Behavior Disorders Final

personality

- regularities and consistencies in behavior, thinking, perceiving, and feeling

- stable across situation and time

- integrated and cohesive

criterion B (general personality disorder)

the enduring pattern is inflexible and pervasive across a broad range of personal and social situations

criterion A (general personality disorder)

- an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture

- affects cognition, affectivity, interpersonal functioning, impulse control

criterion C (general personality disorder)

the enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning

criterion D (general personality disorder)

the pattern is stable and of long duration, and its onset can be traced back at least to adolescents or early childhood

Cluster A

- odd-eccentric

- behaviors similar to schizophrenia

- flat affect, odd thought or speech patterns

- differ in their grasp on reality

- include paranoid personality disorder, schizotypal personality disorder, and schizoid personality disorder

schizotypal personality disorder

- symptoms of schizophrenia that are not severe enough to warrant a diagnosis of schizophrenia

- mild perceptual and cognitive distortions: odd beliefs and unusual perceptual experiences

- odd/eccentric speech patterns and behaviors

- discomfort with and deficits in interpersonal relations; wants close relationships but often avoids them

Cluster B

- dramatic-emotional

- manipulative and potentially uncaring

- show little regard for other sand potentially their own safety

- emotional dysregulation

- inappropriately sexual and seductive behavior

histrionic personality disorder

- exaggerated emotionality that lacks depth: emotions are shallow and shift rapidly

- discomfort when not center of attention: constantly seeks reassurance, approval, and praise

- inappropriate sexual and seductive behavior: extreme focus on appearance

histrionic core beliefs

- self: if I can't entertain people they will abandon me

- other: if other people don't respond to me they are rotten

- learning history: selective interpersonal reinforcement by family and peer relationships leads to excessive attention-seeking behaviors

antisocial personality disorder

- cluster B

- characterized by a disregard for and violation of the rights of others

- failure to conform to social norms with respect to lawful behavior

- deceitfulness

- impulsivity or failure to plan ahead

- irritability and aggressiveness

- reckless disregard for safety of others

- consistent irresponsibility

- lack of remorse for behaviors

history of antisocial personality

- moral insanity

- not psychotically deranged

- no deficit in reasoning abilities

- "constitutionally deficient in moral faculties"

pscyhopath

- term similar to antisocial, but includes grandiosity, arrogance, superficiality

- inability to form emotional bonds

- lack of anxiety

antisocial prevalence

- overrepresented in criminal and substance abuse settings

- 76% of prisoners diagnosed with ASPD

- 8% of men, 3% of women

- 29% concordance for twins

- individuals were more likely to behave like biological parents; not adoptive parents

- heritabilities of .61 for psychopathic deviate scale and .55 for mania scale

learning deficits

- psychopaths incapable of profiting from reward/punishment

- performed as well as controls when incorrect responses resulted in loss of cigarettes or money, but not responsive to shocks or positive or negative social comments

- slow to develop conditioned response to fear

- inclined to ignore painful shocks that controls learned to avoid

low arousal (ASPD)

- aversive physiological state resulting from a lack of novel/rewarding stimuli

- lower baseline levels of arousal and rapid adaptation to novel stimuli

- ASPD individuals spend less time attending to boring material

- exhibit higher-risk sensation-seeking behaviors to increase arousal levels

history of narcissism

- greek myth of Narcissus

- introduced into psychological literature by early psychoanalytic theorists (Ellis, Freud)

- added as a formal diagnosis in DSM-III

narcissistic personality

can be conceptualized as one's capacity to maintain a relatively positive self-image through a variety of self-affect, and field regulatory processes, and it underlies individuals' needs for validation and affirmation as well as the motivation to overtly and covertly seek out self-enhancement experiences from the social environment

healthy narcissism

- can contribute to well-being by increasing an individual's sense of personal agency

- high scores on the NPI have negative associations with trait neuroticism and depression, and positive associations with achievement motivation and self-esteem

autonomy subtype (healthy narcissism)

- correlated with self-ratings and partner-ratings of creativity, empathy, achievement orientation, and individualism

- prototype generally associated with positive trajectories in longitudinal studies

high-functioning/exhibitionistic type (healthy narcissism)

