Week 21: Psychopathology, Psychopathy, and Therapeutic Orientations Flashcards
What is a personality disorder?
A personality disorder is characterized by significant distress, social impairment, and/or occupational impairment due to maladaptive personality traits.
What are the five domains of general personality?
- Neuroticism
- Extraversion
- Openness
- Agreeableness
- Conscientiousness
List the six personality disorders proposed for retention in DSM-5.
- Borderline
- Antisocial
- Schizotypal
- Avoidant
- Obsessive-Compulsive
- Narcissistic
What are the two primary treatments for borderline personality disorder?
- Dialectical Behavior Therapy
- Mentalization Therapy
What traits are associated with high neuroticism?
- Fearful
- Angry
- Pessimistic
- Anxious
- Timid
What traits are indicative of high extraversion?
- Sociable
- Outgoing
- Energetic
- Dominant
- Affectionate
What does the term ‘openness’ refer to in personality traits?
- Creativity
- Imagination
- Unconventionality
- Broad-mindedness
- Self-awareness
What are some traits associated with low agreeableness?
- Skeptical
- Manipulative
- Deceptive
- Aggressive
- Selfish
What characteristics define high conscientiousness?
- Organized
- Reliable
- Efficient
- Perfectionistic
- Ambitious
True or False: The DSM-5 includes 10 personality disorders.
True
What is the purpose of the ‘other specified personality disorder’ (OSPD) in DSM-5?
OSPD is used when traits do not fit well into existing personality disorder diagnoses.
How does avoidant personality disorder manifest?
It is characterized by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
What are common traits of dependent personality disorder?
- Submissiveness
- Clinging behavior
- Fear of separation
What traits are characteristic of antisocial personality disorder?
- Dishonesty
- Manipulativeness
- Callousness
- Exploitative behavior
Fill in the blank: Borderline personality disorder is largely a disorder of _______.
neuroticism
What are the traits associated with obsessive-compulsive personality disorder?
- Workaholism
- Perfectionism
- Ruminative
- Punctilious
What is the alternative view of personality disorders proposed in DSM-5?
Personality disorders are extreme and/or maladaptive variants of normal personality traits.
What are the potential future changes to personality disorders in DSM revisions?
Some disorders may be deleted if they lack empirical support.
What is the etiology of antisocial personality disorder typically attributed to?
An interaction of genetic dispositions and a tough, urban environment.
What environmental factors contribute to borderline personality disorder?
A malevolent, abusive, and/or invalidating family environment.
True or False: Most individuals with personality disorders actively seek treatment.
False
What motivates people with borderline personality disorder to seek help?
High levels of neuroticism and emotional pain.
What is schizoid personality disorder characterized by?
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings.
What motivates individuals with borderline personality disorder to seek treatment?
High levels of neuroticism and emotional pain.
True or False: Many people with personality disorders seek treatment.
False.
What is neuroticism in the context of personality disorders?
The domain of general personality structure that concerns inherent feelings of emotional pain and suffering, including distress, anxiety, and depression.
Which personality disorders are exceptions that may lead individuals to seek treatment?
Borderline personality disorder and avoidant personality disorder.
Fill in the blank: The prevalence of personality disorders within clinical settings is estimated to be well above _______.
50%.
What percentage of inpatients within some clinical settings are diagnosed with borderline personality disorder?
As many as 60%.
What is the estimated percentage of the general population that meets criteria for at least one DSM-IV-TR personality disorder?
10% to 15%.
How do personality disorders impact the treatment of other mental disorders?
They typically inhibit or impair responsivity.
What is a common characteristic of antisocial individuals in therapy?
Irresponsible and negligent behavior.
What is the primary challenge in treating personality disorders?
They involve well-established behaviors integral to a client’s self-image.
Which personality disorder has a developed treatment protocol?
Borderline personality disorder.
What does dialectical behavior therapy involve?
Individual therapy, group skills training, telephone coaching, and therapist consultation team.
True or False: Specific treatment manuals have been developed for all personality disorders.
False.
What is a reason for the lack of treatment manuals for some personality disorders?
The assumption that personality disorders are unresponsive to treatment.
