week 8 Flashcards
What are cluster A, B and C Personality disorders
Cluster A (odd/eccentric) mad
Paranoid
Schizoid
Schizotypal
Cluster B (dramatic/erratic) bad
Histrionic
Narcissistic
Antisocial
Borderline
Cluster C (fearful/anxious) sad
Avoidant
Dependent
Obsessive-compulsive
What is antisocial personality disorder
A pattern of disregard for, and violation of, the rights of others
CORRUPT
C: cannot follow law
O: obligations ignored
R: remorselessness
R: reckless disregard for safety
U: underhanded (deceitful)
P: planning deficit (impulsive)
T: temper (irritable, aggressive)
+ Childhood conduct disorder
Self-View: superior, unconcerned
View of others: suckers, inferior, means to an end
Beliefs: people are there to be taken, if I want something I should do whatever is necessary to get it, there are no consequences for my actions
Threat: none
Strategy: take what you want
Affect: irritability, anger when blocked from goals
What is borderline personality disorder
A pattern of instability in, self-image interpersonal relationships and affect and marked impulsivity
AMUSUICIDE
A- abandonment fears
M- mood instability
S- suicidal/ self-injurious behavior
U- Unstable, intense relationships
I- impulsivity
C- control of anger poor
I- identity disturbance
D- dissociative/ paranoid symptoms
E- emptiness
Self view: unstable and fragmented, helpless, victim
View of others: the cause of and answer to all life’s problems
Beliefs: “I am unlovable” “no one is ever there to meet my needs, to be strong for me, to care for me”
Threat: abandonment
Strategy: Demand love, Test love
Affect: anger, Depression, anxiety
What is obsessive-compulsive personality disorder?
A pattern of preoccupation with orderliness, perfectionism and control
LAW FIRMS
L: loses point of activity (preoccupation with detail)
A: ability to complete tasks compromised
W: worthless objects (unable to discard)
F: friendships excluded (preoccupation with work)
I: inflexible, overconscientious
R: reluctant to delegate
M: miserly toward self and others
S: stubbornness
What is narcissistic personality disorder?
Narcissistic: a pattern of grandiosity, need for admiration and lack of empathy
SPECIAL
S: special (believes they are)
P: preoccupied with fantasies of success
E: envious, entitled, excessive admiration needed
C: conceited
I: interpersonally exploitative
A: arrogant
L: lacks empathy
Self view: superior
View of others: less equal
Beliefs: I am special and other people should recognize how special I am
Threat: being average
Strategy: demand special treatment, begrudge others
Affect: anger
Self esteem is quite fragile
What is avoidant personality disorder
A pattern of social inhibition feelings of inadequacy and hypersensitivity to negative evaluation
AVOIDER
A: avoids occupational activities
V: views self as socially inept, inferior
O: (pre)occupied with being criticized or rejected
I: inhibited in new interpersonal situations
D: declines to get involved with people
E: embarrassed by engaging in new activities
R: refrains from intimate relationships
Self view: social inept and incompetent in academic and work situations
View of others: critical
Beliefs: I am no good
Threat: rejection
Strategy: avoid
Affect: dysphoria: anxiety and sadness
What is dependent personality disorder
A pattern of submissive and clinging behavior related to an excessive need to be taken care of
DEPENDENT
D: difficulty making everyday decisions
E: excessive lengths to obtain nurturance and support from others
P: preoccupied with fears of being elft to take care of self
E: exaggerated fears of being unable to care for himself or herself
N: needs others to assume responsibility for his or her life
D: difficulty expressing disagreement with others
E: end of close relationship = beginning of another
N: noticeable difficulties in initiating/ doing things on their own
(T): “take care of me” is their motto
What is paranoid personality disorder
a pervasive tendency to be inappropriately suspicious of other people’s motives and behaviors
Criteria
SUSPECT
S: spouse infidelity suspected
U: unforgiving (bears grudges)
S: suspicious (of others)
P: Perceives attacks (and reacts quickly)
E: enemy in everyone
C: confiding in others feared
T: threats seen in very benign events
Self view: vulnerable
View of others: adversaries
Beliefs: the world is threatening and I must protect myself, I can only rely on myself
Threat: everyone
Strategy: don’t trust anyone, social isolation
Affect: hostile, anxious, dysphoric
What is schizoid personality disorder
A pattern of detachment from social relationships and restricted range of affect
DISTANT
D: Detached affect
I: Indifferent to praise or criticism
S: Sexually uninterested
T: Tasks don solitarily
A: Absence of close friends (don’t want them)
N: neither desire nor enjoys close relationship
T: Takes pleasure in few activities
Self view: different, empty
View of others: more trouble than worth, impediment to freedom
Beliefs: relationships are problematic, life is less complicated without people
Threat: compliance, complications
Strategy: isolation
Affect: flat
What is a personality disorder
Pervasive and inflexible
Stable and of long duration
Clinically significant distress or impairment in functioning
Manifested in at least two of four areas
Cognition
Affect
Interpersonal functioning
Impulse control
What is the histrionic personality disorder
Histrionic: a pattern of excessive emotionality and attention seeking
PRAISE ME
P: provocative (or seductive) behavior
R: relationships, considered more intimate than they are
A- attention, must be at the center of
I: influenced easily
S: speech (style)- wants to impress, lacks detail
E- Emotional lability, shallowness
M- made up (physical appearance get attention)
E- exaggerated emotions (theatrical)
View of objects: objects to be won over
Beliefs: in order to be happy I need other people to pay attention to me
Threat: being ignored being forgotten
Strategy: entertain and draw attention to self
Affect: anxious when other people ignore them
Schizotypal
A pattern of acute discomfort in close relationships, cognitive or perceptual distortions and eccentricities of behavior
ME PECULIAR
M: magical thinking
E: eccentric behavior or appearance
P: paranoid ideation
E: experiences unusual perceptions
C: constricted (inappropriate) affect
U: unusual thinking and speech
L: Lacks friends
I: Ideas of reference
A: anxiety (socially)
R: rule out psychosis and PDD
Self view: outsider, defective
View of others: strange, scary, but want to interact
Beliefs: I don’t fit in, I must protect myself from threats, there are reasons for everything
Threat: world (don’t understand)
Strategy: social isolation, retreat into delusional ideas
Affect: anxiety, depression
What treatments are available for borderline personality disorder?
Psychotherapy (1st line of treatment)
Dialectical behavior therapy (DBT)
Developed by Marsha Lenhan
Underlying model: BPD = dysregulation
DBT combines CBT with eastern philosophy
Dialectic: truth is synthesis of a thesis and an antithesis
Typical dose is one year of treatment
Treatment targets
Suicidal and life-threatening behavior
Therapy interfering behavior
Quality of life interfering behavior
Skills training
Outpatient individual psychotherapy
Outpatient group skills training
Mindfulness
Interpersonal effectiveness
Emotion regulation
Distress tolerance
Telephone consultation
Therapist support (for therapists)
Adjunctive symptom-targeted pharmacotherapy can be helpful (SSRIs for anger, depression)
Cognitive-perceptual symptoms: low dose neuroleptics
Affective disturbance: SSRIs
Impulsive-behavioral dyscontrol: SSRIs then if not working neuroleptics
What treatments are available for antisocial personality disorder?
Incarceration → unlikely to seek treatment
Early intervention
Parent training
Prevention
Rewards for prosocial behaviors
Skills training
Improve social competence
What developmental factors contribute to antisocial personality disorder
Genetic influences
Twin studies show that antisocial behavior is 40-50% heritable
Environmental factors
stress/trauma
Aggressive model
Low social status
Inconsistent family discipline
Childhood maltreatment
Biological
Under-arousal → need for stimulation
Fearlessness → under-react to threat of punishment
Behavioral inhibition system (BIS) → Low
Reward system (REW) → high
