PSYC3102 Week 11 – Personality Disorders

Question-and-Answer flashcards covering definitions, diagnostic criteria, epidemiology, aetiology and treatment of personality disorders as presented in the Week 11 lecture.

What is ‘personality’ in psychological terms?

Enduring and pervasive patterns of thinking and behaviour that define a person and distinguish them from others.

How does personality pathology differ from normal personality traits?

Traits become rigid, inflexible and maladaptive, representing the extreme end of normal trait dimensions.

DSM-5-TR: In which two (of four) functional areas must a personality disorder markedly deviate from cultural expectations?

At least two of: cognition, affectivity, interpersonal functioning, impulse control.

What does it mean that most personality disorders are ‘ego-syntonic’?

The thoughts and impulses are experienced as acceptable to the person, so they are not viewed as problematic by the individual.

Estimated lifetime prevalence of having at least one personality disorder in the general population?

Approximately 10 %.

Which three personality disorders show the highest prevalence rates?

Obsessive-Compulsive PD, Borderline PD, and Narcissistic PD.

Why is Borderline Personality Disorder (BPD) often the research focus among PDs?

It is highly prevalent, clinically severe and has the largest body of treatment research.

How high is comorbidity between PDs and other disorders overall?

Very high; e.g., 67 % of those with any disorder also meet criteria for a PD in the NCS-R sample.

Gender difference in help-seeking for PDs

Overall prevalence is similar, but females more often present to ED or mental-health services, whereas males more often present in substance-use or forensic settings.

Completed-suicide rate across genders for BPD

Approximately 8–10 %, with males tending to use more lethal means.

Which diagnostic classification systems are mainly used for PDs?

DSM-5-TR and ICD-11.

What semi-structured interview improves PD diagnostic accuracy?

SCID-5-PD (Structured Clinical Interview for DSM-5 Personality Disorders).

Why can diagnosing PDs be confusing for both patient and clinician?

Clients often present in crisis, have low insight and high comorbidity, masking the underlying personality disorder.

Give one reason why communicating a PD diagnosis is important.

Sets realistic treatment goals, prevents misguided treatment and can offer clients validation and hope.

DSM-5-TR Cluster A disorders are described as what?

Odd or eccentric.

Name the three Cluster A personality disorders.

Paranoid, Schizoid, Schizotypal.

DSM-5-TR Cluster B disorders are described as what?

Dramatic, emotional or erratic.

Name the four Cluster B personality disorders.

Antisocial, Borderline, Histrionic, Narcissistic.

DSM-5-TR Cluster C disorders are described as what?

Anxious or fearful.

Name the three Cluster C personality disorders.

Avoidant, Dependent, Obsessive-Compulsive.

Core feature of Paranoid Personality Disorder

Pervasive distrust and suspiciousness of others, interpreting motives as malevolent.

Give two DSM-5 criteria examples for Paranoid PD.

E.g., suspects others are exploiting them; persistently bears grudges.

Core feature of Schizoid Personality Disorder

Detachment from social relationships and restricted emotional expression.

Give two DSM-5 criteria examples for Schizoid PD.

E.g., neither desires nor enjoys close relationships; almost always chooses solitary activities.

Key distinguishing feature of Schizotypal Personality Disorder

Social/interpersonal deficits with cognitive-perceptual distortions and eccentric behaviour.

Give two DSM-5 criteria examples for Schizotypal PD.

E.g., odd beliefs or magical thinking; unusual perceptual experiences.

Age-related requirement for Antisocial Personality Disorder

Evidence of Conduct Disorder before age 15 and the individual is at least 18 years old.

Name three behavioural criteria for Antisocial PD.

Repeated unlawful acts, deceitfulness, impulsivity, irritability/aggressiveness, reckless disregard for safety, etc.

List four hallmark features of Borderline Personality Disorder.

Instability in relationships, self-image and affects; impulsivity; frantic efforts to avoid abandonment; recurrent self-harm or suicidal behaviour.

What specific behaviour is captured by Criterion 5 for BPD?

Recurrent suicidal behaviour, gestures, threats, or self-mutilation.

Two core traits of Histrionic Personality Disorder

Excessive emotionality and attention-seeking.

What is ‘grandiosity’ in Narcissistic Personality Disorder?

An exaggerated sense of self-importance and superiority, often expecting special treatment.

Dominant feelings in Avoidant Personality Disorder

Social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation.

Primary behavioural pattern in Dependent Personality Disorder

Submissive, clinging behaviour and excessive need to be taken care of.

Central preoccupations in Obsessive-Compulsive Personality Disorder

Orderliness, perfectionism and control at the expense of flexibility and efficiency.

Antisocial PD aetiology is theorised as what interaction?

Difficult childhood temperament leading to poorly controlled behaviour that is reinforced over time.

Borderline PD aetiology involves what interaction?

Highly sensitive temperament interacting with an invalidating environment.

Approximate heritability estimate for BPD from twin studies

Up to about 35 %, though findings vary.

Transactional Model of BPD highlights which two components?

Emotion vulnerability and pervasive invalidating responses leading to emotion dysregulation.

Which classes of psychiatric medication may be used for PDs?

Antipsychotics, antidepressants, mood stabilisers and anticonvulsants—aimed at acute distress and comorbid symptoms, not the PD itself.

Primary goal of Dialectical Behaviour Therapy (DBT)

To help clients build ‘a life worth living’ by reducing life-threatening, therapy-interfering and quality-of-life interfering behaviours.

Name the four core DBT skills modules.

Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness.

Three-level behavioural target hierarchy in DBT

1) Life-threatening behaviours, 2) Therapy-interfering behaviours, 3) Quality-of-life behaviours.

Key components of a Youth DBT programme

Intake/commitment, multifamily skills group, individual therapy, telephone coaching, family sessions and therapist consultation team.

Define an Early Maladaptive Schema (EMS).

Stable, pervasive themes about self and relationships formed in childhood that are dysfunctional across life.

List the five broad EMS domains.

Disconnection & Rejection, Impaired Autonomy, Impaired Limits, Other-Directedness, Over-Vigilance & Inhibition.

What is ‘imagery rescripting’ in schema therapy?

Experiential technique where clients revisit painful memories and imagine adult self intervening to meet the child’s unmet needs.

Describe the Gestalt ‘empty-chair’ technique.

Client speaks to an imagined person in an empty chair to explore and modify maladaptive schemas and emotions.

Why do individuals with Antisocial PD rarely seek treatment voluntarily?

They often lack remorse and only engage when legally mandated; substance misuse complicates treatment.

Which psychotherapy shows promise for Schizotypal PD according to a recent case report?

Schema Therapy.

Typical treatment approaches for Avoidant PD

Cognitive-Behavioural Therapy and Schema Therapy with extended exposure-based work to challenge social-judgement fears.

Why might the pace/duration of therapy be extended for Avoidant PD?

Severity of social anxiety and avoidance requires gradual, longer-term exposure and skills practice.