personality - lecture 9 overview & 10 avoidant/dependent PD

cluster C disorders definition

categorical diagnoses associated with personality characteristics relating to fear and anxiety

what can fear and anxiety result from

having to make decisions/do things on one’s own

being inadequate, criticized, rejected by others

not doing things perfectly resulting in inflexibility

key features of avoidant PD

pervasive pattern of avoidance of interpersonal interactions across different areas of life

underlying feeling of inadequacy and fears of things like criticism, disapproval, rejection, shame

reluctance to engage in new activities that put them at risk of embarrassment or criticism

how many symptoms do you need for a diagnosis of avoidant PD

four or more symptoms like

social inhibition

feelings of inadequacy

hypersensitivity to negative evaluation

what FFM traits are associated with avoidant PD

high neuroticism

low extraversion

what pathological traits are associated with avoidant PD

negative affectivity - anxiousness

detachment

• withdrawal

• anhedonia

• intimacy avoidance

impairment in self-functioning → identity for avoidant PD

low self-esteem (biggest symptom) associated with viewing themselves as socially awkward, unappealing or inferior

excessive feelings of shame

impairment in self-functioning → self direction for avoidant PD

unrealistic standards for behavior associated with reluctance to pursue goals, take personal risks, or engage in new activities involving interpersonal contact

not achieving goals due to fear of embarrassment

what is the difference between avoidant PD and social anxiety disorder

severity and pervasive across time

impairment in interpersonal functioning → empathy for avoidant PD

preoccupation with, and sensitivity to, criticism or rejection, associated with distorted interference of others’ perspectives as negative

• cant read a persons emotions because of preoccupation

impairment in interpersonal functioning → intimacy for avoidant PD

reluctance to get involved with people unless being certain of being liked

diminished mutuality within intimate relationships because of fear of being shamed or ridiculed

how is avoidant PD different than schizoid

in schizoid, social withdrawal is due to a lack of desire

in avoidant, desire for relationships may exist but avoided - they want relationships but avoid due to anxiety.

is the AVPD in the DSM

yes, it was added to DSM-3 and stayed largely unchanged

AVPD etiology (cause)

temperament: shy, isolated, fear of strangers

very high harm avoidance

low novelty seeking - doesn’t seek out new things due to fear of rejection

how are SAD and AVPD similar

intense fear of criticism, humiliation, or rejection, avoid social interactions to prevent embarrassment,

AVPD may be a variant of SAD when

anxiety of social situations are pervasive across multiple situations

begins in later adolescence/early adulthood

self-concept of inadequacy is present

dependent PD key features

pervaisve and excessive need to be taken care of leading to submissiveness, clinging behaviors, and fears of separation

underlying self-perception of being unable to function without the help of others

what is the prevalence of dependent pd

about 0.6-0.49 rare

is dependent PD in the AMPD

Naur, bc its not very prevalent

how many symptoms are needed for a diagnosis of dependent PD

5 or morew

what is the big symptom of dependent PD

urgently seeks another relationship as a source of care and support when a close relationship ends

what FFM traits are associated with dependent PD

high neuroticism

lowish conscientiousness

what pathological traits are associated with dependent PD

negative affectivity

• anxiousness

detachment

• restricted affectivity

• separation insecurity

• submissivments

antagonism

• attention seeking

self functioning - identity for dependent pd

self worth and identity is dependent on others

• looks to others for hobbies, opinions

sense of emptiness and inadequacy when alone

self-fucntioning - self-direction in dependent PD

difficulty making decisions by oneself

defer to others for goal setting (both short (lunch?) and long (kids?) term

interpersonal functioning - empathy in dependent PD

empathy may be fake rather than genuine

• seek to appear empathetic to avoid losing relationships

• ‘people pleasing’

hyperfocus on one’s own needs may lead to misinterpretation of other

interpersonal functioning - intimacy - dependent PD

dependence may lead to ‘clinginess’

may tolerate mistreatment, controlling behaviors, abuse to avoid abandonment

fear of being alone often leads to seeking new romantic relationships following termination

why was DPD almost dropped from DSM-5

rarity and its comorbidity with other disorders

etiology of dependent PD psychodynamic

manifestation of dysfunction from the oral stage of development

etiology of DPD

associated with a fearful attachment style

chronic illness and separation anxiety disorder in childhood/adolescence

potential heritability

what are key differences between separation anxiety and DPD

DPD is long-term and pervasive, dependency on individual may change overtime (like a break up)

Separation anxiety is episodic and can fluctuate over time, the attachment figure is generally consistent

is DPD included in the AMPD

NAUR

why is DPD not included in AMPD

limited empirical support, extensive heterogeneity and comorbidity.

rarity

DPD could be potentially better defined as

‘trait-specific’ dimensional disorder when DPD emerges in the absence of other personality pathology.