What is the Five-Factor Model?
Five broad domains or dimensions used to describe human personality.
What defines avoidant personality disorder?
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
What characterizes narcissistic personality disorder?
A pervasive pattern of grandiosity, need for admiration, and lack of empathy.
What is the key feature of histrionic personality disorder?
A pervasive pattern of excessive emotionality and attention seeking.
What is the main characteristic of dependent personality disorder?
A pervasive and excessive need to be taken care of, leading to submissive and clinging behavior.
What is the diagnostic overlap in personality disorders?
Patients meeting criteria for one personality disorder often meet criteria for another.
What is the general conclusion regarding personality disorders?
All individuals have a personality, and for some, traits may result in distress or impairment, constituting a personality disorder.
What is the importance of understanding personality disorders dimensionally?
Each is understood as a maladaptive variant of general personality structure.
What percentage of inmates within a correctional setting may be diagnosed with antisocial personality disorder?
As many as 50%.
What is psychopathy also known as?
Psychopathic personality
This term reflects the clinical understanding of the condition.
Who authored the classic account of psychopathy in ‘The Mask of Sanity’?
Hervey Cleckley
Cleckley’s work significantly influenced the understanding and diagnosis of psychopathy.
What are the three components of the Triarchic model of psychopathy?
- Disinhibition
- Boldness
- Meanness
This model reconciles various conceptions of psychopathy.
What did Philippe Pinel document regarding psychopathy?
Manie sans delire (insanity without delirium)
This concept highlighted episodes of recklessness and aggression without obvious mental clouding.
What is the Psychopathy Checklist-Revised (PCL-R) used for?
Diagnosing psychopathy in correctional and forensic settings
It consists of 20 items rated based on interview and file-record information.
What cutoff score on the PCL-R indicates a diagnosis of psychopathy?
30 out of 40
This score is based on high correlations with impulsive and aggressive tendencies.
What are the two distinct factors of the Psychopathic Personality Inventory (PPI)?
- Fearless Dominance (FD)
- Self-Centered Impulsivity (SCI)
These factors reflect different aspects of personality dispositions related to psychopathy.
True or False: Cleckley characterized psychopathic patients as inherently violent.
False
Cleckley noted that harm caused by psychopaths is often nonphysical and impulsive.
What traits are emphasized in the callous-unemotional (CU) traits for youth?
- Low empathy
- Deficient remorse
- Shallow affect
- Lack of concern
These traits are crucial for predicting conduct problems in children.
What is a significant concern regarding the DSM’s antisocial personality disorder (ASPD) definition?
Limited coverage of interpersonal-affective symptoms
Experts noted that ASPD does not adequately address essential psychopathy features.
Fill in the blank: The __________ model provides a basis for reconciling differing historic conceptions and assessment approaches of psychopathy.
Triarchic
This model integrates various perspectives on psychopathy.
What is the Antisocial Process Screening Device (APSD) used for?
Assessing psychopathic tendencies in youth
It is particularly used for clinic-referred children ages 6 through 13.
What key feature do children high on both APSD factors exhibit?
- Average or above-average intelligence
- Low anxiety levels
- High levels of premeditated aggression
These children tend to learn less from punishment.
What does the disinhibition component of the Triarchic model encompass?
- Impulsiveness
- Weak behavioral restraint
- Hostility and mistrust
- Difficulties in regulating emotion
These traits are indicative of a lack of control and emotional regulation.
What does the boldness component of the Triarchic model include?
- Dominance
- Social assurance
- Emotional resiliency
- Venturesomeness
This component reflects a confident and fearless demeanor.
What is the primary focus of Cleckley’s conception of psychopathy?
Boldness and disinhibition
This contrasts with criminally oriented conceptions that emphasize meanness.
What are the three components of the Triarchic model of psychopathy?
Boldness, Disinhibition, Meanness
These components help in understanding different variants of psychopathy.
What does the Triarchic Psychopathy Measure (TriPM) consist of?
58 items divided into three subscales: Boldness, Disinhibition, and Meanness
The TriPM was developed to operationalize the Triarchic model.
Which scale of the TriPM is specifically designed to index fearless tendencies?
