Well-Being + Personality Disorders

Question 1

How is mood and wellbeing conceptualised in personality research

Answer 1

Using the Circumplex Theory of Affect which introduces subjective well-being and psychological well-being

Question 2

Describe the circumplex theory of affect

Answer 2

WATSON+TELLEGEN 1985: argued that mood is compromised of two dimensions - positive affect and negative affect (feeling) and the theory suggests how the below variables form a circle –

1. High positive affect
2. Low positive affect
3. High negative affect
4. Low negative affect
5. Strong engagement
6. Disengagement
7. Pleasantness
8. Unpleasentness

Each of those two are bio-polar too each other representing a high and a low. The two dimensions of positive affect is typified by a combination of the other dimensions (moods)

Led to the development of the Positive+Negative Affect schedule to measure positive and negative affect using 20 descriptors that measure both

Question 3

What are the two ways of describing well-being

Answer 3

Subjective well-being + Psychological well-being

Question 4

Describe subjective well-being

Answer 4

Shorter term evaluation of well-being which represents a balance between feelings of positive and negative emotions, pleasure attainment and pain avoidance.

Commonly measured by assessing life satisfaction of positive+negative affects

Question 5

Describe psychological well-being

Answer 5

Longer term psychological well-being resulting from engagement with individual development and challenges within life with the individual looking for meaning and self reflection in their life.

KEYES etal 2002 argues that there are 6 variables to psychological well-being:

1. autonomy
2. environmental mastery
3. personal growth
4. purpose in life
5. positive relations with others
6. self-acceptance

Has been criticised for being different from the original philosophical constructs of eudemonic wellbeing

Question 6

Describe the association between personality and wellbeing

Answer 6

Wellbeing is shown to be related to the Big 5 Personality traits, although some are better understood by some dimensions better than others:

Affect is a bridge concept, as it can be considered both a personality trait (a predictor) and a measure of SWB (a criterion) simultaneously.

– Subjective Wellbeing
The personality characteristics that have been most frequently studied in relation to SWB are extraversion and neuroticism (Diener & Lucas, 1999).
Suggested that, having the personality traits associated with conciousntouness and agreeableness will result in higher positive outcomes in terms of wellbeing (higher in positive affect). Extraversion is also associated with positive affect whilst neuroticism is associated with negative affect. MCOSTA+MCRAE correlations of 0.4

The fact that they were stable over time led Costa and McCrae to suggest that stable individual differences were important for well-being. The basic pattern of results that Costa and McCrae identified has been replicated often (Emmons & Diener, 1985; Headey & Wearing, 1989; Magnus, Diener, Fujita, & Pavor, 1993) and has been found using non-self-report measures of personality and subjective well-being (Lucas & Fujita, 2000).

Extraversion and positive affect are more closely aligned whilst the other personality dimensions and wellbeing are more instrumental, sharing a vicarious relationship with wellbeing

Recently, Steel, Schmidt, and Shultz (2008) conducted a comprehensive meta-analysis and evaluated the associations between each personality factor and SWB. Their findings support a strong relationship between neuroticism, extraversion, agreeableness, conscientiousness and all components of SWB, whereas openness to experience shows close associations with the SWB facets of happiness, positive affects, and quality of life.

In another meta-analysis by DeNeve and Cooper (1998), Neuroticism was most closely related with happiness, life satisfaction and negative affect, and Extraversion with positive affect.

– Psychological Wellbeing
The dimensions of psychological well-being demonstrated by Keyes 2002 relate to the Big 5 personality traits -

1. Neurotic - “care about what others think” (Autonomy)
2. Extroverted - “have warm relationships” (+ve relat. others)
3. Open - “don’t need to conform” (autonomy)
4. Agreeable - “trust my friends/ they trust me” (+ve rel)
5. Conscientious - “good at organising my life” (env mast)

DIERENDONCK 2004 found using factor analysis that conscientiousness shares positive relationship with purpose in life and personal growth whilst openness shares pos relationship with persons positive relations with others

