Abnormal Psychology: Personality Disorders, Schizophrenia Spectrum, and Substance-Related Disorders

Comprehensive practice flashcards covering DSM-5 Personality Disorders (Clusters A, B, and C), Schizophrenia Spectrum and Other Psychotic Disorders, and Substance-Related, Addictive, and Impulse-Control Disorders.

How are personality disorders clinically defined?

A persistent pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and relationships.

What does it mean that personality disorders are typically ego-syntonic?

Unlike other disorders, they often feel consistent with one's identity, meaning patients often do not feel that treatment is necessary.

What is the distinction between categorical and dimensional models of personality disorders?

The categorical model views disorders as all-or-nothing categories (kind), whereas the dimensional model rates individuals on the degree to which they exhibit various personality traits.

Which personality traits comprise the Five Factor Model ("Big Five")?

Openness to experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.

How are the ten DSM-5 personality disorders organized into clusters?

Cluster A comprises the odd or eccentric disorders; Cluster B comprises dramatic, emotional, or erratic disorders; and Cluster C comprises anxious or fearful disorders.

What is the estimated prevalence of personality disorders in the general population?

Approximately $10\%$ of the general population.

Which two personality disorders are identified as being under study requiring further research?

Sadistic personality disorder (enjoy inflicting pain) and Passive-aggressive personality disorder (defiant, undermine authority).

What are the core clinical features and primary treatment targets for paranoid personality disorder?

Core features include pervasive and unjustified mistrust and suspicion, few meaningful relationships, and hypersensitivity to criticism. Treatment focuses on developing trust and cognitive therapy to counter negativistic thinking.

Which specific groups are culturally more vulnerable to paranoid personality disorder due to life experiences?

Prisoners, refugees, people with hearing impairments, and older adults.

What are the defining characteristics of schizoid personality disorder?

A pervasive pattern of detachment from social relationships and a very limited range of emotions in interpersonal situations, showing significant overlap with Autism Spectrum preferences for isolation.

What clinical features characterize schizotypal personality disorder?

Odd or unusual behavior and dress, social isolation, high suspicion, magical thinking, ideas of reference, and illusions, often conceptualized as a milder form of schizophrenia with high comorbidity with major depression.

What are the essential clinical features of antisocial personality disorder?

Failure to comply with social norms, violation of the rights of others, irresponsible, impulsive, deceitful behavior, and a profound lack of conscience, empathy, and remorse.

According to this graph of criminality across age periods, how does the percentage of psychopaths in prison change between ages 21–25 and ages 41–45?

The percentage of psychopaths in prison peaks at approximately $89\%$ to $90\%$ during ages 21–25 and drops sharply to below $60\%$ by ages 41–45.

What four neurobiological hypotheses explain the lack of fear and arousal in antisocial personality disorder?

The underarousal hypothesis (cortical arousal is too low), cortical immaturity hypothesis (cerebral cortex is not fully developed), fearlessness hypothesis (failure to respond to danger cues), and Gray's model (inhibition signals are outweighed by reward signals).

What rates of major depression, bipolar disorder, and substance use disorder are comorbid with borderline personality disorder?

$80\%$ have comorbid major depression, $10\%$ have bipolar disorder, and $67\%$ are diagnosed with at least one Substance Use Disorder.

What are the three components of the triple vulnerability model applied to borderline personality disorder?

Generalized biological vulnerability (high emotional reactivity), generalized psychological vulnerability (tendency to lash out when threatened), and specific psychological vulnerability (stressors that elicit borderline behavior).

What is dialectical behavior therapy (DBT), and what core areas does it target for borderline personality disorder?

The most promising treatment for BPD, focusing on the dual reality of acceptance of difficulties and the need for change, interpersonal effectiveness, and distress tolerance to decrease reckless and self-harming behavior.

What clinical features characterize histrionic personality disorder?

Overly dramatic, sensational behavior, sexually provocative tendencies, impulsivity, an intense need to be the center of attention, and shallow emotions and thinking.

What are the key clinical features of narcissistic personality disorder?

