Week 5c: Personality Disorders Flashcards
Personality Disorders
Personality Disorder Diagnosed if traits are:
- persistently maladaptive; lead to chronic difficulty in interpersonal, occupational, and social functioning
2 definitions of Personality Disorders:
- Personality disorders are associated with ways of thinking and feeling about oneself and others that significantly and adversely affect how an individual functions in many aspects of life
- Enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment”
~6-9% of Canadians have a personality disorder
6 criteria for Personality Disorders
- Must show up in at least two of the following areas: cognition, emotions, interpersonal functioning, or impulse control.
- Enduring pattern of behaviour that consistently shows up across a broad range of social and personal situations.
- Leads to distress in social, occupational, or other important areas of functioning.
- Stability and long duration of symptoms, with onset in adolescence or earlier.
- Cannot be accounted for by another mental disorder.
- Not result of substance use (not only when using) or of another medical condition.
Schizoid Personality Disorder
Cluster A: Odd & Eccentric Personality Disorders
Detachment from others and limited (flat) range of emotional expressions
Personality Disorder: Cluster B
Dramatic, Emotional, or Erratic Personality Disorders
- Antisocial
- Borderline
- Histrionic
- Narcissistic
Manipulative, volatile, and uncaring in social relationships
Personality Disorder: Cluster C
Anxious & Fearful Personality Disorders
- Avoidant
- Dependent
- Obsessive-Compulsive
Extremely concerned about being criticized or abandoned by others and thus have dysfunctional relationships with them.
Histrionic Personality Disorder (short)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
- Rapidly shifting moods, unstable relationships, and intense need for attention and approval; excessive emotionality and attention-seeking behaviour.
Antisocial Personality Disorder (short)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
- Pervasive pattern of criminal, impulsive, callous, or ruthless behaviour; disregard for rights of others; no respect for social norms.
Borderline Personality Disorder (short)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
- Rapidly shifting and unstable mood & self-concept; Unstable interpersonal relationships; Marked impulsivity. Key trait: Instability
Narcissistic Personality Disorder (short)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
- Grandiose thoughts and feelings of one’s own worth; obliviousness to others’ needs; need for admiration; lack of empathy.
Personality Disorder: Cluster A
Odd & Eccentric Personality Disorders
- Paranoid
- Schizoid
- Schizotypal
Symptoms similar to schizophrenia, but maintaining grasp on reality.
Schizotypal Personality Disorder
Cluster A: Odd & Eccentric Personality Disorders
Cognitive or perceptual distortions, eccentric behaviour. Distortions or odd thoughts.
Paranoid Personality Disorder
Cluster A: Odd & Eccentric Personality Disorders
Distrustful, suspicious, negative interpretation of others’ intentions. People’s intentions are often
Obsessive-Compulsive Personality Disorder (short)
Cluster C: Anxious & Fearful Personality Disorders
Ritual behaviours, preoccupation with orderliness and cleanliness
Avoidant/Dependant Personality Disorder (short)
Cluster C: Anxious & Fearful Personality Disorders
Avoidant and Dependent
PD: Other
- Personality change due to medical condition
-
Other or unspecified
- meeting general but not specific criteria
Antisocial Personality Disorder (BPD) (long)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
Person just doesn’t care or empathize
- Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
- Deceitfulness
- Impulsivity or failure to plan ahead
- Irritability and aggressiveness
- Reckless disregard for safety of self or others
- Consistent irresponsibility
- Lack of remorse
___________
Comorbidity
Of all personality disorders, APD has highest association with substance abuse (in men). ex. In a sample of 200 male alcoholics, 49% met the diagnostic criteria for APD
Childhood precursors: ADHD, conduct disorders
➡︎ themselves are associated with adult substance use disorders
Shame often felt if problem realized ➡︎ self-medication
Denial: Easier to blame others for problems
May not consider the personality trait causing problems as undesirable
➡︎ Rationalization, Minimalization
Difficulty regulating behaviour and affect intolerance ➡︎ substance abuse
Drugs provide immediate gratification followed by regressive behaviors (impulsivity, self-centeredness, passivity, affect intolerance)
________
Diagnosis of APD is based largely on behaviour (that is illegal or harmful to others)
APD often co-occurs with substance use disorders because:
Willingness to break the law is part of drug-taking
Circumstances that lead to crime can lead to addiction
Drugs disinhibit behaviour
Both could be related to stimulation-seeking preference
Borderline Personality Disorder (BPD) (long)
Cluster B: Dramatic, Emotional, or Erratic Personality Disorders
- Characterized by instability of mood; abandonment depression; unstable sense of own identity (self-concept); instability in (often very intense) interpersonal relationships (rapidly switch from idolizing to despising others). Very sensitive to criticism.
