PSYC 212: Exam 4: Chapt 9

What is required for something to be a personality disorder?

• Disturbance in at least 2 of the following areas:

  • Cognition 

  • Affect/Emotion

  • Interpersonal functioning

  • Impulse control

• Occur across contexts

• Emerges by early adulthood and is maintained over time (non-episodic)

• At least 18

What makes personality different from a personality disorder?

A personality disorder markedly from the expectations of one’s culture

What does it mean for a disorder to be ego-syntonic?

The person has poor insight into their illness because their symptoms are viewed as “natural” to the person

What are the Cluster A Personality Disorders?

Odd/Eccentric Cluster:

• Paranoid personality disorder

• Schizoid  personality disorder

• Schizotypal personality disorder

What are the Cluster B Personality Disorders?

Erratic/Dramatic:

• Histrionic personality disorder

• Narcissistic personality disorder

• Borderline personality disorder

• Antisocial personality disorder

What are the Cluster C Personality Disorders?

Anxious/Fearful:

• Avoidant personality disorder

• Dependent personality disorder

• Obsessive-compulsive personality disorder

What are the symptoms of Paranoid personality disorder?

4 Needed

• Suspects people are exploiting, harming, deceiving them

• Doubts trustworthiness & loyalty of others

• Find threatening hidden meaning in benign comments

• Reluctant to confide in others

• Hold grudges

• Unjustly perceives others as attacking their character

• Recurrent suspicion regarding partner’s fidelity (unfounded)

What are the symptoms of Schizoid personality disorder?

4 Needed

• Does not desire or enjoy close relationships

• Lacks close friends or confidants

• Little or no interest in sexual experiences with others

• Prefers solitary activities

• Finds pleasure in few activities

• Emotionally cold, detached, or flat

What are the symptoms of Schizotypal personality disorder?

5 Needed

• Odd or eccentric behavior

• Inappropriate or constricted affect

• Unusual perceptual experiences (e.g., bodily illusions)

• Odd beliefs/magical thinking (e.g., ideas of reference)

• Odd thought expression/speech (e.g., vague, metaphorical, overelaborated, circumstantial)

• Suspicious or paranoid thinking

• Social anxiety related to paranoid fears that does not diminish with familiarity

• Lacks close friends or confidants (they do want relationships, but they often know people find them weird)

What are the symptoms of Histrionic personality disorder?

5 Needed

• Uncomfortable when not the center of attention

• Uses appearance to draw attention to oneself

• Inappropriate sexually seductive/provocative behavior

• Considers relationships to be more intimate than they are

• Highly suggestive/easily influenced by others

  • Part of the theory is that they don’t really know who they are so they’re leaning into the other people

• Rapidly shifting, shallow emotional expression

• Impressionistic speech that lacks real detail

• Theatrical, exaggerated expression of emotion

What are the symptoms of Narcissistic personality disorder?

5 Needed

• Grandiose sense of self

• Fantasizes about power/status, beauty, achievements

• Belief in their specialness, can only be understood by or associate with other special people

• Arrogant, haughty behavior/attitudes

• Needs excessive admiration

• Interpersonally exploitative

• Envious; believes others envy them

• Lacks empathy for others

What are the symptoms of Borderline personality disorder?

5 Needed

• Frantic efforts to avoid abandonment

• Unstable, intense relationships (idealization/devaluation)

• Unstable self-image (e.g., not knowing self outside of others)

• Chronic feelings of emptiness

• Transient, stress-related paranoia or dissociation

• Affective instability

• Inappropriate, intense, or difficult to control anger

• Impulsive behavior (e.g., sex, substance use, spending)

• Recurrent suicidal or self-injurious behavior

What are the symptoms of Antisocial personality disorder?

3 Needed

• Not conforming to social norms (grounds for arrest)

• Reckless disregard for the safety of self/others

• Deceitfulness (lying, aliases, cons)

  • Lying can almost be a pride

• Lack of remorse

• Impulsivity/failure to plan ahead

  • Unrealistic expectations about what will happen

• Consistent irresponsibility

  • Job, child support, etc.

• Irritability or aggressiveness

What are the symptoms of Avoidant personality disorder?

4 Needed

• Avoids work settings with significant interpersonal interaction, to avoid criticism, negative feedback, etc.

• Inhibited in new social settings due to perceived inadequacy

• Unwilling to get involved unless certain of being liked

• Preoccupied with being criticized/rejected in social situations

• Reluctant to try new things for fear of embarrassing oneself

• Restrained in intimate relationships for fear of shame/ridicule

• Views self as socially inept, personally unappealing, inferior

What are the symptoms of Dependent personality disorder?

