PSYC Quiz 5

personality disorders

psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning

Ego-dystonic

a disorder where the individual perceives the symptoms to be undesirable--making them more likely to seek treatment

Ego-syntonic

the individual perceives her behavior as correct, normal, or in harmony with her goals--less likely to seek treatment

3-5

Average number of comorbid personality disorders amongst people who have a personality disorder

ocean

- Big give personalty traits

- openness, conscientiousness, extraversion, agreeableness, neuroticism

- Extreme on either end could indicates personality disorder

openess/closedness

the tension between the desire to share private thoughts, feelings, and experiences with intimates and the desire to preserve personal privacy

Conscientousness/carelesness

someone who is responsible, dependable, persistent, and organized

Extraversion/Introversion

The extent to which people are social or unsocial, talkative or quiet, affectionate or reserved

agreeableness/antagonism

softhearted or ruthless, trusting or suspicious, helpful or uncooperative

Neuroticism/emotional stability

calm or anxious, secure or insecure, self-satisfied or self-pitying

categorical classification

- Most commonly used

- A system of placing disorders in categories with the assumption that each disorder is clearly different from every other disorder

-"all-or-none" approach.

- Based on the model in which every diagnosis has a distinct set of characteristics and underlying cause.

dimensional model

model in which a mental disorder differs from normal functioning in degree rather than kind. Not broadly used

Cluster A disorders

Odd or eccentric traits, socially isolated behavior. (not the same as schizophrenia). Schizoid and schizotypal are v. comorbid.

- Paranoid

- Schizoid

- Schizotypal

paranoid personality disorder

A personality disorder marked by a pattern of distrust and suspiciousness of others, with no justification. Applies to all aspects of life. (4+ symptoms)

- Reluctance to confide in others

- Reads hidden meanings in benign actions

- Holds long grudges,

- Doubts loyalty of others,

- Thinks others are lying

- Jealous and suspicious

schizoid personality disorder

detachment from social relationships and restricted range of emotional expression (4+ symptoms)

- Doesn't want/like social relationships.

- Almost always chooses solitary activities

- Little if any interest in sex

- Takes pleasure in few if any activities

- Indifferent to praise/criticism

- Lacks close friendships other than direct relatives

- Coldness, detachment, flat affect

Schizotypical Personality Disorder

Interpersonal and social defects with discomfort and reduced capacity for relationships, cognitive or perceptual distortions, eccentric behavior (not to level of psychosis). Needs 4+ symp.

Cognitive Symptoms

- Odd beliefs and magical thinking

- Ideas of reference

-Unusual perceptual experiences.

Interpersonal Symptoms

- Suspiciousness/paranoid thinking

- Lack of close relationships

- Social anxiety

- Inappropriate affect

Disorganized symptoms

- Odd speech and behavior

theory of mind

people's ideas about their own and others' mental states—about their feelings, perceptions, and thoughts, and the behaviors these might predict.

Cluster B personality disorders

Dramatic, Emotional, Erratic behavior

- antisocial, borderline, histrionic, narcissistic personality disorders

antisocial personality disorder

Disregard for safety/rights of others. Does not exhibit prosocial behavior. Must be 18 or older, and have history of conduct disorder by age 15. 3+ symptoms

- Disrespect to laws

- Manipulative/deceitful

- Impulsive

- Irratibility/aggression

- Reckless disregard for safety of self/others

- Doesn't take responsibility

- Lack of remorse

learning deficits

Antisocial pd and Psychopathy causes difficulties learning about emotions and consequences

-Hypothesis 1: Emotional deficits causes a lack of fear of punishment.

- Hypothesis 2: Can't think about longterm consequences, which makes them impulsive.

borderline personality disorder

condition marked by extreme instability in mood, identity, and impulse control. Higher diagnosis in women. Needs 5+ symptoms.

- Frantically avoids abandonment

- Intense unstable relationships that range between extreme idealization and devaluation

- Unstable self-image, doesn't know who they are.

- Impulsive, can be hedonistic,

- Out of proportion reactivity of mood

- Chronic feelings of emptiness, needs to be completed.

- Inappropriate intense anger.

- Recurrent suicidal behavior/self harm

- Stress related paranoia and dissociative symptoms

histrionic personality disorder

excessive emotionality and attention seeking. Almost always diagnosed in women. Needs 5+ symptoms

- Uncomfortable when not center attention

- Rapidly shifting/shallow emotions

- Uses appearance to get attention

- Impressionistic speech w/out detail

- Theatrical, dramatic emotion

- Suggestible, easily influenced

- Thinks relationships are more intimate than they are, lacks inhibition

Narcisstic Personality Disorder

grandiosity, need for admiration, lack of empathy. Needs 5+ symptoms

- Grandiose self worth

- Fantasies of unlimited success

- Tries to only associate w/ people of high status

- Needs lots of admiration

- Entitled

- Uses others for gain

- Lacks empathy

- Jealous, or thinks others are jealous

- Arrogant, looks down on others

Etiology of Cluster A

-highly heritable

-links to schizophrenia: relatives of individuals with schizophrenia at greater risk for schizotypal

-enlarged ventricles, less grey matter

- Imaipred theory of mind

- Childhood abuse/neglect

Treatment of Cluster A PDs

Cluster A PD's are characterized by reluctance to seek treatment

- Paranoid: Create trust environment, challenge irrational thoughts.

- Schizoid: Work on social skills.

- Schizotypal: Low dose antipsychotics, CBT, family/life skills training.

Psychological/Social Factors for BPD

- Core feature is emotional dysregulation

- Lower threshold to activate emotion, feels more intense, takes a while to get back to baseline.

- Engages in dangerous self-soothing activities

- Invalidating or abusive early environments

Neurological factors for BPD

HYPERactive amygdala

HYPOactive frontal lobe

Low sertotonin

dialectical behavior therapy

Extreme, holistic CBT. A form of treatment in which the focus is on getting people to accept who they are, and know change must occur.

- Work on emotional regulation

- Tolerate distress

- Interpersonal effectiveness

- Emotional regulation

grandiose vs vulnerable narcissism

Grandiose: higher self esteem, exhibitionism

Vulnerable: Insecure, depressed, reactive aggression. "Why don't people like me",

treatment for narcism

Often go because of bad relationships, develop depression.

- Negative feedback

- Appropriate career goals

- Challenge self-worth

Cluster C disorders

anxious and fearful behavior

Avoidant, dependent, obsessive-compulsive disorders

- Least studied, has little comorbidity

avoidant personality disorder

a personality disorder characterized by inhibition in social situations; feelings of inadequacy; oversensitivity to criticism. Needs 4+ symptoms

- Avoids interpersonal job activities

- Not willing to be involved in with others unless certain of being liked.

- Restraint in relationships for fear of shame

- Preoccupied with shame/rejection in social situations

- Inhibited in new social situations

- Views self as inept, unappealing, inferior

- Won't try new things for fear of embarrassment.

Epidemiology of Avoidant PD

higher in women, starts in early childhood. Worst reported quality of life.

Treated with group CBT, best treated personality disorder.

Avoidant PD vs. Social Phobia

Avoidant PD can be more severe.

- Increased social withdrawal.

- Fewer friends

- Nonspecific, generalized.

dependent personality disorder

a personality disorder characterized by helplessness; excessive need to be taken care of; submissive and clinging behavior; pervasive insecurity. 5+ symptoms.

- Difficulties making both major and minor decisions.

- Needs others to be responsible for life.

- Won't express disagreement for fear of disapproval.

- Can't start projects on their own, lacks confidence in self

- Goes to extreme lengths to be nurtured.

- Feels helpless when alone, fear of unable to care of self

- Urgently seeks relationships when one ends.

- Unrealistically afraid of having to take care of self,

obsessive-compulsive personality disorder

preoccupation with orderliness, perfection, and control. Can't tolerate uncertainty. Needs 4+ symptoms

- Preoccupied w/ lists, rules

- Perfectionism interferes w/ task completion

- Neglects loved ones for work

- Rigid and stubborn

- Over concerned w/ rules

- Can't discard worthless objects

- Refuses to delefate tasks.

- Very frugal spending style

epidemiology/treatment dependent pd

More common in women. For treatment, clinician can't be nurturer. Difficult to prescribe homework between sessions.

epidemiology/treatment of obsessive compulsive pd

No gender differences. Treatment addresses need for control, relaxation techniques

OCPD vs OCD

NOT COMORBID

OCPD - Enjoys being organized, feels relaxed when done

OCD - Doesn't enjoy compulsions, unwanted and intrusive, rigid. Thinks matter of life and death

Antisocial PD vs. Psychopathy

Psychopathy is more expansive than ASPD. Not all people with ASPD are psychopaths, but all psychopaths have ASPD

Psychopathy: parasitic lifestyle, doesn't plan for future, superficial charm.

Both: Diminished empathy response, irresponsibility

Antisocial vs borderline personality disorder

ASPD: Abandons people, father can be risk factor

BPD: Idolizes people then devalues them, dysphoric and dissociative symptoms, family dysfunction is risk factor

Both: Impulsive, criminality runs in family, burns out with age, hard to treat.