Personality Disorders and Substance Use Disorders Study Guide

A collection of flashcards summarizing key concepts related to personality disorders, substance use disorders, schizophrenia, and legal and ethical issues regarding mental health.

Personality Disorders

Enduring maladaptive patterns for relating to the environment and self, exhibited

in a range of contexts that cause significant functional impairment or subjective distress.

Paranoid Personality Disorder

Cluster A personality disorder involving pervasive distrust and suspicion of others such that their motives are interpreted as malevolent.

Schizoid Personality Disorder

Cluster A personality disorder featuring a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions.

Schizotypal Personality Disorder

Cluster A personality disorder involving a pervasive 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.

Ideas of Reference

the tendency to believe that neutral or random events, objects, or people are specifically directed at or have personal significance for oneself, even when there's no real basis for such a belief. Related to schizotypal PD

Antisocial Personality Disorder

Cluster B personality disorder involving a pervasive pattern of disregard for and violation of the rights of others.

Psychopathy

non-DSM-5 category similar to ASD. But with less emphasis on overt behavior. Indicators include superficial charm, lack of remorse, and other personality characteristics.

Borderline Personality Disorder

Cluster B personality disorder involving a pervasive pattern of instability of interpersonal relationships, self-image, affects, and control over impulses.

Dialectical Behavioral Therapy (DBT)

Promising treatment for borderline personality disorder. involves exposing the client to stressors in a controlled situation, as well as helping the client regulate emotions and cope with stressors that might trigger suicidal behavior

Avoidant Personality Disorder

Cluster C personality disorder featuring a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism.

Psychoactive substances

Substances, such as drugs, that alter mood or behavior.

Substance Abuse

Pattern of psychoactive substance use leading to significant distress or impairment in

social and occupational roles and in hazardous situations.

Substance Dependence

Maladaptive pattern of substance use characterized by the need for increased amounts to achieve the desired effect, negative physical effects when the substance is withdrawn, unsuccessful efforts to control its use, and substantial effort expended to seek it or recover from its effects. Also known as addiction.

Tolerance

Need for increased amounts of a substance to achieve the desired effect.

Withdrawal

Severely negative physiological reaction to removal of a psychoactive substance, which can be alleviated by the same or a similar substance

Depressants

The psychoactive substances that result in behavioral sedation. Include alcohol and

the sedative, hypnotic, and anxiolytic drugs.

Alcohol-related Disorders

Cognitive, biological, behavioral, and social problems associated with alcohol use.

Stimulants

Any psychoactive substances that elevate mood, activity, and alertness. Include

amphetamines, caffeine, cocaine, and nicotine.

Opiates

Addictive psychoactive substances such as heroin, opium, and morphine that cause

temporary euphoria and analgesia (pain reduction).

Hallucinogens

Any psychoactive substance such as LSD or marijuana that can produce delusions,

hallucinations, paranoia, and altered sensory perception.

Schizophrenia

A devastating psychotic disorder that may involve characteristic disturbances in thinking (delusions), perception (hallucinations), speech, emotions, and behavior.

Positive Symptoms of Schizophrenia

Symptoms that refer to distorted reality such as hallucinations and delusions.

Negative Symptoms of Schizophrenia

Symptoms of schizophrenia that involve deficits in normal behavior in such areas as speech, blunted affect (or lack of emotional reactivity), and motivation.

Disorganized Symptoms of Schizophrenia

Symptoms that include rambling speech, erratic behavior, and inappropriate affect (for example, smiling when you are upset.

Attention Deficit/Hyperactivity Disorder (ADHD)

Developmental disorder featuring maladaptive levels of inattention, excessive activity, and impulsiveness.

Autism Spectrum Disorder

Neurodevelopmental disorder characterized by significant impairment in social interactions and communication and restricted patterns of behavior, interest, and activity.

Intellectual Developmental Disorder (IDD)

A diagnosis received when one achieves a significantly below-average score on a test of intelligence and by limitations in the ability to function in areas of daily life.

The cause of intellectual disability is unknown in about 30% of cases

Civil Commitment Laws

Legal proceedings to determine if a person is mentally disordered and may be hospitalized involuntarily. Critical criterion: dangerousness to self or other.

Deinstitutionalization

Systematic removal of people with severe mental illness or intellectual disability

from institutions like psychiatric hospitals.

Transinstitutionalization

Movement of people with severe mental illness from large psychiatric

hospitals to smaller group residences.

Competence

Ability of legal defendants to participate in their own defense and understand the charges and the roles of the trial participants.