- May engage in self-destructive acts, abuse substances, undermine acheivements. Likely to overdose or try prescription drugs.
Substance abuse likely to blunt intensity of emotions. Abstinence essential.
Diagnostic criteria for BPD
A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by 5 or more of the following 9 criteria:
- Frantic efforts to avoid abandonment
- A pattern of unstable and intense interpersonal relationships
- Identity disturbance: marked and persistently unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging
- Recurrent suicidal behaviour, gestures, or threats or self-mutilating behavior
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
Histrionic Personality Disorder (long)
- Distinguished by attention-seeking behaviours: Overly dramatic, self-centered, always wanting to be the ‘life of the party’.
- Insincere & shallow, easily annoyed if they feel ignored: Difficulty with relationships.
Narcissistic Personality Disorder (long)
Pervasive pattern of grandiosity, need for admiration, & lack of empathy, beginning by early adulthood and present in a variety of contexts, indicated by 5 or more of the 9 following criteria:
- Has a grandiose sense of self-importance
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
- Requires excessive admiration
- Has a sense of entitlement
- Is interpersonally exploitative
- Lacks empathy
- Is often envious of others or believes that others are envious of him or her
- Shows arrogant, haughty behaviors or attitudes
Narcissism
Excessive interest in
- oneself
- one’s appearance
Borderline Personality Disorder
Essential features are pattern:
- marked impulsivity
- instability of affects
- interpersonal relationships
- self image
Three-dimensional model of personality for addiction
(Cloninger, 1987)
(CloningerHNR)
- Harm avoidant
- Novelty seeking
- Reward dependent
Maladaptive motivational structure: also important. Can’t maintain motivation to achieve goals
Two personality disorders have the highest correlation with substance abuse
- Narcissism
- Borderline personality disorder
how Depression, Mood and Feelings affect addiction
- Disturbances in these common causes of addiction, especially in women
- Negative affect states incentivise self-medication.
- Can spiral into pattern of isolation that exacerbates affective disorder and can develop to social phobia
All the ways we have of acting, thinking, believing, and feeling that make each of us unique.
Personality
Narcissism
Excessive interest in
- oneself
- one’s appearance
Borderline Personality Disorder
Essential features are pattern:
- marked impulsivity
- instability of affects
- interpersonal relationships
- self image
Three-dimensional model of personality for addiction
(Cloninger, 1987)
(CloningerHNR)
- Harm avoidant
- Novelty seeking
- Reward dependent
Maladaptive motivational structure: also important. Can’t maintain motivation to achieve goals
Two personality disorders have the highest correlation with substance abuse
- Narcissism
- Borderline personality disorder
how Depression, Mood and Feelings affect addiction
- Disturbances in these common causes of addiction, especially in women
- Negative affect states incentivise self-medication.
- Can spiral into pattern of isolation that exacerbates affective disorder and can develop to social phobia
All the ways we have of acting, thinking, believing, and feeling that make each of us unique.
Personality
A complex pattern of behaviour, thought, and feeling that is stable across time and across many situations.
Personality Trait
Aware they have the problem and don’t like it. Dissonant.
Egodystonic
Don’t know they have a problem and thinks others do
Egosyntonic
