abnormal psych exam 4

Personality disorders

When personality characteristics interfere with relationships with others, cause the person distress, or in general disrupt activities of daily living, we consider these to be personality disorders.

Are personality disorders chronic or periodic?

Chronic

When do personality disorders originate

Childhood

Personality disorder

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

Self associated distress

May or may not be present

Does the person with the personality disorders always decide the disorder is causing a significant functional impairment

No, they often have someone else decide that

How do people with personality disorders do in treatment

Poorly

Why do people with personality disorders do badly with treatment

Therapists feel negatively about those diagnosed with personality disorders.

Before the DSM-5, personality disorders were in what?

Second axis due to the thought that they were ingrained and inflexible

What type of difficulty do personality disorders people have?

Degree vs type

How is degree vs kind/type usually described?

Dimensions rather than categories

What is the issue debated with personality disorders.

Whether they are extreme versions of otherwise typical personalities, or ways of relating that are different than the typical way.

How does the DSM5 diagnoses work?

Categorical, yes or no. No degrees

Advantages to using categorical models of behavior

Convenience

Negatives of using categorical models to describe/diagnose personality disorders

Cause clinicians to see disorders as physical issues. Called refiying, compared to broken arm or infection

Who argues that a dimensional system would be better for diagnosing personality disorders

Widiger

Widiger’s 3 advantages over a categorical system

1: retains more information about each person

2: more flexible

3: avoids arbitrary decisions involved in assigning a person to a diagnostic category.

Widely accepted personality model

Five-factor/ Big Five model

Extroversion

talkative, assertive, and active versus silent, passive, and reserved

Agreeableness

kind, trusting, and warm versus hostile, selfish, and mistrustful

Conscientiousness

organized, thorough, and reliable versus careless, negligent, and unreliable

Neuroticism

even-tempered versus nervous, moody, and temperamental

Openness to Experience

imaginative, curious, and creative versus shallow and imperceptive

Cluster A type

Odd/eccentric

Cluster A disorders

Paranoid, schizoid and schizotypal

Cluster B types

Dramatic, emotional, erratic

Cluster B diagnoses

Antisocial, borderline, histrionic, narcissistic personality disorder

Cluster C types

Anxious/fearful

Cluster C disorders

Avoidant, dependent & OCD

How many adults may have a personality disorder in the US

1/10 - so they are relatively common

How many adults have a personality disorder worldwide

6%

How do personality disorders change over time?

Start in childhood, but may disappear or get replaced with a different diagnosis over time

Borderline personality disorder characterized by

volatile and unstable relationships; they tend to have persistent problems in early adulthood, with frequent hospitalizations, unstable personal relationships, severe depression, and suicidal gestures

Suicide rates for borderline personality disorder

50% higher than general population, 8 -10% of patients with the diagnosis

Antisocial personality disorder characteristics

characteristic disregard for the rights and feelings of others; they tend to continue their destructive behaviors of lying and manipulation through adulthood

Male traits with personality disorders

Aggressive, structured, self-assertive & detached

Woman with personality disorder traits

Submissive, emotional, insecurity

Common gender with antisocial personality disorder

Males

Gender associated with dependent personality disorder

Females

Histrionic & borderline personality disorder gender

Equal men I women

Women with antisocial personality disorder often misdiagnosed with

Histrionic personality disorder

Why are women misdiagnosed with histrionic personality disorder

many of the features of histrionic personality disorder, such as overdramatization, vanity, seductiveness, and overconcern with physical appearance, are characteristic of the Western “stereotypical female.”

Are people likely to have co-morbidl personality disorders?

Yes but controversial thought

refers to meeting diagnostic criteria for multiple disorders, which is particularly common among individuals with personality disorders.

Comorbidity

Personality disorder lifetime is considered

Chronic

Paranoid

I cannot trust people.

Schizotypal

It’s better to be isolated from others.

Schizoid

Relationships are messy, undesirable.

Histrionic

People are there to serve or admire me.

Narcissistic

Since I am special, I deserve special rules.

Borderline

I deserve to be punished.

Anti-social

I am entitled to break rules.

Avoidant

If people knew the “real” me, they would reject me.

Dependent

I need people to survive, be happy.

Obsessive-compulsive

People should do better, try harder.

Paranoid personality disorder

Cluster A, excessively mistrustful & suspicious with no justification

Paranoid individuals are sensitive to blank, and have a need for blank

Criticism and autonomy

T or F, relatives of individuals with schizophrenia are more likely to have paranoid

True, but not strong evidence

Paranoid disorder has a potential relation to

Schizophrenia

Psychological contributions to paranoid

Childhood mistreatment, but have to take individuals word with grain of salt, due to disorder itself

Who is more susceptible to paranoid disorder

prisoners, refugees, people with hearing impairments, and older adults

Paranoid therapy treatment

Trusting atmosphere, cognitive therapy to counter assumptions,

Not particularly helpful though

Schizoid personality disorder

Pattern of detachment from social relationship & a restricted range of expression of emotions cluster A

All people with schizoid disorder are insensitive to others

False, some are sensitive but unable to express

What societal issue is prevalent among those with schizoid personality

Homelessness

What traits do schizoid and paranoid disorders share

social isolation, poor rapport, and constricted affect

What are precursors to having schizoid disorder

Childhood shyness, abuse and neglect, similar biological causes to autism

Treatment of schizoid personality disorder

Social skills training, taught empathy

Schizotypal personality disorder

Cluster A- pattern of interpersonal deficits featuring acute discomfort with and reduced capacity for close relationships, as well as cognitive or perceptual distortions and eccentricities of behavior

Schizotypal is on a spectrum of what

Schizophrenia, usually considered a minor form of or a precursor of

Ideas of reference

Knowing that something is unlikely, but still believing it

Magical thinking

Schizotypal

Feels like vs. There is

Schizotypal vs schizophrenia

Children who later develop schizotypal tend to

Be passive, unengaged and hypersensitive to criticism

Schicotypal disorders often have beliefs around

Religion or spiritual themes

What to be sensitive about to not misdiagnose one with schizotypal

Cultural practices

Phenotype

How a gene appears

Genotype

Genes that make up a phenotype

Schizotypal=

Schizophrenia genes, but not enough bio/environmental stresses to cause schizophrenia

Schizophrenic family = more likely to have

Schizophrenia