- exaggerated sense of self-importance

- outgoing, articulate, and energetic

- show "good adaptive functioning and use their narcissism as a motivation to succeed"

grandiose narcissism

- arrogant, conceited, and domineering attitudes and behaviors

- repressing negative aspects of self

- distorting disconfirming external information

- can lead to entitled attitudes and an inflated self-image without requisite accomplishments and skills

- engaging in regulatory fantasies of unlimited power, superiority, perfection, and adulation

- anger, manipulativeness, pursuit of power and control, lack of remorse, exaggerated self-importance, feelings of privilege

vulnerable narcissism

- inability to consistently maintain a grandiose sense of self

- prone to narcissistic injury

- emotional states characterized by shame, anxiety, depression, and feelings of inadequacy

- grandiose self-states oscillate or co-occur with vulnerable self-states and affective dysregulation

- grandiosity can't be maintained

- more vulnerable to shame, panic, helplessness, or depression

narcissism genetics

- heritability estimates range widely from .37 to .77

- estimates depend on the specific traits under investigation

- different variations of narcissism differ substantially in their genetic and environmental determinants

- overvaluation by parents not balanced with realistic feedback can lead to narcissism

borderline personality disorder

- instability in emotion, cognition, behavior, sense of self, and interpersonal relationships

- profound fears of abandonment and desperate bids to avoid abandonment

early learning factors (borderline)

- experiencing trauma in the form of physical abuse, sexual abuse, or neglect

- maternal and paternal absence, discord between parents, physical violence in the family

- invalidating early attachment environment

- instability in self-concept

borderline genetics

- 25% concordance in monozygotic twins compared with 75% for dizygotic

- certain predisposing traits are inherited as opposed to symptoms of the disorder

Cluster C

- anxious-fearful

- extreme concern of criticism and abandonment that leads to impaired relationships

avoidant personality disorder

- feelings of extreme social inhibition, inadequacy, and sensitivity to

negative criticism and rejection

- avoidance of activities of daily living (e.g., work) involving people for fear of criticism or rejection

- low-self esteem and social isolation

dependent personality disorder

- feelings of helplessness, submissiveness, dependence, reassurance seeking

- difficulty making independent decisions

- avoidance of adult activities and tolerance of abuse and maltreatment

obsessive-compulsive personality disorder

- a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency

- preoccupied with details, rules, lists, order, organization

- shows perfectionism that interferes with task completion

- excessively devoted to work and productivity to the exclusion of leisure activities and friendships

sexual dysfunction

- problems in the psychophysiological characteristics of the sexual response cycle

- represent quantitative problems with the strength/intensity of sexual response

paraphilias

- sexual arousal to non-normative or deviant stimuli and the associated sexual behaviors

- represent deviations in the qualitative aspects of sexuality or direction of sexual feelings

paraphilias in the DSM

- DSM-5 introduced a distinction between non pathological paraphilia interests and paraphilic disorders

- no such distinction was in place previously

- paraphilia describes a persistent, intense, atypical sexual arousal pattern

- paraphilia disorder describes a paraphilia accompanied by clinically significant distress or impairments

victimless paraphilias

- fetishism

- transvestite fetishism

- sexual masochism & sadism

paraphilias with victims

- exhibitionism

- frotteurism

- pedophilia

- sexual masochism & sadism

- voyeurism

paraphilia, not otherwise specified

- telephone scatalogia (obscene telephone calling)

- necrophilia (corpses)

- zoophilia (animals)

- coprophilia (feces)

- urophilia (urine)

classical conditioning (paraphilia)

- pairing of a neutral stimulus with sexual arousal

- fetishes conditioned in normal volunteers

imprinting (paraphilia)

early sexual experiences influence the shaping of subsequent sexual desires and fantasies

fetishism

- erotic attraction to nonliving objects

- wide variety of behavioral manifestations: masturbation with object, incorporation of object into sexual behavior, theft or collection of objects

partialism (fetishism)

- a form of fetishistic behavior involving intense erotic attraction to specific parts of the body