An exaggerated and unreasonable sense of self-importance, preoccupation with receiving attention, lack of sensitivity and compassion for others, extreme sensitivity to criticism, envy, and arrogance.

How does avoidant personality disorder present clinically, and what disorder does its treatment resemble?

Extreme sensitivity to opinions of others, high avoidance of interpersonal relationships, fear of rejection, and low self-esteem; its treatment is similar to that for social phobia.

What are the core clinical manifestations of dependent personality disorder?

Reliance on others to make major and minor life decisions, unreasonable fear of abandonment, and clingy, submissive behavior in interpersonal relationships.

How does obsessive-compulsive personality disorder differ from obsessive-compulsive disorder (OCD)?

Obsessive-compulsive personality disorder is characterized by an excessive and rigid fixation on doing things the right way, perfectionism, orderliness, and reluctance to delegate; actual obsessions and compulsions are rare.

How did Emil Kraepelin and Eugen Bleuler historically define schizophrenia?

Emil Kraepelin used the term dementia praecox and identified subtypes (catatonia, hebephrenia, and paranoia); Eugen Bleuler introduced the term "schizophrenia" and conceptualized it as a spectrum of variants.

What is the distinction between positive and negative symptoms of schizophrenia?

Positive symptoms represent distortions or excesses of normal functioning (delusions, hallucinations), whereas negative symptoms represent the absence or insufficiency of normal behavior (avolition, alogia, anhedonia, asociality, affective flattening).

What do the negative symptoms avolition, alogia, anhedonia, and affective flattening represent?

Avolition is the inability to initiate and persist in activities; alogia is relative absence of speech; anhedonia is presumed lack of pleasure; and affective flattening is showing little or no expressed emotion.

Which brain region shown in this diagram is unexpectedly found by SPECT studies to be the most active during auditory hallucinations?

Broca's area, which is responsible for speech production, rather than language comprehension.

What are cognitive slippage, tangentiality, and loose associations in disorganized speech?

Cognitive slippage refers to illogical and incoherent speech; tangentiality refers to going off on a tangent rather than answering questions; and loose associations involve abruptly shifting conversation in unrelated directions.

How is schizophreniform disorder diagnosed in terms of symptom duration and prevalence?

It requires psychotic symptoms lasting between $1\text{ to }6\text{ months}$ (beyond $6\text{ months}$ is schizophrenia), is associated with relatively good functioning, and has a lifetime prevalence of approximately $0.2\%$.

What clinical criteria define schizoaffective disorder?

Symptoms of schizophrenia concurrent with a major mood episode (depressive or manic), where psychotic symptoms must also occur outside the mood disturbance.

What are the key epidemiological and clinical features of delusional disorder?

Persistent delusions contrary to reality without other positive or negative symptoms; affects $26\text{ to }60\text{ individuals per }100{,}000$, has an onset between ages $35\text{ to }55$, and $55\%$ of patients are female.

What is the duration threshold and typical trigger for brief psychotic disorder?

Symptoms last less than $1\text{ month}$, making it the briefest psychotic disorder, and it is typically precipitated by severe trauma or stress.

In the natural history of schizophrenia illustrated here, what characteristic features define the prodromal stage?

Unusual psychotic-like behaviors, occurring between roughly age $10$ and $20$, before the acute onset and deterioration phase.

According to this chart, what are the respective risks of developing schizophrenia for monozygotic twins compared to dizygotic twins?

Monozygotic twins face an approximate risk of $48\%$, whereas dizygotic twins face an approximate risk of $17\%$.

What behavioral marker (endophenotype) is identified in schizophrenia patients and their relatives?

Deficits in smooth-pursuit eye movement, reflected in a reduced ability to track a moving object smoothly with their eyes.

What is the dopamine hypothesis of schizophrenia, and why is it considered overly simplistic?

It proposes that schizophrenia is partially caused by overactive dopamine (supported by dopamine agonists producing and antagonists reducing psychotic behavior); it is overly simplistic because many other neurotransmitters are also involved.