Criminal commitment

Legal procedure by which a person found not guilty of a crime by reason of insanity must be confined in a psychiatric hospital.

Diminished capacity

Evidence of an abnormal mental condition in people that causes criminal charges against them requiring intent or knowledge to be reduced to lesser offenses requiring only reckless or criminal neglect.

Duty to warn

Mental health professional’s responsibility to break confidentiality and notify the potential victim whom a client has specifically threatened.

Expert witness

Person who because of special training and experience is allowed to offer opinion

testimony in legal trials.

Underarousal hypothesis

Neurobiological theory: cortical arousal is too low. Ppl with APD are chronically under-aroused and seek stimulation from the types of activities that would be too fearful or aversive for most

Fearlessness hypothesis

Neurobiological theory: failing to respond to danger cues

Histrionic personality disorder

Cluster B personality disorder involving a pervasive pattern of excessive emotionality and attention seeking.

Narcissistic Personality Disorder

Cluster B personality disorder involving a pervasive pattern of grandiosity in fantasy or behavior, need for admiration, and lack of empathy.

Dependent Personality Disorder

Cluster C personality disorder characterized by a person’s pervasive and excessive need to be taken care of, a condition that leads to submissive and clinging behavior and fears of separation.

Obsessive-compulsive personality disorder

Cluster C personality disorder featuring a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.

Substance use

The ingestion of psychoactive substances in moderate amounts that does not

significantly interfere with social, educational, or occupational functioning.

Substance intoxication

The psychological reaction to ingested substances, such as drunkenness or

getting high. Variables that interact include type of drug taken, amount ingested, and individual biological reaction. It can be experienced as impaired judgment, mood changes, and lowered motor ability (including problems walking or talking).

Substance-related and addictive disorders

Range of problems associated with the use and abuse of drugs such as alcohol, cocaine, heroin, and other substances people use to alter the way they think, feel, and behave. These are extremely costly in human and financial terms.

Physiological dependence

The use of increasingly greater amounts of a drug to experience the same

effect (tolerance) and a negative physical response when the substance is no longer ingested (withdrawal).

Wernicke-Korsakoff Syndrome

Organic brain syndrome resulting from prolonged heavy alcohol use, involving confusion, unintelligible speech, and loss of motor coordination. It may be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers.

Fetal alcohol syndrome

Pattern of problems including learning difficulties, behavior deficits, and characteristic physical flaws, resulting from heavy drinking by the victim’s mother when she was pregnant with the victim.

Prodormal stage

Featuring heavy drinking but with few outward signs of a problem. This is the second of E. Morton Jellinek’s four stages identified in the progression of alcoholism.

Barbiturates

Sedative (and addictive) drugs including Amytal, Seconal, and Nembutal that are

used as sleep aids.

Benzodiazepines

Antianxiety drugs including Valium, Xanax, Dalmane, and Halcion also used to

treat insomnia. Effective against anxiety (and, at high potency, panic disorder), they show some side effects, such as some cognitive and motor impairment, and may result in substance dependence. Relapse rates are extremely high when the drug is discontinued

Amphetamines

A stimulant medication used to treat hypersomnia by keeping the person awake during the day, and to treat narcolepsy, including sudden onset episodes, by suppressing rapid eye movement sleep.

Amphetamine use disorders

Severe intoxication or overdose through the use of amphetamines, including significant behavioral impairments and physiological symptoms.

Cocaine

Derivative of coca leaves used medically as a local anesthetic and narcotic; often a

substance of abuse.

Cocaine use disorders

Severe intoxication or overdose through the use of cocaine,

including significant behavioral impairments and physiological symptoms.

Nicotine

Toxic and addictive substance found in tobacco leaves

Nicotine patch

Patch placed on the skin that delivers nicotine to smokers without the carcinogens in cigarette smoke. Somewhat more successful than nicotine gum because it requires less effort by the wearer and delivers the drug more consistently; should be coupled with counseling to stop smoking and avoid relapse.

Nicotine use disorder/tobacco-related disorder

Cognitive, biological, behavioral, and social problems associated with the use and abuse of nicotine.

Caffeine use disorder

Gentle stimulant.” Cognitive, biological, behavioral, and social problems

associated with the use and abuse of caffeine

Opiod-related disorders

Severe intoxication or overdose through the use of opiates, which have a narcotic effect

Cannabis (cannabis sativa, marijuana)

Dried flowers and leaves of the hemp plant; a hallucinogen that is the most widely used illegal substance

Cannabis use disorder

Problematic pattern of cannabis use leading to clinically significant impairment or distress.

Hallucinogen use disorders

Cognitive, biological, behavioral, and social problems associated with the use and abuse of hallucinogenic substances.

LSD (d-lysergic acid diethylamide):

Most common hallucinogenic drug; a synthetic version of the grain fungus ergot

Other commonly misused substances

Other substances that produce psychoactive effects and that are misused but do not fit neatly into other categories. Such as: Inhalants, anabolic steroids, other over-the-counter and prescription medications

Biological Causes of substance-use disorder

• Genetic tendency

• “Pleasure pathway”

• Rate of metabolism

• Comorbid disorders

Psychological Causes of substance-use disorders

a) Positive reinforcement

b) Negative reinforcement

Social and cultural Causes of substance-use disorders

a) Influence of media

b) Parents and peers

Biological treatments for substance-use disorder

agonists

antagonists

Psychological treatments for substance use disorders

Inpatient vs outpatient treatments: not much difference in effectiveness

Support programs (AAs and NAs) – may be helpful, research is mixed

Agonist substitution

Replacement of a drug on which a person is dependent with one that has a similar chemical makeup, an agonist. Used as a treatment for substance dependence.

Antagonist drugs

Medications that block or counteract the effects of psychoactive drugs.

Dementia praecox

Latin term meaning “premature loss of mind,” an early label for what is now called schizophrenia, emphasizing the disorder’s frequent appearance during adolescence. Called démence précoce in France.

Associative Splitting

Separation among basic functions of human personality (for example, cognition, emotion, and perception) seen by some as the defining characteristic of schizophrenia

Psychotic Behavior

Severe psychological disorder category characterized by hallucinations and loss of contact with reality.

Delusion

A false belief or judgment about external reality, held despite incontrovertible evidence to the contrary, occurring especially in mental conditions. positive symptom of schizophrenia. includes both paranoia and delusions of persecution

Paranoia

People’s irrational beliefs that they are especially important (delusions of

grandeur) or that other people are seeking to do them harm

Delusions of persecution

believing that they are someone close to them will be attacked or deceived.

Hallucination

A sight, sound, smell, taste, or touch that a person believes to be real but is not

real

Avolition

lack of motivation — apathy, or the inability to initiate or persist in important

activities

Alogia

lack of regular speech — deficiency in the amount or content of speech, a disturbance often seen in people with schizophrenia

Anhedonia

lack of pleasure — inability to experience pleasure, associated with some mood and

schizophrenic disorders

Asociality

lack of interest in social interactions

Flat affect

Apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected.

Inappropriate affect

Emotional displays that are improper for the situation. A disorganized symptom of schizophrenia

Disorganized speech

style of talking often seen in people with schizophrenia, involving incoherence and a lack of typical logic patterns. A disorganized symptom of schizophrenia

Catatonia

Disorder of movement involving immobility or excited agitation. Sometimes

accompanies psychotic disorders or mood disorders. A disorganized symptom of schizophrenia

Catatonic immobility

Disturbance of motor behavior in which the person remains motionless,

sometimes in an awkward posture, for extended periods.

Other psychotic disorders

fall under schizophrenia spectrum. include:

• schizophreniform disorder

• shizoaffective disorder

• delusional disorder

• Substance-induced psychotic disorder

• Psychotic disorder associated with another medical condition:

• Brief psychotic disorder

• attenuated psychosis syndrome

Schizophreniform Disorder

Psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months.

Schizoaffective Disorder

Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder.

Delusional Disorder

Psychotic disorder featuring a persistent belief contrary to reality (delusion) but no other symptoms of schizophrenia.

Jealous type

type of delusional disorder when the central theme of the delusion is that their spouse or lover is unfaithful.

Ertomanic type

type of delusional disorder when the central theme of the delusion is that another person is in love with the individual.

Somatic type

type of delusional disorder when the central theme of the delusion involved bodily functions or sensations

Persecutaory Type

type of delusional disorder when the central theme of the delusion involves the individual’s belief that they are being conspired against, cheated, spied on, sollowed, poisoned/drugged, maliciosuly maligned, harrased, or obstructed in the pursuit of long-term goals.

Grandiose Type

type of delusional disorder when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.

Mixed type

type of delusional disorder where is no dominant type

Unspecificed type

type of delusional disorder where the dominant type doesn’t fit into one of the categories

Substance-induced psychotic disorder

Psychosis caused by the ingestion of medications, psychoactive drugs, or toxins.

Psychotic disorder associated with another medical condition:

Condition that is characterized by hallucinations or delusions and that is the direct result of another physiological disorder, such as stroke or brain tumor.