Boldness scale
This scale references the FD factor of the Psychopathic Personality Inventory (PPI).
What are the two types of theories that investigate causal factors in psychopathy?
- Theories emphasizing core deficits in emotional sensitivity or responsiveness
- Theories positing basic impairments in cognitive-attentional processing
These theories provide different perspectives on psychopathy’s underlying mechanisms.
What neurobiological finding is commonly associated with psychopathy?
Lack of normal enhancement of the startle blink reflex to aversive stimuli
This reflects a failure in defensive (fear) reactivity.
What does the Triarchic model suggest about the relationship between boldness and psychopathy?
Boldness is linked to lack of startle enhancement and is associated with the interpersonal-affective factor of psychopathy
This highlights the connection between boldness and emotional processing in psychopathy.
True or False: The Triarchic model indicates that all individuals high in disinhibition also qualify for a diagnosis of psychopathy.
False
Individuals must also be high in either boldness or meanness to qualify.
What characterizes the ‘mean-disinhibited’ type of psychopath?
Presence of salient aggressive behavior
This subtype is marked by both meanness and disinhibition.
Fill in the blank: Cleckley’s view of psychopathy includes indicators of _______.
positive adjustment
This contrasts with clinical assessments that focus on deviancy.
What is the relationship between anxiety and the components of psychopathy according to the Triarchic model?
Boldness is negatively correlated with anxiousness; Disinhibition and Meanness have negligible correlations
This indicates differing impacts of these components on anxiety.
What do current theories suggest about gender differences in psychopathy?
Differences in prevalence may relate to levels of boldness, meanness, and disinhibition
Men generally score higher on psychopathy measures than women.
What is a significant question regarding ‘successful’ psychopaths?
Whether dispositional fearlessness (boldness) can lead to success without high disinhibition
This suggests a nuanced view of psychopathic traits in leadership roles.
What does the term ‘dark triad’ refer to?
A collection of three personality traits: Machiavellianism, psychopathy, and narcissism
These traits are often studied together in social psychology.
What are some characteristics of boldness in the context of psychopathy?
Social poise, emotional stability, enjoyment of novelty and adventure
Boldness can also be associated with narcissistic tendencies.
What is the implication of cluster analytic studies of offenders with high PCL-R scores?
Existence of subtypes characterized by low anxiety and high impulsivity/aggression
This suggests variability in psychopathic traits among offenders.
How does the Triarchic model address the definition of psychopathy?
By separating the disorder into subcomponents that relate differently to various traits
This helps clarify ongoing debates about the essential features of psychopathy.
What is associated with high externalizing proneness (disinhibition)?
Higher success in occupations calling for leadership and/or courage
This is due to psychopathic tendencies manifested in social effectiveness, affective resilience, and venturesomeness.
Which study estimated scores on the FD and SCI factors of the PPI using personality trait ratings of former U.S. presidents?
Lilienfeld et al. (2012)
The study involved assessments by expert historians.
What did higher estimated levels of PPI-FD (boldness) predict in U.S. presidents?
Higher ratings of presidential performance, persuasiveness, leadership, and crisis management ability
What were higher estimated levels of SCI associated with?
Adverse outcomes such as documented abuses of power and impeachment proceedings
What is the purpose of further research on high levels of boldness and/or meanness in the absence of high disinhibition?
To yield valuable new insights into dispositional factors underlying psychopathy
What is the counterpart diagnosis to psychopathy included in the DSM?
Antisocial personality disorder
Defined by specific symptoms of behavioral deviancy in childhood continuing into adulthood.
Who introduced the term psychopathy?
Julius Koch in 1888
What model reconciles alternative historic conceptions of psychopathy?
Triarchic model
What are the three symptomatic components of the triarchic model of psychopathy?
- Boldness
- Meanness
- Disinhibition
Define boldness in the context of the triarchic model.
Involves social efficacy, emotional resiliency, and venturesomeness
What does meanness entail in the triarchic model?
Lack of empathy/emotional-sensitivity and exploitative behavior toward others
What does disinhibition refer to in the triarchic model?