- distinguished from normal erotic attraction by the tendency to override sexual interest in the partner or partner's body as a whole

sadism

involves excitement in response to the infliction of psychological and physical suffering

masochism

- involves excitement in response to being humiliated or made to suffer

- some individuals become excited in either role, whereas some only become aroused in a particular role

sadomasochistic behaviors

- beating/burning

- restraint

- blindfolding

- body piercing

- humiliation

- forcing someone to crawl or wear infantile clothing

paraphilic disorder

- diagnosis requires (a) a non consenting person or (b) cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning"

- not just distress from social disapproval

pedophilia

- adults for whom prepubescent children are the focus of erotic attraction and interest

- highly culture-specific

- heterogeneity of behavioral manifestations

- subtypes: opportunistic, pervasively angry, sexual

exhibitionism

- recurrent urge for exposure of genitals to strangers or unsuspecting persons

- arousal response to shock, fear, or embarrassment of victims

- associated with acts of sexual aggression and antisocial traits

- difficulty with social relations with the opposite sex of a nonsexual nature

frotteurism

- characterized by the individual's touching or rubbing his genitals against the leg, buttocks, or other body parts of an unsuspecting person

- typically occurs in situations where behavior will go undetected by victim

- associated with withdrawn, immature, or socially avoidant personality style

voyeurism

- involves the observation of an unsuspecting person or persons who are nude, disrobing, or engaging in a sexual act

- essential feature is the lack of awareness of the victim

- often involves masturbation during or immediately following voyeurism

- associated with: sadism, aggression, and sexual assault; feelings of inferiority; little sexual experience and lack of heterosocial skills

clinical features of BPD

- fear of abandonment

- unstable and intense personal relationships

- identity disturbance; unstable sense of self

- impulsive behavior

- recurrent self-mutilating behavior or suicide threats

- highly reactive mood; affective instability

- persistent feelings of emptiness

- intense or inappropriate anger

- brief periods of paranoid ideation or dissociative symptoms when under stress

Stern

first created the term borderline to reflect his view that the disorder did not fit well within the existing classification system, which was principally oriented around differentiating between neurosis and psychosis

Knight

his patients had severely impaired ego functions and primary process thinking, which is a type of thinking that reflects unconscious wishes and urges; he used the term but considered the disorder to be on the border not just of neurosis but of both neurosis and psychosis

gender differences in BPD

- women account for approximately 75% of cases

- little support for the idea that this is the result of a gender bias in the diagnostic criteria

- women might be more likely to seek treatment, which could bias prevalence estimates

Linehan

affective instability is the core of BPD: rapid mood changes, extreme reactivity to the environment, and dysthymic baseline mood that best characterize the disorder

Gunderson

suggest that emotional instability is a secondary phenomenon that results from instability in the self-structure; takes a more interpersonal perspective and highlights tear and intolerance of aloneness as a central to the disorder

Biosocial theory (Linehan)

BPD results when biological or temperamental vulnerabilities interact with failures in the child's social environment, such that problems with emotion regulation are either created or exacerbated; problems with sensitivity to negative emotions and emotional reactivity are thought to be precursors of the chronic problems with emotional regulation that are characteristic of BPD

executive neurocognition

- being able to delay or terminate a given response (cognitive or motor) for the purpose of achieving another goal or reward that is less immediate

- individuals with BPD struggle with this

BIS/BAS model

three systems that serve to regulate behavior: the fight/flight system (FFS), which responds to the unconditioned or innately aversive stimuli; the behavioral activation system (BAS), described as sensitive to reward stimuli and likely to activate responses in the face of cues or conditioned stimuli signaling reward; and the behavioral inhibition system (BIS), described as sensitive to punishment stimuli and likely to inhibit ongoing responses in response to cues or conditioned stimuli signaling punishment or frustrate nonreward

amygdala

most prominent brain area in Blair's conceptualization of learning deficits in psychopathy

response modulation hypothesis

holds that abnormalities in selective attention undermine the ability of psychopathic individuals to consider contextual information that modulates the goal-directed behavior of others

attention bottleneck

hampers the simultaneous processing of multiple channels of information; thus, once attention is allocated to a specific goal, psychopathic individuals are less able to process the full range of affective and noneffective stimuli, and their associated meanings, that normally provide an evaluative context for goal-directed behavior