What structural and functional abnormalities are consistently identified in the brains of individuals with schizophrenia?

Enlarged lateral and third ventricles, reduced brain tissue volume, and hypofrontality (decreased activity in the frontal lobes).

According to this chart on cultural differences in expressed emotion (EE), which culture displays the highest percentage of families with high EE?

Anglo-American culture, with nearly $70\%$ of families exhibiting high expressed emotion.

Based on this study of psychosocial interventions in schizophrenia, which treatment group exhibited the highest relapse rate after 2 years?

Drugs combined with support or education, resulting in a major relapse rate of over $60\%$ (compared to under $40\%$ for social skills training or family stress management).

What severe motor side effects are associated with first-generation neuroleptic medications?

Parkinson's-like side effects and tardive dyskinesia (involuntary movements often of the tongue, face, and mouth).

How are tolerance and withdrawal defined in substance use disorders?

Tolerance is needing more of a substance to get the same effect or experiencing reduced effects from the same amount; withdrawal is the negative physical and psychological response when a substance is discontinued after regular use.

What are the five main categories of psychoactive substances outlined in the DSM-5?

Depressants, Stimulants, Opiates, Hallucinogens, and Other drugs of abuse (such as inhalants and anabolic steroids).

According to this anatomical diagram, what is the precise numerical sequence (1 through 5) of alcohol's path through the body?

1. Ingestion, 2. Stomach, 3. Small intestine, 4. Heart, 5. Liver.

What is the primary neurochemical mechanism of alcohol in the central nervous system?

It acts as a central nervous system depressant primarily by increasing the inhibitory effects of GABA, making neural cells less able to fire.

What are delirium tremens and Wernicke-Korsakoff disorder in relation to alcohol use?

Delirium tremens consists of severe hallucinations and tremors brought on by alcohol withdrawal; Wernicke-Korsakoff disorder is a condition caused by long-term heavy alcohol use characterized by confusion, lack of coordination, and impaired speech.

What neurochemical mechanisms account for the central nervous system stimulation caused by amphetamines and cocaine?

Amphetamines enhance the release of norepinephrine and dopamine and block their reuptake; cocaine directly blocks the reuptake of dopamine.

According to this diagram, which neurotransmitter systems are stimulated by nicotine to reduce anxiety and tension?

Beta-endorphin and GABA.

What does this graph illustrate regarding 12-month abstinence rates after quitting alcohol, heroin, and nicotine?

Relapse trajectories are remarkably similar across all three substances, with only about $20\%$ to $30\%$ of individuals maintaining abstinence at $12\text{ months}$.

How does caffeine produce its stimulant effect in the brain?

By blocking the reuptake of the inhibitory neurotransmitter adenosine.

What endogenous brain systems do opioids activate, and what dangers are associated with their use?

They activate the body's natural enkephalins and endorphins; high doses can cause death via respiratory depression, and intravenous use incurs high mortality and HIV risks from shared needles.

What is the opponent-process theory of substance use disorders?

It posits that an initial euphoric state is followed by a negative crash, and over time, the drug itself becomes the easiest and quickest way to escape or alleviate the unpleasant feelings of withdrawal.

How do agonist, antagonist, and aversive biological treatments for substance use disorders differ?

Agonist treatments substitute a safer drug of similar chemical composition (e.g., methadone, nicotine patch); antagonist treatments block the positive effects of the drug (e.g., naltrexone); aversive treatments make drug consumption extremely unpleasant (e.g., antabuse).

How is gambling disorder categorized in the DSM-5, and how many symptoms are required for diagnosis?

It is classified under "Addictive Disorders" due to biological and genetic origins shared with substance use disorders, requiring at least $4+$ symptoms within a year.

What are intermittent explosive disorder, kleptomania, and pyromania?

Impulse-control disorders characterized by failure to resist urges: intermittent explosive disorder involves frequent aggressive outbursts; kleptomania is the urge to steal unneeded items; pyromania is the irresistible urge to set fires (diagnosed in $3\%$ of arsonists).