Question 7

Evaluate measurement scales of wellbeing

Answer 7

1. Research examining the psychometric properties of SWB measures has shown that self-report scales tend to be reliable and valid. For instance, multiple-item measures of life satisfaction, domain satisfaction, and positive and negative affect scales all show high reliability, regardless of whether reliability is assessed using interitem correlations or short-term test-retest correlations (Diener, Suh, Lucas, & Smith, 1999).
2. There is increasing evidence for the validity of these measures. Different measures of the same well-being construct tend to correlate more strongly with one another than with measures of related but theoretically dis- tinct constructs (Lucas et al., 1996).
3. However, Schwarz et al (1988) have argued that a variety of irrelevant contextual factors (including minor changes in instructions, setting, question wording, question order, or response options) can have a strong influence on well-being judgments and therefore that these reports should not be trusted. The malleability of well-being reports study showed that simply changing the order of two questions could dramatically influence the correlation between them. In their study, when questions about satisfaction with a specific domain (e.g., relationship satisfaction) preceded a question about general life satisfaction, then the correlation between the two measures was strong. When the general life satisfaction question was asked first, however, then the two measures correlated quite weakly. This pattern of associations suggests that asking about specific life domains makes information about these domains salient when an individual is later asked to judge his or her life as a whole. It also implies that life satisfaction judgments are constructed “on the fly” and are susceptible to irrelevant contextual effects.

Question 8

Explanations of the associations between personality and wellbeing

Answer 8

McCrae & Costa (1991) suggested that instrumental theories posit an indirect link from personality to SWB through choice of situations or the experience of life events. For example, extraverts may enjoy and participate in social activities, which may in turn affect the amounts of positive affect that they experience.

These instrumental theories can be contrasted with temperament theories, which posit a direct link from the trait to the outcome in question. According to temperament theories, the association does not flow through life choices, life events, or life experiences.

Temperament theories link extraversion and neuroticism to affect through two basic motivational systems. Gray: much of the variability in personality can be explained by three fundamental systems; the behavioral activation system (BAS), which regulates reac- tions to signals of conditioned reward and nonpunishment; the behavioral inhibition system (BIS), which regulates reactions to signals of conditioned punishment and nonreward; and the fight–flight system (FFS), which regulates reactions to signals of unconditioned punishment and nonreward. Extraverts are though to be higher in BAS strength, and thus, they should be more sensitive to signals of reward. This reward sensitivity should be expressed in the form of enhanced information processing and increased positive emotions when exposed to positive stimuli. Sim- ilarly, the neuroticism dimension is thought to reflect individual differences in BIS strength. Thus, neurotics should be more sensitive than stable people to signals of punishment.

Question 9

Define and describe personality disorders

Answer 9

An extreme or severe disturbance or imbalance in the overall character and the behaviours shown by an individual that affects several aspects of the person’s personality
- Involves considerable personal and social disruption

They tend cause disturbances in behaviour and character and emerge early on in life with some symptoms occurring in childhood.

Question 10

Describe the diagnosis of personality disorders

Answer 10

To identify:
1. A persistent pattern of behaviours/experience
- Deviate markedly from what is expected in the culture of the individual
In two (or more) of the following ways:
- Cognitions (thoughts/perceptions)
- Affect (emotional experiences and expressions)
- Interpersonal functioning (relating to others)
- Ability to control impulses

2. Pattern must be enduring/inflexible and not context dependent/specific
3. Causes disruption or distress in the person’s life (or those around them)
4. Has been present for a long time, emerged in childhood
5. Is not caused by another mental disorder
6. Is not result of drug use or medical condition

Question 11

Describe the clusters of personality disorders

Answer 11

Cluster A: Odd or Eccentric

• Paranoid PD
• Schizoid PD
• Schizotypal PD

Cluster B: Dramatic/Emotional/Erratic

• Antisocial PD
• Borderline PD
• Histrionic PD
• Narcissistic PD

Cluster C: Anxious or Fearful

• Avoidant PD
• Dependent PD
• Obsessive-Compulsive PD

Question 12

What Axis of the DSM do personality disorders fall

Answer 12

In Axis 2 - therefore some of the personality disorders that overlap with clinical disorders such as schizophrenia are not the same as those are clinical disorders that fall under axis 1

Question 13

Describe one disorder in cluster A

Answer 13

PARANOID PERSONALITY DISORDER
Characterised by a pattern of paranoia, extreme distrust and irrational suspicions of others.

Messier (1995): These individuals are hypersensitive and often mistrust other people while holding grudges. They need to maintain a high degree of control over the people around them and thus tend to be critical and unable to work with others whilst simultaneously seeking out others who share their beliefs.