Deficient behavioral restraint and lack of control over urges/emotional reactions
True or False: The triarchic model includes only one component of psychopathy.
False
Fill in the blank: Antisocial personality disorder is defined by specific symptoms of _______.
[behavioral deviancy in childhood]
What is the most effective modern approach to treating mental illness?
Cognitive Behavioral Therapy (CBT)
CBT is recognized for its effectiveness across various psychiatric illnesses.
What are the key components to consider for each therapeutic approach?
- History
- Goals
- Key techniques
- Empirical support
These components help evaluate the effectiveness and application of each therapy.
What was the earliest organized therapy for mental disorders?
Psychoanalysis
Developed by Sigmund Freud, focusing on unconscious conflicts and desires.
Who is the founder of psychoanalysis?
Sigmund Freud
Freud’s work emphasized the importance of unconscious processes in mental health.
What are the three components of Freud’s structural model of the mind?
- Id
- Superego
- Ego
These components interact to influence behavior and mental health.
What is the goal of psychoanalytic therapy?
To bring unconscious struggles into conscious awareness
This is believed to relieve psychological stress.
What is free association in psychoanalytic therapy?
A technique where the patient shares thoughts without censorship
This method helps uncover patterns and meanings in the patient’s thoughts.
What is transference in psychoanalytic therapy?
Displacing feelings for significant others onto the therapist
This helps therapists understand the patient’s emotional conflicts.
What is the main disadvantage of psychoanalytic therapy?
Lack of empirical support for effectiveness
Research suggests limited reliability in improving mental health outcomes.
What therapy focuses on the inconsistency between behavior and personal identity?
Person-Centered Therapy (PCT)
Developed by Carl Rogers, emphasizing self-discovery and personal worth.
What is the therapist’s role in Person-Centered Therapy?
To provide a supportive and nonjudgmental environment
This encourages patients to explore their identity and feelings.
What is unconditional positive regard in PCT?
The therapist’s non-condemnatory attitude towards the patient
This fosters a safe space for self-exploration.
What is a key advantage of Person-Centered Therapy?
Highly acceptable to patients
The supportive environment helps patients feel valued.
What is a main disadvantage of Person-Centered Therapy?
Mixed findings about its effectiveness
Treatment may not be specific enough to address individual needs.
What is the primary focus of Cognitive Behavioral Therapy (CBT)?
To alleviate psychological symptoms by changing underlying cognitions and behaviors
CBT emphasizes the interaction between thoughts, emotions, and behaviors.
Who were the key figures in the development of CBT?
- Dr. Aaron T. Beck
- Albert Ellis
Both contributed to understanding and treating cognitive distortions.
What is the concept of automatic thoughts in CBT?
Spontaneous thoughts that arise in response to situations
These thoughts can lead to maladaptive emotions and behaviors.
What is the typical duration of Cognitive Behavioral Therapy?
12 to 16 weekly sessions
This timeframe is designed to be relatively brief yet effective.
Fill in the blank: The __________ focuses on changing maladaptive thoughts and behaviors to improve mental health.
Cognitive Behavioral Therapy (CBT)
CBT is evidence-based and widely practiced.
True or False: Psychoanalysis is primarily focused on present behaviors rather than past experiences.
False
Psychoanalysis emphasizes understanding past experiences, particularly childhood.
What is the primary goal of cognitive-behavioral therapy (CBT)?
To help people make adaptive appraisals instead of maladaptive ones.
This involves cognitive restructuring, where therapists assist patients in modifying inaccurate or maladaptive thoughts.
Define ‘maladaptive appraisals’ in the context of CBT.
Untrue judgments and evaluations of certain thoughts.
These appraisals can lead to psychological distress, as they reinforce negative beliefs about oneself.
What technique is fundamental to CBT for addressing inaccurate thoughts?
Cognitive restructuring.
This technique involves helping patients identify and modify maladaptive thoughts.
What is exposure therapy?
A form of intervention in which the patient engages with a problematic (usually feared) situation without avoidance or escape.
This method aims to reduce fear through gradual exposure to the feared stimulus.
What is the ABC model in CBT?
A model where A stands for antecedent event, B stands for belief, and C stands for consequence.
