339 Session 4

Assumptions w Categorical approach to PDs

1. personalities can be divided into categories of ? or ?
2. there are ?, non-? types of disorders
3. members of each diagnostic group share the same ?

normal, abnormal, discreet, overlapping, features

the DSM-5 uses a ? approach to diagnosing

categorical

Dimensional Approach to PDs

personality traits differ along a ? of ? to ?

? of ? of a characteristic determine personality ?

personality disorders are ? rather than ? different from normal personality (ex. being persistent vs very stubborn)

continuum, normality, abnormality, levels, expression, pathology, quantitatively, qualitatively

criticisms of the DSM-5

1. ? categories
2. ? among clients w same disorder
3. lack of clear boundary between ?/?

4. “catch all” default category- personality disorder: [NAME]
5. disconnect w findings from normal personality ?
6. lack of diagnostic stability over ?
7. arbitrary selections of thresholds to ? PDs

overlapping, heterogeneity, normality, abnormality, Not otherwise specified, research, time, define

the Axis II system was eliminated because

1. not needed for effective ?
2. PDs are well established as a ? (no longer need a separate category requiring clinicians to ?)
3. Info in Axis #-# now subsumed in diagnosis
4. Global Assessment of Functioning (Axis 5) has no real ? validity (ex. Prof ex, dif numbers to same patient)

diagnosis, phenomenon, consider, 3, 4, Psychometric

Axis 1

psychiatric disorders

Axis 1 examples (3)

GAD, depression, schizophrenia

Axis 2 example

PDs

Axis 3

medical/neurological

Axis 4

v codes

Axis 5

Global Assessment of Functioning

Changes from DSM-4 to 5
1. removes names from ?
2. changed ? of criteria
3. splits schizotypal criteria # from to #
4. includes Section 3: Proposed ? ( in
order to encourage further refinement of some diagnostic categories (inc. PD’s)

clusters, order, 6, 9, revision

trait

tendency to ?, ?, and ? across all ? and all ? in which the trait may manifest

feel, perceive, behave, think, time, situations

domain

broad traits

facet

specific traits

domain example

antagonism

trait example

callousness

facet example

sadism (facet of callousness)

personality research assumes persons have different levels of ? 

facets

What remained the same in the DSM-5
1.? model
2. ? of PDs
3. ? of diagnoses
4. ? ? approach
5. Diagnostic ?
6. Consideration that PDs are ? from other disorders

Categorical, number, names, cluster, thresholds, distinct

Personality Disorders are characterized by ???? + ??

Impairments in personality functioning, pathological traits

general criteria for a personality disorder

A. Moderate or greater ? in ?/? functioning

inpairment, self, interpersonal

general criteria for a personality disorder

B. one or more pathological ? ex, ?

traits, callousness

general criteria for a personality disorder

C. impairments in functioning and pathological traits are
relatively ? and ?

inflexible, pervasive

which PDs did not meet the DSM-5 HYBRID cut? (4)

dependent, histrionic, paranoid, schizoid

general criteria for a personality disorder

D. Impairments in functioning and pathological traits are
relatively stable across ?, with onsets in ? or early ?

time, adolescence, adulthood

general criteria for a personality disorder

E. Impairments in functioning and pathological traits are not better explained by another ??

Mental disorder

general criteria for a personality disorder

F. Impairments in functioning and pathological traits are not solely attributable to the physiological effects of a ? or another ??

substance, medical condition

general criteria for a personality disorder

G. Impairments in functioning and pathological traits are not better understood as normal for an individual’s ? stage or ? environment

developmental, sociocultural

Functioning is comprised of 2 variables: ? Functioning and ? Functioning

self, interpersonal

self functioning

identity, self-direction

interpersonal functioning

empathy, intimacy

B. Pathological Personality traits
1. Negative vs Emotional Stability (example: )
2. Detachment vs. Extraversion (example: )
3. Antagonism vs. Agreeableness (example: )
4. Disinhibition vs Conscientiousness (example: )
5. Psychoticism vs. Lucidity (example: )

borderline, paranoid, antisocial, antisocial, schizotypal

FUNCTIONING

Not otherwise specified can see Difficulties in # or more of the following # areas:
?, ??, ?, ?

One can be rated from # to #

2, 4, identity, self-direction, empathy, intimacy, 0, 4

TRAITS SPECIFIED

# or more pathological trait domains OR specific trait facets
within domains; ALL of the following domains are considered:

??

?

?

?

?

1, Negative Affectivity, Detachment, Antagonism, Disinhibition, Psychoticism

Hybrid model uses both ? & ? approaches

categorical and dimensional

different ways of saying the alternative model (2)

hybrid, dimensional

Advantages of the Proposed Integrative Approach in DSM V

1. simplifies from # to #
2. provides formal personality system for ?
3. links growing personality ?
4. encourages explorations of relationships of personality traits with other mental ?
5. reduces ?

79, 25,
everyone,
literature,
disorders
stigma

Pros to Integrated approach

-provides multiple ? of personality within each individual patient
-corresponds to personality ? for DSM 5 (available in self report and informant report forms)

-personality traits are continuously distributed in ?

-elevations more easily ?
-provides indecent info about degree of ?, risk for ??, violence, criminality

-informs most useful ? type, ?, ?

views, inventory, population, assessed, disability, self-harm, treatment, intensity, prognosis

Identity

Self ?/Appraisals, ? w/others, Self-?
stability, Ability to ? range of emotional experience

Perception, Boundaries, esteem, regulate

Self-direction

Nature & pursuit of short & long term ?, standards of ? and capacity for productive self-?

goals, behavior, reflection

Trait Specified Proposed Criteria

Difficulties in # or more of the following # areas:
-?
-??
-?
-?

2, 4, Identity, Self-direction, Empathy, Intimacy