Diagnosis (Four+ Criteria needed):

1. Suspects without any sufficient basis that other people are harming or deceiving them
2. The individual is preoccupied with unjustified doubts about the trustworthiness of friends
3. Shows reluctance to confide in others as they are fearful that the info they share will be used in a malicious way against them
4. Perceives innocent remarks as threatening or demeaning

Question 14

Describe one disorder in cluster B

Answer 14

ANTISOCIAL PERSONALITY DISORDER
Characterised by a general disregard for others and has a prevalence of approx 0.7-3% of general population.

Diagnosis (three+ criteria):

1. Continued failure to conform to ones social norms in respect to law
2. Continued deceitfulness such as repeatedly lying
3. Continous impulsivity or repeated failures to plan ahead

Question 15

Describe genetic influences on personality disorders

Answer 15

GENETICS

1. TORGERSEN etal (2001) studied heritability estimates among twins (92 MZ and 129 DZ) sampled from registry in Oslo. Found heritability estimates for all disorders except anti social disorder e.g for Borderline disorder it was 0.69. This was similar amongst other disorders, providing strong support for a genetic component to personality disorders
2. COOLIDGE et al (1998) similarly found that the average heritability co-efficent for the 12 scales of personality disorders for children between 4 -15 years was 0.75, providing further support that childhood personality disorders have a substantial genetic basis and are similar to coefficients for adults.

Question 16

Evaluation for genetic influences on personality disorders

Answer 16

1. The high coefficient estimates found in Trrgerson’s study must be observed with caution as it is suggested that these result may have been a result of a moderate sample size and low prevalence of specific disorders within the sample. Such issues may have distorted results and so the usefulness of a biological explanation for personality disorders is weakened.
2. Methodology flaws as well such as the use of twin studies and the inability to detangle environmental effects etc - Clearly it is not a 100% attributed to genetics so other causes must be a play which need to be examined to reach a conclusive explanation for personality disorders.

Question 17

Describe neuropsychological influences on personality disorders

Answer 17

SIEVER+ DAVIS provides a model that explains personality disorders using the role of neurotransmitters and their effect on four aspects of psychological functioning:

1. DOPAMINE an its effect on the cognitive/perceptual aspects in personality disorders. Dopamine is involved in the control of movement, motivation, concentration, focus in the frontal lobe of the brain.
   Suggested that high levels of dopamine associated with CLUSTER A disorders as it is associated with increased levels of excitement and suspiciousness. For example, for paranoid disorder, dopamine can have a role in increasing suspicions a person has and the accuracy of their informational processing .
2. SEROTONIN and its effect on impulsivity/aggression where low levels are suggested to result in pain and impulses being unregulated which is important in understanding CLUSTER B disorders such as antisocial where people have difficulty respecting laws
3. DOPAMINE+SEROTONIN in the effects anxiety/inhibition - reduced dopamine levels and increased serotonin are related to CLUSTER C disorders such as avoidance disorder where people involve themselves with less interpersonal contact as they fear criticism
   Increased ad reduced levels cause reduced pleasure-seeking activity and increase emotion and impulses.
4. NOREPINEPHRINE and its effect on affect regulation as this is a stress hormone that affects part of the brain where attention and impulsivity is controlled and the regulation of stress in nervous system. Linked to CLUSTER B disorders as they suggest increased levels of this hormone

Question 18

Evaluation of neuropsychological model of personality disorders

Answer 18

+ Last factor in the model is less clinically evidenced however other factors are empirically supported. Coccaro and Siever (2005) reported that people with Schizotypal Personality Disorder have some of the same brain abnormalities found in people with diagnoses of Schizophrenia. These similarities include brain chemicals and structures known to be critically important for the proper functioning of affect, (emotion) perception, attention, and certain types of memory. These are the very symptoms that affect both disorders. This finding informs our understanding of the biological bases of psychotic-like symptoms. This helps us to understand why Schizotypal Personality Disorder occurs more frequently in relatives of people who have Schizophrenia than in the general population (Coccaro & Siever, 2005).

+ Can be a very useful model with high practical applications in terms of its role in developing treatments. The suggestion of a chemical imbalance as a cause of personality disorders means the drug therapy can be produced which alter the levels of serotonin and dopamine to counteract these effects. Thus improving the wellbeing of these individuals whose lives are being distorted.