5 Needed

• Afraid of being left to take care of oneself

• Urgently seeks new relationships when one ends

• Excessive lengths to get nurturance/support

• Feels helpless when alone

• Difficulty making decisions without advice/reassurance

• Difficulty initiating tasks on one’s own

• Needs others to assume responsibility for their life

• Difficulty expressing disagreement for fear of loss of support

What are the symptoms of Obsessive-compulsive personality disorder?

4 Needed

• Excessive devotion to work, at expense of other life domains

• Reluctant to delegate tasks or work with others, unless they do exactly as the person says

• Perfectionism that interferes with task completion

• Preoccupied with details, rules, order, schedules, etc.

• Scrupulous/inflexible about morals, ethics, values

• Excessive stubbornness and rigidity

• Miserly; always saving for future catastrophes

• Hoarding behavior

What areas are impacted by Paranoid personality disorder?

Cognition and interpersonal functioning

What areas are impacted by Schizoid personality disorder?

Affect/emotion and interpersonal functioning

What areas are impacted by Schizotypal personality disorder?

Cognition, Affect/emotion, Interpersonal functioning

What areas are impacted by Histrionic personality disorder?

Affect/emotion, interpersonal functioning, and impulses

What areas are impacted by Narcissistic personality disorder?

Cognition, affect/emotion (little less), interpersonal functioning

What areas are impacted by Borderline personality disorder?

interpersonal functioning, affect/emotion, cognition, impulses

What areas are impacted by Antisocial personality disorder?

Interpersonal functioning, impulses, affect/emotions

What areas are impacted by Avoidant personality disorder?

interpersonal functioning, affect/emotion, cognition

What areas are impacted by Dependent personality disorder?

cognition, interpersonal functioning, affect/emotion

What areas are impacted by Obsessive-compulsive personality disorder?

Cognition, interpersonal functioning, impulses (LOW end of impulsivity; NOT impulsive)

What is Paranoid personality disorder?

A pervasive mistrust and suspiciousness of others such that their motives are interpreted as malevolent

What is Schizoid personality disorder?

A pervasive pattern of detachment from social relationships and restricted range of expression of emotions in interpersonal settings

What is Schizotypal personality disorder?

A pervasive pattern of interpersonal and social deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior

What is Histrionic personality disorder?

Pervasive pattern of excessive emotionality and attention-seeking behavior

What is Narcissistic personality disorder?

Pervasive grandiosity, need for admiration, and lack of empathy

What is Borderline personality disorder?

Pervasive instability of self-concept, affect, relationships, as well as impulsivity

What is Antisocial personality disorder?

Pervasive disregard for and violation others’ rights

What is Avoidant personality disorder?

Pervasive social inhibition, feelings of inadequacy, and fears of negative evaluation

What is Dependent personality disorder?

Pervasive/excessive need to be cared for that leads to submissive or clingy behavior and fears of separation

What is Obsessive-compulsive personality disorder?

Pervasive preoccupation with orderliness, perfectionism, and mental & interpersonal control

What childhood diagnosis is required for Antisocial personality disorder?

Conduct Disorder

• Based on actions prior to age 15

• Essentially, juvenile delinquency, aggression, and callousness

Which Cluster A: Odd/Eccentric Cluster disorders are slightly more common in men?

Schizoid PD and Schizotypal PD

What may be an endophenotype for Schizotypal PD?

Problems with smooth-eye pursuit

What is the etiology for Schizotypal PD?

• Genetic predisposition

• Deficits in Theory of Mind

• Associated with childhood maltreatment

What are treatments for Schizotypal PD?

• Low doses of antipsychotic meds

• Social skills training

• CBT

Often don’t come in for treatment or drop out early

What does the Biopsychosocial Theory say contributes to BPD?

• Genetic predisposition

  • Emotional vulnerability

• Invalidating environments

• Emotion dysregulation

What are the treatments for BPD?

• Medications such as SSRIs, mood stabilizers, and anticonvulsants

• Dialectical Behavior Therapy

  • Weekly individual sessions

  • Weekly skills training group

  • 24/7 coaching calls (brief)

  • Team consultation

What PD is highly comorbid with Substance Use Disorder?

Antisocial Personality Disorder

Which symptoms does ASPD have in common with Psychopathy?

Mostly Factor 2

What % of people with ASPD are psychopaths?

20-38%

What contributes to ASPD?

Gene x Environment Interaction and Reciprocal Causality

What is the gender prevalence of Cluster B: Erratic/Dramatic disorders?

Histrionic - N/A

Narcissists - Slightly more common in men

Borderline - More common in women

Antisocial - 3x more common in men

What is the gender prevalence of Cluster C: Anxious/Fearful disorders?

Avoidant - More common in women

Dependent - More common in women

OCDP - More common in men

How old do you have to be to get a PD diagnosis and how many years of symptoms do we look for?

18, 2 years