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Personality and Individual Differences (y2s2) > Week 7 Lecture 11 - personality disorders > Flashcards

Week 7 Lecture 11 - personality disorders Flashcards

1
Q

In the DSM-IV, what was Axis II –> personality disorders?

A
  • enduring pattern of inner experience and behaviour
  • deviate from cultural expectations
  • are pervasive and inflexible
  • cause distress and impairment
  • not due to another disorder, drugs, intoxication etc.
  • in past largely seen as untreatable
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2
Q

Why in the DSM-IV was personality disorders placed on a separate axis?

A

originally to increase clinical/research attention

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3
Q

In the DSM-V where are personality disorders placed?

A

DSM-V grouped axes I-III (clinical psychological disorders, personality disorders and intellectual disabilities and medical conditions and physical disorders) into a single axis

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4
Q

True or false?

Until recently, categorisation and understanding of personality disorders has been unrelated to empirical personality theories

A

True

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5
Q

How many clusters are personality disorders split into?

A

3

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6
Q

What does Cluster A of personality disorders represent? What disorders are included?

A
  • “odd or eccentric’ disorders
  • paranoid
  • schizoid
  • schizotypal
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7
Q

What does Cluster B of personality disorders represent? What disorders are included?

A
  • ‘dramatic, emotional, or erratic’ disorders
  • antisocial
  • borderline
  • histrionic
  • narcissistic
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8
Q

What does Cluster C of personality disorders represent? What disorders are included?

A
  • ‘anxious or fearful’ disorders
  • avoidant
  • dependent
  • obsessive-compulsive
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9
Q

Is co-occurrence of PDs common?

A
  • yes
  • can occur within and across clusters
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10
Q

What is a criticism of the DSM-V clusters of PDs?

A

highly questionable validity and utility of diagnostic groups

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11
Q

What is paranoid PD?

A
  • Paranoia; mistrust of others; has irrational suspicions.
  • Pre-occupied with doubts; reluctance to confide; misinterprets innocent remarks, and holds grudges against people
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12
Q

How do the PDs in Cluster A differ from a full-blown psychotic disorder?

A
  • greater maintenance of contact with reality
  • narrower, more focussed set of symptoms
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13
Q

What is schizoid PD?

A
  • Detachment from interpersonal relationships; emotional coldness; indifference to praise/criticism of others.
  • Has few friends; chooses solitary activities.
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14
Q

What is Schizotypal PD?

A
  • Distortions in thinking, feelings and perceptions e.g. ideas of reference, magical thinking, perceptual illusions.
  • Discomfort in social situations; suspicions and paranoia.
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15
Q

What is antisocial PD?

A
  • Lack of empathy and remorse; disregard for others.
  • Failure to conform to norms/laws; impulsivity; deceitfulness; irresponsibility, and disregard for safety of self/others
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16
Q

What is histrionic PD?

A
  • Excessive need for approval; need to be centre of attention.
  • Shallow/over-dramatic emotions; sees relationships as more intimate than they are.
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17
Q

What is narcissistic PD?

A
  • 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
18
Q

What is borderline (emotionally unstable) PD?

A
  • 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
19
Q

Is BPD stigmatised?

A

yes

20
Q

What is Avoidant PD?

A
  • 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
21
Q

What is dependent PD?

A
  • 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.
22
Q

What is obsessive-compulsive PD?

A
  • Preoccupation with orderliness, rules, moral codes, caution and perfectionism; excessive devoted to work; inflexibility and overly-conscientious.
23
Q

What is the continuity hypothesis?

A

there is no discontinuity between normality and illness

24
Q

Are there strong correlations between PDs and the Big 5?

A
  • no
  • while there are significant correlations they are all fairly weak
  • suggests that we need to look at personality at a facet level rather than trait level when determining the relationship between PD and personality
25
Q

True or false

Big 5 facets conceptually associated with PDs

A

True

26
Q

What is a criticism of the Big 5 Profile Approach?

A
  • profiles may indicate risk (but not diagnosis) of PD
27
Q

What might the Big 5 Profile Approach be useful for?