This model illustrates the causal relationship between beliefs and emotional responses.
True or False: CBT interventions are typically long-term and require minimal patient effort.
False.
CBT interventions tend to be relatively brief but require significant effort from patients.
What are two key components of mindfulness?
- Self-regulation of attention
- Orientation toward the present moment.
These components help individuals focus on their thoughts and feelings without judgment.
What is mindfulness-based therapy (MBT)?
A form of psychotherapy that incorporates mindfulness practices.
MBT includes approaches like mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).
Fill in the blank: ___________ is a therapeutic approach designed to foster nonjudgmental observation of one’s own mental processes.
Acceptance and commitment therapy.
What distinguishes dialectical behavior therapy (DBT) from cognitive-behavioral therapy (CBT)?
DBT focuses on skills training and addresses symptoms while CBT focuses on understanding the psychological motivation for behaviors.
DBT incorporates mindfulness and acceptance strategies, while CBT primarily targets cognitive restructuring.
What is cognitive bias modification?
Using exercises (e.g., computer games) to change problematic thinking habits.
This approach aims to alter automatic, subconscious thoughts that contribute to mental disorders.
What is the significance of pharmacological treatments in mental health?
They can be prescribed by general medical practitioners and are frequently used to treat various mental disorders.
While effective, the choice between pharmacological and therapeutic interventions depends on the individual and their specific disorder.
What is the focus of acceptance and commitment therapy (ACT)?
To observe thoughts from a detached perspective and recognize beneficial versus harmful thoughts.
ACT encourages acceptance of thoughts rather than attempting to change or avoid them.
What is the role of technology in emerging treatment strategies for mental health?
Enhances existing treatments, making therapy more accessible through online and mobile-delivered therapies.
Technological advances allow for remote therapy and symptom tracking.
What does the term ‘comorbidity’ refer to?
Having more than one psychological or physical disorder at a given time.
True or False: Mindfulness-based therapies have a consensus on their efficacy among psychologists.
False.
While there is growing evidence supporting the effectiveness of MBT, a consensus has not yet been reached.
What are the benefits of integrative or eclectic psychotherapy?
Incorporates techniques from multiple therapeutic approaches to address various patient needs.
Many therapists identify their approaches as integrative or eclectic, utilizing skills from different therapies.
What is the main advantage of mindfulness-based stress reduction (MBSR)?
Uses meditation, yoga, and attention to physical experiences to reduce stress.
This reduction in stress helps individuals evaluate their thoughts more objectively.
What is CBT?
A family of approaches with the goal of changing the thoughts and behaviors that influence psychopathology.
What does comorbidity describe?
A state of having more than one psychological or physical disorder at a given time.
What is Dialectical Behavior Therapy (DBT) used for?
A treatment often used for borderline personality disorder that incorporates both cognitive-behavioral and mindfulness elements.
What does the dialectical worldview in DBT emphasize?
The joint importance of change and acceptance.
What is exposure therapy?
A form of intervention in which the patient engages with a problematic (usually feared) situation without avoidance or escape.
Fill in the blank: In psychodynamic therapy, _______ is a process in which the patient reports all thoughts that come to mind without censorship.
[Free association]
What does integrative or eclectic psychotherapy refer to?
Approaches combining multiple orientations (e.g., CBT with psychoanalytic elements).
What is mindfulness?
A process that reflects a nonjudgmental, yet attentive, mental state.
What is mindfulness-based therapy?
A form of psychotherapy grounded in mindfulness theory and practice, often involving meditation, yoga, body scan, and other features of mindfulness exercises.
What is the focus of person-centered therapy?
Creating a supportive environment for self-discovery.
Who developed psychoanalytic therapy?
Sigmund Freud.
What is psychodynamic therapy?
Treatment applying psychoanalytic principles in a briefer, more individualized format.
What is reappraisal, or cognitive restructuring?
The process of identifying, evaluating, and changing maladaptive thoughts in psychotherapy.
What is a schema?
A mental representation or set of beliefs about something.
Fill in the blank: In person-centered therapy, an attitude of warmth, empathy, and acceptance is called _______.
[Unconditional positive regard]
