do?
Grouping 1-3 together means that it removes the qualitative distinction between personality disorders and other psychological disorders. This recognises all the disorders as clinical disorders and are worth of specific focus for treatment within their own right.
What is the justification for the DSM-IV for putting Personality Disorder on its own axis?
Increase the clinical/research attention as it was very important. They generally tend to be less understood/historically have been less researched.
What is the definition of personality disorders? (5 characteristics)
Enduring pattern of inner experience and behaviour.
Deviations from cultural expectations.
Experiences and behaviours are pervasive (influence many aspects of life) and inflexible (stable and unchanging).
They cause distress/impairment.
They are not due to another disorder e.g., drugs/intoxication etc.
What type of disorders are cluster A?
Odd/eccentric disorders.
What are examples of Cluster A personality disorders?
Paranoid, schizoid, schizotypal.
What type of disorders are cluster B?
Dramatic/emotional or erratic disorders.
What are examples of disorders that are in cluster B?
Antisocial, borderline, histrionic and narcissistic.
(emotional, dramatic or erratic disorders)
What are cluster C disorders?
Anxious/fearful disorders.
What are examples of cluster C disorders?
Avoidant, dependent, obsessive-compulsive.
What did Haslam (2007) suggest about personality disorders?
Co-occurrence of PDs is common. Many people meet the criteria for multiple at any one time. This can be within clusters or across clusters.
What did Lofti et al., (2018) suggest about personality disorders?
Highly questionable validity and utility of diagnostic groups. Because there is overlap between what individuals can experience.
What is paranoid PD? (A)
Paranoia; mistrust of others; has irrational suspicions. Extreme mistrust in other people with lack of evidence.
Pre-occupied with doubts; reluctance to confide; misinterprets innocent remarks, and holds grudges against people. Misperception that innocent things are actually attacks on them personally.
What is Schizoid PD? (A)
Detachment from interpersonal relationships; emotional coldness; indifference to praise/criticism of others.
Has few friends; chooses solitary activities. Does not necessarily need social engagement.
What is Schizotypal PD? (A)
Distortions in thinking, feelings and perceptions
e.g. ideas of reference, magical thinking, perceptual illusions. → Positive symptoms of schizophrenia.
There may be phantom pains/misperceptions of touch.
Discomfort in social situations; suspicions and paranoia.
Is cluster A or cluster B more diverse?
Cluster B is more diverse.
What is antisocial (dissocial) PD? (B)
Lack of empathy and remorse; disregard for others.
Failure to conform to norms/laws; impulsivity; deceitfulness; irresponsibility, and disregard for safety of self/others.
Increased risk of getting into trouble with the law.
What is histrionic PD? (B)
Excessive need for approval; need to be centre of attention. Shallow/over-dramatic emotions; sees relationships as more intimate than they are. Misinterpretation of relationships.
(almost the opposite of antisocial PD)
What is narcissistic PD? (B)
Inflated self-importance and sense of entitlement; belief they are special; seeks attention and admiration from others.
Fantasises of success; arrogance; envy of others; low in empathy.
What is Borderline (Emotionally Unstable) PD?
Unstable personal relationships; frantic attempts to avoid real/imagined abandonment; lack of well-formed identity; feelings of emptiness/worthlessness; Instability of feelings.
Frequent suicidal, self-harming, self-mutilating behaviours; Impulsivity in self-damaging behaviours.
How is BPD portrayed in the media?
Sensationalised media portrayal.
What is Avoidant PD? (C)
Social inhibition; avoids and withdraws from social situations.
Low self-worth; fear rejection, disapproval and criticism; feel socially-inept; reluctant to engage in new things for fear of embarrassment.
What is the Dependent PD? (C)
Persistent psychological dependence on others; lack confidence in ability to take responsibility; has difficulty doing things alone.
Tends to agree with others; seeks out new relationships.
What is Obsessive-compulsive PD? (C)
Preoccupation with orderliness, rules, moral codes, caution and perfectionism; excessive devoted to work; inflexibility and overly-conscientious.
What is the continuity hypothesis?
There is no discontinuity between normality and illness.
In terms of the continuity hypothesis, why is considering personality and personality disorders distinctly potentially not appropriate?
Since there is connection between personality and personality disorders, considering them completely separately may be redundant.
What did the Salesman and Page (2004) study reveal about the connection between traits and personality disorders?
Meta-analysis of 12 studies.
Looked at the level of personality disorders and the Big-5 traits.
Some disorders have correlations with the Big-5 traits. The associations with the personality trait seem to fit with the symptoms of the disorder.
What is a Big-5 Profile Approach?
Conceptual profiles by which facets relate to the diagnostic characteristics for disorders.
What was identified from the Wider et al., (1994) conceptual profile for Paranoid PD?
For paranoid PD, we can see that there are specific facets that are relevant for this disorder. E.g., anger hostility etc.
What are the facets associated with Obsessive-compulsive Personality disorder?
High Competence (C1)
High ‘Order’ (C2)
High Dutifulness (C3)
High Achievement-striving (C4)
High Deliberation (C6)
What are the facets associated with Dependent PD?
High Anxiety (N1)
High Self-consciousness (N4)
High Vulnerability (N6)
High Altruism (A3)
High Compliance (A4)
High Modesty (A5)
What are the facets associated with Avoidant PD?
Low Gregariousness (E2)
Low Assertiveness (E3)
High Anxiety (N1)
High Self-consciousness (N4)
High Vulnerability (N6)
What are the facets associated with Schizoid PD?
Low Warmth (E1)
Low Gregariousness (E2)
Low Positive emotionality (E6)
What did McCrae et al., (2001) suggest about using these Big-5 Profiles to diagnose PD’s?
Profiles may indicate risk (but not diagnosis) of PD. May be useful for ruling out a PD, or characterising a known PD. You cannot just diagnose someone based on these profiles.
How did McCare et al., (2001) test the Big-5 approach?
(hint - interview)
- 1926 patients from psychiatric hospitals:
- Personality Disorder Interview.
- Personality Disorder Questionnaire (PDQ).
- NEO-PI-R.
- Calculated ‘profile agreement’ scores for each patient.
- Significant correlations – but only “modest to moderate.”
- Potential need to revise the current diagnostic classification system for personality disorders (DSM-IV).
What were the limitations in drawing conclusions from the results of the McCrae et al., (2001) study?
Even though the correlations are significant, they are not extreme correlations (they were only modest-moderate) and so the facets do not necessarily provide a full account of these disorders.