• However, there is a difficulty in establishing a causal relationship between chemical imbalances and personality disorders. It may be possible that it is the onset of a personality disorder that causes the chemical imbalance such as reduced serotonin levels

Question 19

Describe environmental influences of personality disorders

Answer 19

1. CHILDHOOD FACTORS as onset is normally then.
   – Parenting behaviours: JOHNSON etal (2006) found that low levels of affection or nurturing from parents were associated with high risk of antisocial disorder when the child reached adulthood. Also found In a study of 793 mothers and children, researchers asked mothers if they had screamed at their children, told them they didn’t love them or threatened to send them away. Children who had experienced such verbal abuse were three times as likely as other children to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood.
   Supported by RETTEW etal (2003) where self report results of adults looking back found that 61% of those with antisocial disorder said they had high levels of emotional abuse.

– Abuse shown to be influential in borderline disorder as well. Zanarini 1997; Quadrio 2005; found that individuals with this disorder report history of abuse and neglect in childhood as well as sexual abuse which has been associated.

– Findings from one of the largest studies of personality disorders, the Collaborative Longitudinal Personality Disorders Study, offer clues about the role of childhood experiences.
YEN etal 2002 found a link between the number and type of childhood traumas and the development of personality disorders. People with borderline personality disorder, for example, had especially high rates of childhood sexual trauma.

Question 20

Evaluation of environmental influences on personality disorders

Answer 20

1. ETHICAL CONCERNS as he role of abuse is particularly controversial among family members of people with a borderline disorder, who say they are being unfairly blamed–similar to what happened in the early days of schizophrenia research. Emphasizing maltreatment and abuse is misleading and has a devastating effect on families (PORR, 2004)
2. Further research is needed for the vast range of personality disorders as right now there are some which are more widely studied than others such as borderline and antisocial. It is particularly difficult to talk about the exact causes of personality disorders (taken as a group) because few researchers study all the personality disorders at once. At the present time, the more commonly diagnosed personality disorders, such as the Borderline Personality Disorder, have attracted the lion’s share of research attention. Consequently, our knowledge of these more commonly diagnosed disorders is far more advanced than is our knowledge of the less common disorders. So explanations remain inconclusive as it is uncertain if they can be attributed to all disorders.
3. There is also the issue of the categorisation approach to the diagnosis and understanding of personality disorders. The main issue is the comorbidity of other personality disorders and other factors. Comorbidity means that the presence of one or more personality disorder in addition to a primary personality disorder or the existence of additional clinical conditions alongside. This calls into question the conceptualisation of personality disorders as misdiagnosis can frequently occur.

Question 21

Evaluation of personality and wellbeing associations

Answer 21

1. PRACTICAL APPLICATION Mental health professionals need to understand the relationship between personality, well-being and mental health in order to help motivate both the promotion of health and the reduction of distress and disability (Amering & Schmolke, 2009; Cloninger, 2006).

Question 22

Contrast of studying personality disorder vs. normal personality

Answer 22

In contrast to previous studies of clinical psychologists who were interested in understanding distress (Wood & Tarrier, 2010) and alleviating human suffering (Joseph & Wood, 2010), positive psychology research can best impact on the scientific knowledge base of psychology, and be utilized to improve people’s lives (Wood & Tarrier, 2010).

2. With the emergence of positive psychology as a field and the added emphasis on underlying dimensions in clinical psychol- ogy, personality traits have gained recognition as major determi- nants of individuals’ psychological health and disorders

Question 23

Describe what personality disorders tell us about normal personality

Answer 23

Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish human beings. Hence, personality disorders are defined by experiences and behaviors that differ from societal norms and expectations.

All of the fundamental symptomatology of the personality disorders can be understood as maladaptive variants of personality traits evident within the normal population (16). For example, much of the symptomatology of borderline personality disorder can be understood as extreme variants of the angry hostility, vulnerability, anxiousness, depressiveness, and impulsivity included within the broad domain of neuroticism

FFM + DISORDERS
WIDIGER 1995 proposed the Five Factor Model of personality as an alternative to the classification of personality disorders. For example, this view specifies that Borderline Personality Disorder can be understood as a combination of emotional lability (i.e., high neuroticism), impulsivity (i.e., low conscientiousness), and hostility (i.e., low agreeableness).

SUPPORT:
Research studies examining relations between the DSM PDs and measures of normal-range personality, including the FFM, have revealed that the domains of normal and abnormal personality are largely overlapping (O’Connor 2002).