A
  • May be useful for ruling out a PD, or characterising a known PD
28
Q

McCrae et al (2001) had 1926 patients from psychiatric hospitals complete:
- Personality Disorder Interview
- Personality Disorder Questionnaire (PDQ)
- NEO-PI-R

They then calculated ‘profile agreement’ scores for each patient

What was found? What are the implications of this?

A
  • Significant correlations – but only “modest to moderate”
  • Potential need to revise the current diagnostic classification system for personality disorders (DSM-IV)
29
Q

What are some limitations of DSM-IV PD Classification

A
  • Extensive co-morbidity.
  • Low temporal/inter-assessor reliability.
  • Not based on empirical personality modes
30
Q

What are some suggestions that were made for the DSM-V for PDs?

A
  • dimensional rather than categorical approach
  • Assess personality facet profile (NEO-PI-R).
  • Assess personality-related social/ occupational impairments and distress.
  • If dysfunction & distress clinically significant – diagnose PD.
  • (determine if the profile matches with PD category descriptor)
31
Q

Suggestions were made to improve PDs in the DSM-V, what happened when the DSM-V was published?

A
  • Retention of all 10 PDs and Clusters in main DSM-5
  • But: additional ‘emerging measures and models’ section

DSM-5: Section III (Emerging Measures and Models)
Criterion A: Severity
- Significant impairments in functioning of
self (identity or self-direction)
- Interpersonal (empathy or intimacy)

Criterion B: Style
- One or more pathological personality trait domains or facets (measured with ‘Maladaptive Trait Model’)

32
Q

In the emerging measures and models section of the DSM-V, how many PDs are listed?

A
  • 6 + trait specified
  • borderline PD
  • obsessive-compulsive PD
  • avoidant PD
  • schizotypal PD
  • antisocial PD
  • narcissistic PD
  • PD - trait specified
33
Q

What does the DSM define DID as?

A
  • A mental disorder defined by the presence of two or more distinct identities or personalities.
  • Amnesia for prior or recent events.
  • Cause distress and/or functional impairment.
  • Not due to e.g. substance use, cultural practice or imaginative play.
34
Q

According to Haslam (2007) what are the typically features of DID?

A
  • Primary ‘host’ personality plus one or more alters.
  • Alters take turns to control behaviour.
  • Distinctive patterns of thinking and behaving.
  • Different names, ages, genders etc.
  • Memory loss for experiences as other alters.
  • Reports of severe childhood sexual/ physical abuse common.
  • Patients high in ‘suggestibility’.
    Clustering of cases –> Geographically, by therapist
35
Q

Is DID a PD?

A
  • no
  • is a type of dissociative disorder
36
Q

Have cases of DID increased?

A

yes
Up to 1980: Fewer than 200
Current: 10s of thousands

37
Q

Are reported cases of DID becoming more extreme?

A

yes
From 2/3 alters to >100 (including animals)
More extreme abuse

38
Q

What is the Post-Traumatic Model of DID?

A

Primitive response to trauma:
- Dissociation of consciousness to escape initial trauma.
- Dissociation becomes response mechanism for future stress

  • Suggestibility pre-disposes to dissociation
39
Q

What is the Socio-Cognitive Model of DID?

A

Symptoms emerge as a product of therapy
- Hypnosis and leading questions cause patient to reinterpret experiences.
- Mood swings expressed as multiple personalities.
- A culture-bound phenomenon (not ‘faking’).
- Suggestibility increases susceptibility .
- Accounts for clustering of cases and rise in prevalence and severity.

40
Q

What evidence support the Socio-Cognitive Model of DID?

A

Spanos (1994):
- Experimental, hypnotic manipulations can ‘reveal’ apparent hidden self or past life identities in psychologically healthy individuals.

Paris (2012):
- Transcripts of ‘Sybil’’s therapy sessions show that the multiple personality narrative was imposed upon her

41
Q

What debates remain around DID?

A
  • The causes of the disorder
  • It’s validity as a scientific concept
42
Q

What are some criticisms of DID?

A
  • described as a fad
  • diagnosis for DID fails to meet criteria for a valid diagnosis

Personality and Individual Differences (y2s2) (11 decks)

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