Week 3 Topic 1 Flashcards
What is personality?
There is no agreed definition, but it is someones enduring features, made up of traits and can influence situations
What is personality disorder?
Variations or Exaggerations of normal personality attributes
What does personality disorder impair?
Well-being and social functioning, and can reduce effectiveness of usual treatments
Give 4 reasons why there was a shift from Categorical models to Dimensional Models?
1) Few people fit neatly into one box
2) Reliability of diagnosis is poor between different practitioners
3) Only a few of the categories are used in clinical practice
4) Dimensional models identify different traits or domains which represent the more pathological end of the OCEAN personality factors
What are the BIG 5 (OCEAN) ?
Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism
What is Borderline Personality Disorder?
A significant instability of interpersonal relationships, self image and mood
Name 3 symptoms that may lead to a diagnosis of Borderline Personality Disorder?
Impulsive behaviour, Rapid fluctuations of mood, Fear of rejection
Name 3 issues around diagnosis of Personality Disorder
Validity of diagnosis and low reliability, Atheoretical basis (less for new models), Stigma of “bad person”
What can Personality Disorder overlap with?
Complex PTSD
Name 3 benefits of retaining concept of Personality Disorder?
1) Pragmatism
2) Communication between staff
3) Choice of treatments with better outcomes
Personality Disorder affects ___% of the general population
10
Where is there a higher prevalence of Personality Disorder?
In mental health population
__% - __% of adult prisoners have Personality Disorder
50-70
There are differences in which _____ diagnosed more frequently in men and women
Categories
How can biology explain Personality Disorders?
Dimensions have variable heritability, and genetic differences impact on resilience e.g. some people need less of a setback to go unstable
What is the biggest risk factor for Personality Disorder?
Emotional neglect
What family factors can explain Personality Disorders?
Insecure attachments (disorganised is the worst), Dysfunction in family mediated by attachment e.g. substance users, domestic violence, makes parents less reliable, Childhood trauma
What is Disorganised attachment? (others are avoidant and ambivalent)
When there is a frightened or frightening caregiver, and the child experiences fear without a solution so alternates between flight, freezing, fighting
What does the Model of Disorganised attachment say?
That Distress/Fear leads to Activation of an Attachment System, which then leads to Seeking proximity, which then leads to Exposure to Maltreatment
What are the 5 Models of Therapy for BDP?
1) Mentalisation Based Therapy
2) Dialectical Behaviour Therapy
3) Schema Based Therapy
4) STEPPS programme
5) Structured Clinical Management
What is Mentalisation? And why is it important?
Working out what is going on in your mind and the minds of others. Because the patient won’t know why they feel the way they do, they will just feel bad
How can developing a disorganised attachment affect Mentalisation?
Because we internalise representations of ourselves from responses of an attachment figure, so therefore if this attachment is disorganised, our capacity to mentalise fails to develop sufficiently and our attachment system is triggered too easily
So, what is the purpose of Mentalisation Based Therapy?
To focus on promotiong mentalisation about the self, others and relationships, focusing on keeping emotional arousal at an optimum level, delivered via a weekly group and 1:1 therapy
What does Dialectical Behaviour Therapy aim to teach?
Skills to improve emotion regulation, as it views this as the primary dysfunction, as well as aims to improve distress tolerance and interpersonal functioning
What 2 things does Dialectical Behaviour Therapy combine?
CBT and Mindfulness e.g. balancing opposites
How is Dialectical Behaviour Therapy delivered?
Via weekly skills group and 1:1 therapy
What does Schema Based Therapy say about Personality Disorder?
That it involves Early Maladaptive Schemas (EMS), which interfere with self expression, autonomy and social validation
What does Schema Based Therapy focus on?
EMS are explored and related to developmental origins,
What does the STEPPS programme focus on?
This is a highly structured psycho-educational 20 week group programme, with 1:1 reinforcement and teaching about schemas, as well as other CBT techniques
What does the Structured Clinical Management focus on?
Draws on MBT and DBT, delivered by generalist mental health professionals and there is an emphasis on clear structure to treatment and active and collaborative, focus on learning to tolerate emotions
Is there one Therapy that’s considered better for treating BPD?
No, no clear evidence