1. WIDIGER The Five Factor Model has been shown to significantly predict all 10 personality disorder symptoms and outperform the Minnesota Multiphasic Personality Inventory (MMPI) in the prediction of borderline, avoidant, and dependent personality disorder symptoms
2. SAULSMAN + PAGE: analyzed data from 15 other studies to determine how personality disorders are different and similar, respectively, with regard to underlying personality traits. In terms of how personality disorders differ, the results showed that each disorder displays a FFM profile that is meaningful and predictable given its unique diagnostic criteria. With regard to their similarities, the findings revealed that the most prominent and consistent personality dimensions underlying a large number of the personality disorders are positive associations with neuroticism and negative associations with agreeableness.
3. PIEDOMONT 2012 At least three aspects of openness to experience are relevant to understanding personality disorders: cognitive distortions, lack of insight and impulsivity. Problems related to high openness that can cause problems with social or professional functioning are excessive fantasising, peculiar thinking, diffuse identity, unstable goals and nonconformity with the demands of the society
   High openness is characteristic to schizotypal personality disorder (odd and fragmented thinking), narcissistic personality disorder (excessive self-valuation) and paranoid personality disorder (sensitivity to external hostility). Lack of insight (shows low openness) is characteristic to all personality disorders and could explain the persistence of maladaptive behavioral patterns

Question 24

Describe the argument for a dimensional approach

Answer 24

The personality disorders classification follows a categorical approach that views personality disorders as discrete entities that are distinct from each other and from normal personality.
In contrast, the dimensional approach is an alternative approach that personality disorders represent maladaptive extensions of the same traits that describe normal personality.

Normal personality traits are described within the dimensional models of general personality structure. It has been proposed that most of the problems in treating personality disorders could be resolved based on normal personality (Aboaja, Duggan, & Park, 2011). By considering personality and personality disorders on a spectrum (Widiger & Smith, 2008), the contribution of personality in mental health and well-being would be more clear.

ADVANTAGES:
Vermeil (2005), however, turned the complexity argument around, noting that dimensions provide diagnostic richness and subtlety not afforded by the DSM categories, which are criticized for oversimplicity.
- Moreover, he argued that the current diagnostic system does not direct either treatment selection or planning; rather, severity is the primary determinant of the decision to treat (see also Tyrer 2005).
- Moreover, dimensions provide more information for predicting the effectiveness of different treatment options at both the “macro” (e.g., in- versus outpatient, session frequency/duration) and “micro” (e.g., targeting self-harm for initial intervention) levels

Clinicians preferred the FFM to the DSM for describing actual cases and did so reliably (Samuel & Widiger 2006). When rating vignettes of prototypic and nonprototypic cases, interrater reliability was acceptable for all cases using the FFM, but only for prototypic cases (which are rare in actuality) using categories (Sprock 2003). Yet, clinicians’ confidence in their (unreliable) diagnostic and (reliable) FFM ratings of the nonprototypic cases was nearly identical. Thus, the FFM—especially the facet level—appears to have broadband applicability in assessing PD-relevant traits, as well as superior psychometric properties

Question 25

Stability of personality disorders

Answer 25

PD is defined as inflexible, possibly suggesting more stability, but this term likely is intended instead to indicate lack of situational adaptivity. On the other hand, given the strong affective component in most PD (Trobst et al. 2004, Widiger et al. 2002) and the lower stability of trait affect, PD may be less stable than normal-range personality. This issue deserves further consideration, but absent compelling reason to hypothesize otherwise, it is reasonable to assume that the empirical results are face valid—PD has comparable stability to normal-range personality.

Given that dimensional PD scores are more stable than diagnoses and that PDs are composed of traits (manifested in specific criteria), how do personality traits relate to PD diagnoses when assessed independently of PD diagnoses? In the CLPS, latent longitudinal models demonstrated significant cross-lagged relations between year-one FFM traits and year-two PD diagnoses (but not baseline—year one) for three PDs (not OCPD), beyond the considerable trait and PD diagnostic (rank-order) stability, whereas the reverse was not observed (Warner et al. 2004). Thus, change in personality traits predicted PD change, but not vice versa.

Question 26

Brief description of five-factor model

Answer 26

The five-factor model arguably represents a general consensus as to the structure of normal personality Costa & McCrae, 1992a, Costa & Widiger, 1994a, Digman, 1990, Digman, 1994, Digman, 1996 and McCrae, 1991. The five-factor model provides a dimensional account of the structure of normal personality traits, dividing personality into the five broad dimensions of Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness