Abnormal Psych Exam 3

interpersonal perspective

personality is best conceptualized as the social product of interactions with significant others. Personality cannot be understood from the inside out, it develops in the context of interpersonal relationships

Harry Stack Sullivan

Father of interpersonal perspective. His main contribution was that medical disorders manifest through the individual, and mental disorders are crated through maladaptieve patterns of social interaction and communication.

Sullivan definition of personality

The recurrent set of interpersonal situations which characterize a person’s life. He felt that only a concept of the self exists and it is continuously being defined by and redefined by the interpersonal communications of others.

Consequences of sullivans approach bridge psychology with existentialism

We are never exactly sure who and what we are. The self concept is a collection of probabilistic hypotheses. Existentialism is the idea that we exist and then we define ourselves. Interpersonalism is the idea that others are essential to the formation of our self identity.

Timothy Leary first level of personality

public communication (what is observable and objective in interpersonal behavior)

Timothy Leary second level of personality

conscious description (expresssed through the verbal content of statements made about the self or others)

Timothy Leary third level of personality

private symbolization (concerned with preconscious and unconscious attributions that are expressed through projective indirect fantasy materials)

Timothy Leary fourth level of personality

unexpressed unconscious (issues that are censored from consciousness and systematically and compulsively avoided by the subject at all other levels of personality)

Timothy Leary fifth level of personality

values (expressed not only in the ego ideal, but in the standards through which self and others are judged)

Interpersonal circumplex (Timothy Leary)

Often called the interpersonal circle and differs from the DSM categorical representation of disorders. Each personality shades onto its neighbors. Crosses content dimensions of dominance and affiliation with each personality receiving a different name and unique blend of the two. Segments near each other are closely related and those opposite are opposite in real life.

complementarity

Our interpersonal actions are designed to invite, pull, elicit, draw, entice, or envoke restricted classes of reactions from persons with whom we interact especially from significant others. Each interpersonal bid is intended to implicitly exclude invalidating responses.

Complementarity and the circumplex

Behaviors are considered complementary when on opposite sides of the vertical axis (control) and same sides on the horizontal axis (affiliation)

Normality to Abnormality

The social reality associated with any particular interpersonal style evokes responses that confirm that reality which results in a self fulfilling prophecy. For those with personality disorders this is often the result of a vicious circle: only one type of response from others is seen as validating and sought from interpersonal interactions.

Goldwater rule

amongst psychiatrists in that they do not diagnose famous people (those in which they have never met)

Avoidant personality disorder: key conflict

Desire to be close to others and live up to their intellectual and vocational potential, with a fear of being hurt, rejected, and unsuccessful.

Avoidant personality disorder: self view

Socially inept and incompetent in academic or work situations

Avoidant personality disorder: view of others

they see others as potentially critical, uninterested, and demeaning

Avoidant personality disorder: beliefs

“I am no good”, “I am worthless”, “I am unlovable”

Avoidant personality disorder: threats

being discovered to be a fraud and being put down, demand, or rejected

Avoidant personality disorder: strategy

To avoid situations in which they could be evaluated. They tend to hang back in social groups and avoid attracting attention. They avoid taking on new responsibilities at work or seeking advancement.

Avoidant personality disorder: affect

dysphoria, a combination of anxiety and sadness. Related to deficits in obtaining the pleasures they would like to receive from close relationships and a sense of mastery

Dependent personality disorder: key feature

Picture themselves as helpless and therefore try to attach themselves to some stronger figure who will provide resources for their survival and happiness.

Dependent personality disorder: self view

Needy, weal, helpless, and incompetent

Dependent personality disorder: view of others

See the strong caretaker in an idealized way. Nurturing, supportive, and competent. Can function quite well as long as the strong figure is accessible.

Dependent personality disorder: beliefs

“I need other people - specifically a strong person in order to survive”. Their happiness depends on having such a figure available. They need a steady, uninterrupted flow of support and encouragement.

dependent personality disorder: threats

rejection and or abandonment

Dependent personality disorder: strategy

cultivate a dependent relationship or subordinate themselves to a strong figure and trying to placate or please the person

dependent personality disorder: affect

anxiety - concern over possible disruption of the dependent relationship. Anxiety is heightened when they perceive that the relationship is strained or may sink into a depression if the figure is removed. Gratification and or euphoria when their dependent wishes are granted.

obsessive compulsive personality disorder: key feature

Control and should are key words and to them orderliness is godliness

OCPD: self view

as responsible for themselves and others. They believe that they can only depend on themselves to see that things get done. They are accountable for their own perfectionistic conscience. They are driven by shoulds. Core image of the self as inept or helpless.

OCPD: view of others

see others as too casual, often irresponsible, self indulgent, or incompetent. Liberally apply shoulds to others in attempt to shore up their own weaknesses.

OCPD: beliefs

I could be overwhelmed, I am basically disorganized or disoriented, I need order, systems, and rules in order to survive.

OCPD: threats

flaws, mistakes, disorganization, and imperfections. They also tend to catastrophize.

OCPD: strategy

in applying rules, they evaluate and rate other people’s performance as well as their own

OCPD: Affect

Prone to experience regrets, disappointment, and anger towards self and others. Anxiety or anger in anticipation of substandard performance. Depression when serious failure occurs.

Antisocial personality disorder: key feature

Many forms varying from conniving, manipulating, and exploiting to direct attack.

Antisocial personality disorder: self view

As longers, autonomous, and strong. Some see themselves as abused and mistreated by society. Some cast themselves in the predatory role in a dog eat dog world.

Antisocial personality disorder: view of others

See others as exploitative and thus deserving to be exploited in retaliation. Can also view others as weak and vulnerable, thus deserving to be preyed upon.

Antisocial personality disorder: Beliefs

I need to look out for myself, I need to be the aggressor or I will be the victim

Antisocial personality disorder: strategy

overt antisocials will openly attack, rob, and defraud others. Subtle antisocials (con artists) seek to inveigle others and exploit or defraud them.

Antisocial personality disorder: affect

anger over injustice that other people have possessions that they deserve

Narcissistic personality disorder: key feature

self aggrandizement

Narcissistic personality disorder: self view

as special and unique - almost as princes or princesses. Consider selves superior and entitled to special favors and favorable treatment. Above rules that govern other people.

Narcissistic personality disorder: view of others

As inferior. Sees selves as prestigious and elevated above the average person. See others as their vassals and potential admirers. Seek recognition from others in order to document their own grandiosity and preserve their superior status.

Narcissistic personality disorder: beliefs

Since I am special I deserve special dispensations, priveleges, and prerogatives. I am superior to others and they should acknowledge this. I am above the rules.

Narcissistic personality disorder: strategy

Plans revolve around activities that can reinforce their superior status and expand their personal domain. They seek glory, wealth, position, power, and prestige. Tend to be highly competitive with others who claim an equally high status.

Narcissistic personality disorder: Affect

Anger when others do not accord them to the admiration or respect they believe they are entitled to and prone to depression if strategies are foiled.

Histrionic personality disorder: key feature

expressiveness. tendency to dramatize or romanticize all situations. Trying to impress or captivate others.

Histrionic personality disorder: self view

As glamorous, impressive, and deserving of attention

Histrionic personality disorder: view of others

Favorably, as long as they can elicit their attention, amusement, and affection. Self esteem depends on their receiving continuous expressions of appreciation. Are more involved with interpersonal interactions than those with narcissistic personality disorder.

Histrionic personality disorder: beliefs

I am basically unattractive and i need other people to admire me in order to be happy.

Histrionic personality disorder: strategy

To use dramatics and demonstrativeness to bind people to them. When they do not succeed, they believe they are being treated unfairly. Coerce compliance through expressions of pain and anger.

Histrionic personality disorder: Affect

Gaiety mixed with mirth when successful in engaging other people. Undercurrent of anxiety reflecting their fear of rejection.

Schizoid personality disorder: key feature

isolation, the embodiment of the autonomous personality. Willing to sacrifice intimacy to preserve detachment and autonomy

Schizoid personality disorder: self view

As self sufficient and as longers, prize mobility, independence, and solitary pursuits

Schizoid personality disorder: view of others

As intrusive and controlling

Schizoid personality disorder: beliefs

I am basically alone, close relationships with other people are unrewarding and messy, I can do things better if I am not encumbered by other people, close relationships are undesirable because they interfere with my freedom of action.

Schizoid personality disorder: strategy

to keep their distance from other people, insofar as this is feasible.

Schizoid personality disorder: affect

Sadness, as long as they keep their distance and are anxious when forced into an encounter.

type of person with avoidant personality disorder

students in class who want to participate but do not say anything out of fear of judgement, someone at a party who shows up early/stays late but spends most of their time in the corner, those with one or two trusted friends

Avoidant personality disorder and isolation

Person is not content with the isolated way of life. The pain from loneliness and seclusion hurts them. They would rather be alone than be vulnerable to the social humiliation. They resist life change that could bring them into the public eye.

Avoidant personality disorder DSM definition

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four or more of the criterion.

Avoidant personality disorder criterion #1

Avoiding occupational activities that involve significant interpersonal contact

Avoidant personality disorder criterion #2

Unwilling to get involved with people unless certain of being liked. Insecurities constitute their perceived reality, thickness of outer shell does not make it less fragile.

Avoidant personality disorder criterion #3

Shows restraint within intimate relationships due to fear of being shamed or ridiculed

Avoidant personality disorder criterion #4

preoccupied with being criticized or rejected in social situations

Avoidant personality disorder criterion #5

is inhibited in new interpersonal situations because of feelings of inadequacy

Avoidant personality disorder criterion #6

views self as socially inept, personally unappealing or inferior to others

Avoidant personality disorder criterion #7

Unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing which results in stagnation

Underlying assumptions of avoidant personality disorder

Not all children with critical or rejecting significant others become avoidant

Avoidant personality disorder fear of rejection

Avoidants make the error of assuming that others will react to them in the same negative way as a critically significant other did. Prediction of rejection causes dysphoria which itself is extremely painful.

Avoidant personality disorder and self criticism

Avoidant patients experience a string of self critical automatic thoughts that happen in social situations as well as anticipated encounters . Thoughts are rarely evaluated but produce dysphoria

Schizoid personality disorder DSM definition

a pervasive pattern of detachment from social relationships and a restricted range of expression of emotion in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four or more of the following criterion

Schizoid personality disorder criterion #1

Neither desires nor enjoys close relationships, including being part of a family. This is the fundamental difference between all other personality disorders. They want to be alone.

Schizoid personality disorder criterion #2

Almost always chooses solitary activities. Individuals are simply indifferent and often sense that a response is desired but do not know how to respond appropriately or have no desire.

Schizoid personality disorder criterion #3

Has little if any interest in having sexual experiences with another person. They have a drive but prefer self induced arousal.

Schizoid personality disorder criterion #4

Lacks close friends or confidants other than first degree relatives. Central theme of detachment from human relationships.

Schizoid personality disorder criterion #5

Takes pleasure in few if any activities. Lifestyles lack fascination, immersion, intimacy etc.

Schizoid personality disorder criterion #6

Appears indifferent to the praise or criticism of others

Schizoid personality disorder criterion #7

Shows emotional coldness, detachment, or flattened affectivity. Introverted.

In order to give a diagnosis of schizoid when comorbid with delusional or other mood disorders

The personality disorder must have been present before the onset of psychotic symptoms. The personality disorder must persist with the psychotic symptoms are in remission.

Difference between avoidant and schizoid

Avoidant personalities avoid relationships due to a fear of rejection whereas schizoids fear criticism but do not have the desire for relationships in general

Schizoid is seen as the reverse of which other personality disorder?

Histrionic

Core beliefs and assumptions of Schizoids

I am different/loner/oddity etc, if I try and befriend others they will notice and ridicule me, I dont fit in (this leads them to avoid all contact with others)

Dependent personality disorder

Individuals who are caring, committed to their personal relationships, live their lives for others, have a passive role in relationships

Dependent personality self feelings

Underneath the surface they see themselves as helpless and fear doing anything on their own. They seek people who help them. They are incapable of making routine decisions without getting advice from another.

Dependent personality disorder DSM definition

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts as indicated by five or more of the following criterion

Dependent personality disorder criterion #1

Difficulty making everyday decisions without an excessive amount of advice and reassurance from others. The style is one who seeks out opinions of others but makes the decision based on their own analysis.

Dependent personality disorder criterion #2

Needs others to assume the responsibility for most major areas of his or her life. Self perpetuating. The style is when they are comforted by the support of others but can preform well without them.

Dependent personality disorder criterion #3

Has difficulty expressing disagreement with others because of fear of loss of support/approval. the style here is preferring interpersonal harmony but also being able to speak up when necessary.

Dependent personality disorder criterion #4

Has difficulty initiating projects or doing things on his or her own. The disorder here is a lack of confidence to start new protects or carry out their own responsibilities. The style is one being capable of functioning independently but they prefer to work with others.

Dependent personality disorder criterion #5

Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant. The disorder is when one desires nurturance and support to do the unpleasant. The style is when one is considerate and occasionally self sacrifices.

Dependent personality disorder DSM criterion #6

Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself. The style for this one is someone who prefers the company of others but can enjoy being alone.

Dependent personality disorder criterion #7

Urgently seeks another relationship as a source of care and support when a close relationship ends. The style here is nostalgic about lost intimacy but they do not immediately seek to merge.

Dependent personality disorder criterion #8

Unrealistically preoccupied with fears of being left to take care of himself or herself. The style here is enjoying the affection of others as expressed through thoughtfulness.

devoted dependent style

caring and solicitous putting welfare of others first

Agreeing dependent personality style

built around cooperativeness, consideration, and amiability

histrionic personality disorder DSM definition

A pervasive pattern of excessive emotionally and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the criterion

histrionic personality disorder criterion #1

Is uncomfortable in situations in which he or she is not the center of attention. Thoughts and behaviors depend on attention.

histrionic personality disorder criterion #2

interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.