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PSY305 - Clinical Psychology > Week Eight - Personality Disorders > Flashcards

Week Eight - Personality Disorders Flashcards

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1
Q

Personality Disorders

A

Are pervasive and rarely remit without treatment
– Although some do seem to dissipate as the individual
ages

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2
Q

Onset of PD

A

Generally around adolescence/ early adulthood, but
to diagnose before the age of 18 the symptoms need to be
present for at least 12 months (with the exception of
antisocial personality disorder).
– Antisocial personality disorder can only be diagnosed in individuals who are aged 18 or older

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3
Q

In DSM-5 personality disorders appear in two sections and

they can be coded as

A

– Categorical (present/absent)

– Dimensional (traits on a continuum)

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4
Q

Dimensional approach

A

Involves diagnosing a personality disorder based on

pathological personality traits

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5
Q

Personality traits are considered to be a disorder when they are?

A

– Inflexible
– Maladaptive
– Causes significant distress or impairment in functioning

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6
Q

Dimensional Approach DSM-5 (A)

A 
A. Moderate or greater impairment in personality
(self/interpersonal) functioning
• Self
• Identity
• Self direction
• Interpersonal
• Empathy
• Intimacy
B. One or more pathological personality traits
There are 5 broad trait domains and 25 specific trait facets
including:
1. Negative affectivity
2. Detachment
3. Antagonism
4. Disinhibition
5. Psychoticism

C. The impairments in personality functioning and the individual’s personality trait expression are relatively inflexible and pervasive across a range of personal and social situations

D. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time, with onset that can be traced back to at least adolescence or early adulthood

E. The impairments are not better explained by another mental disorder

F. The impairments are not solely attributable to the
physiological effects of a substance or another medical condition

G. The impairments are not better understood as normal for an individual’s developmental stage or sociocultural environment

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7
Q

Categorical Approach (3 clusters)

A

– Cluster A - Odd, eccentric cluster
– Cluster B - Dramatic, emotional, erratic cluster
– Cluster C - Anxious, fearful cluster

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8
Q

Cluster A

A

Paranoid personality disorder
• Characterized by excessive distrust and suspiciousness

Schizoid personality disorder
• Characterized by severe disinterest in social relationships and restricted range of emotional expression

Schizotypal personality disorder
• Characterized by extreme discomfort in relationships and odd/eccentric behaviour

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9
Q

Cluster B

A

Antisocial personality disorder
• Characterized by significant disregard for and violation of the rights of others

Borderline personality disorder
• Characterized by extreme impulsivity, unstable sense of self and instability in interpersonal relationships

Histrionic personality disorder
• Characterized by patterns of intense emotionality and attention seeking

Narcissistic personality disorder
• Characterized by grandiosity and need for admiration

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10
Q

Cluster C

A

Avoidant personality disorder
• Characterized by extreme feelings of inadequacy, hypersensitivity to
negative evaluation and social avoidance

Dependent personality disorder
• Characterized by clingy and submissive behaviour and an excessive need to be taken care of

Obsessive compulsive personality disorder
• Characterized by preoccupation with orderliness, perfectionism and
control

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11
Q

Dimensional advantages and disadvantages

A

Advantages

  • Trait descriptions are more stable over time
  • Provides more descriptive information for clinicians
  • Avoids patient getting multiple personality disorder diagnoses

Disadvantages
- Not clear when a dimension becomes pathological

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12
Q

Categorical advantages and disadvantages

A

Advantages

  • Used for decades
  • Easy transmission of information between clinicians
  • Helpful for devising evidence based treatments

Disadvantages

  • Diagnoses are not stable
  • Do not have great inter-rater reliability
  • Stigmatising
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13
Q

Schizotypal Personality Disorder DSM-5 Criteria (A & B)

A

Criteria A.
A pervasive pattern of social and interpersonal deficits marked by:
- Acute discomfort with, and reduced capacity for, close relationships
- Cognitive or perceptual distortions and eccentricities of behavior,

