Week 6) Personality Disorders Flashcards
What are 4 key characteristics of a Personality Disorder (PD) ?
“A Personality Disorder is an enduring pattern of inner experience & behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive & inflexible, has an onset in adolescence or early adulthood, is stable over time, & leads to stress or impairment”
A) Enduring patterns of thinking/feeling/acting/relating
B) Culturally deviant
C) Pervasive & inflexible (endures across time).
D) Lead to distress or social impairment
What is the categorical approach for diagnosis, used in the DSM 4 and 5?
the approach to classifying mental disorders involving assessment of whether an individual has a disorder on the basis of symptoms and characteristics that is described as typical of the disorder
distinct clinical entities
What was the failure of the categorical model and what four reasons were there for this?
1) Extensive co-occurrence of PDs e.g. if you have one PD, likely to have another.
2) Extreme heterogeneity (eg. 256 different ways to diagnose one PD) e.g. 5 out of 9 symptoms means you have BPD. Too much heterogenity.
3) PD NOS most common diagnosis (not otherwise specified. about 40% of all cases is this. too high).
4) Poor-inter rater reliability (cohens kappa, usually want .7 or above correlation. At the moment ppl rating
PD is about .2)
What was the new proposal to replace the categorical model?
Dimensional model
Describe dimensional model
quantifies a person’s symptoms or other characteristics of interest and represents them with numerical values on one or more scales or continuums, rather than assigning them to a mental disorder category.
maladaptive variants of personality traits
Did the DSM 5 adopt new dimensional model?
No. New model was too complex for clinical practice.
It was going to basically be a hybrid approach with some categorical and some dimensional, but too complex. So they retained the same 10 PD from the DSM 4
What DID they change from the DSM 4 to 5 ?
1) Changed PDs on Axis II to distinguish them from ‘traditional mental disorders”. originally were on the same axis, which is misleading because mental retardation almost impossible to change but PD can be addressed via therapy. SO MOVES away from this whole axial system.
2) Recognises the possible effects of enduring personality characteristics on the treatment of more transient clinical cases e.g. say you were treating someone with exposure therapy. Someone with PD and a phobia may be more difficult to treat because perhaps not as compliant. So new Dsm takes into account this and you need to consider its effects on other disorders.
Identify the cluster names for each of these:
Cluster A?
Cluster B?
Cluster C?
A: odd, eccentric
B: dramatic, erratic, emotional
C: anxious or fearful
Describe three strands in cluster A of PD?
1) Paranoid: distrust, suspiciousness. Misinterprets others’s actions, motives
2) Schizoid: social detachment, limited emotions
Prefers isolation; lacks close friendships/relationships. no desire for sex, doesnt want to interact with ppl, distress if forced to interact.
3) Schizotypal: acute discomfort in close relations; perceptual distortions; eccentricities. Schizophrenia spectrum disorder
Describe Antisocial personality disorder. What cluster?
Prevalence in males and females?
Antisocial (Dissocial) (CLUSTER B).
“…a pervasive pattern of disregard for, & violation of, the rights of others that begins in childhood or early adolescence & continues into adulthood”
3% of males; 1% of females (males more aggressive than females generally).
70% of men in prison have Antisocial personality Disorder.
Describe Borderline PD.
What cluster?
Borderline PD (CLUSTER B)
About instability. Might have really strong views one day e.g. vegetarian one day, bashing everyone who eats meat, but next day eats meat.
“Instability of interpersonal relationships, self-image & emotions; impulsivity”
- Fear of abandonment/rage
- Splitting ( idealisation someone one day, then devaluation, despise you the next).
- Disorganised self-concept
- Emptiness often accompanied with acute theories of abandonment.
- Self-mutilation, suicide risk
1-3% pop’n (c.80% female)
What REALLY sets off BPD?
Childhood trauma, obviously.
Describe Histrionic PD?
What cluster?
Histrionic: (CLUSTER B) e.g. miley cyrus haha
=excessive emotionality & attention seeking Self-dramatisation Incessant drawing of attention to self Craving for activity & excitement Overreaction to minor events Irrational, angry outbursts or tantrums 2-3% pop’n (F > M)
BUT you cant label someone who is
a bit seductive as histrionic. Theres a line somewhat. Although lets be honest i probably am.
Describe narcissism PD?
What cluster?
Narcissistic: (CLUSTER B)
“a pervasive pattern of grandiosity, need for admiration, & a lack of empathy”
Feels privileged, entitled; expects preferential treatment
Exaggerated sense of self-importance
1% of pop’n (50-75% male)
(mostly male disorder).
wasnt enough agreement that it was a disorder or not.
Considering getting rid of it in the dsm.
Describe the effects of childhood abuse
What cluster?
Cluster B:
Persons with documented childhood abuse or neglect were more than 4 times as likely as those who were not abused or neglected to be diagnosed with PDs during early adulthood after age, parental education, & parental psychiatric disorders were controlled statistically”
Therefore childhood maltreatment is common ground for PDs