Indicated by five (or more) of the following:

  • Ideas of reference (excluding delusions of reference).
  • Odd beliefs of magical thinking
  • Superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”
  • Unusual perceptual experiences, including bodily illusions Special power to sense events that will occur in the future or sensing that another being might be in the room
  • Odd thinking and speech (Vague, circumstantial, metaphorical, overelaborate or stereotyped)
  • Suspiciousness or paranoid ideation (People are intentionally out to get them)
  • Inappropriate or constricted affect
  • Behavior or appearance that is odd, eccentric, or peculiar
  • Lack of close friends or confidants other than first degree relatives
  • Excessive social anxiety paranoid fears

Criteria B.
Does not occur exclusively during the course of schizophrenia, a bipolar disorder, or depressive disorder with psychotic features, another disorder or autism spectrum disorder.

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14
Q

Treatment for Schizotypal Personality Disorder

A

Combination of antipsychotic medication, community treatment and therapy including social skills training
• CBT for Psychosis

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15
Q

Social Skills Training?

A

Social skills training is a structured and therapeutic
approach to teaching clients how to interact with others

It involves teaching clients “the rules” of social interaction thought psychoeducation, modelling, role play and behavioural experiments

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16
Q

Borderline Personality Disorder DSM-5 Criteria

A

Criteria A.
A pervasive pattern of instability of interpersonal relationships, self image, and affect, and marked impulsivity.

Indicated by five (or more) of the following:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships
  • Identity disturbance: Markedly and persistently unstable self-image or sense of self
  • Impulsivity in at least two areas that are potentially self damaging (e.g. spending, sex, substance use, reckless driving, binge eating)
  • Recurrent suicidal behaviour, gestures, or threats, or self mutilating behaviour
  • Affective instability due to a marked reactivity in mood (e.g. intense episodic dysphoria, irritability, or anxiety)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid ideation or severe dissociative symptoms.
17
Q

Borderline personality disorder - Etiology

A

Abuse history
• People with BPD is are likely than individuals with other
PDs to report an abusive history

Linehan’s Diathesis-Stress Theory
• People with BPD have a biological diathesis
• They are then raised in an environment that is invalidating

18
Q

Treatment for BPD (DBT)

A

A variant of CBT called dialectical behaviour therapy (DBT)
- DBT involves helping the client regulate emotions and cope with stressors that might trigger self-destructive behaviour.

Involves 4 skills that are taught in a rotating fashion
• Mindfulness skills
• Interpersonal skills
• Emotional regulation
• Distress tolerance skills
19
Q

Avoidant Personality Disorder DSM-5 Criteria

A

Criteria A.
A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Indicated by four (or more) of the following:

  • Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection
  • Is unwilling to get involved with people unless certain of being liked
  • Shows restraint with intimate relationships because of the fear of being shamed or ridiculed.
  • Is preoccupied with being criticized or rejected in social situations
  • Is inhibited in new interpersonal situations because of feelings of inadequacy
  • Views self as socially inept, personally unappealing, or inferior to others
  • Is unusually reluctant to take personal risks or to engage in any new activity because they may prove embarassing
20
Q

Treatment of APD

A

Avoidant Personality Disorder has been considered an extreme and pervasive form Social Anxiety Disorder

CBT focusing on behavioural activation, behavioural
experiments and social skills training is indicated

Therapeutic alliance is vital for all clients but is particularly
important for treatment success with this client group

21
Q

Assessment measure for personality disorders

A

Structured Clinical Interview for DSM-5-Personality

– Semi structured interview

22
Q

OVERALL treatment for ALL personality disorders

A

• Most people with a PD enter treatment for a reason
other than their PD.
• The presence of a PD predicts slower response to
therapy.
• Therapeutic alliance is necessary.
• Multidisciplinary team.

PSY305 - Clinical Psychology (12 decks)

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