Psychopathology: Chapter 10 - Personality Disorders

Flashcards from Chapter 10 Lecture

General features of Personality Disorder include…

chronic interpersonal difficulties, problems with one’s identity or sense of self, and an inability to function adequately in society.

People with personality disorders often cause…

at least as much difficulty in the lives of others as they do in their own lives.

There are how many clusters of personality disorders in DSM-5?

3

Cluster A:

paranoid, schizoid, and schizotypal personality disorders.

Cluster B:

histrionic, narcissistic, antisocial, and borderline personality disorders.

Cluster C:

avoidant, dependent, and obsessive-compulsive personality disorders.

Approximately 1 person in 10…

has a diagnosable personality disorder of some kind.

Which cluster disorders are most common, with a prevalence rate of around 7%?

Cluster C

Diagnostic criteria are

not as sharply defined as they are for most other diagnostic categories.

Unified Dimensional Classification

There is no unified classification of personality disorders.

What are some difficulties in studying the causes of Personality Disorders?

1. Not much is known about what causes development of personality disorders.

2. High level of comorbidity among disorders

3. Biological Factors: infants’ temperament may predispose them to developing particular personality traits and disorders.

Psychodynamic theory of personality disorders:

an infant’s getting excessive versus

insufficient gratification of its impulses in the first few years of life

Learning-based theories of personality disorders:

1. May originate in disturbed parent-child attachment relationships.

2. Early emotional, physical, and sexual abuse may also be important factors.

3. Parent psychopathology and ineffective parenting practices also implicated.

Sociocultural factors of personality disorders:

Social stressors, societal changes and cultural values.

Paranoid Personality Disorder

a mental health condition characterized by a long-term pattern of distrust and suspicion of others, where individuals interpret their actions as intentionally harmful or threatening, even when there is no evidence to support this.

Why is Paranoid Personality Disorders not well studied?

in part because people who are highly suspicious and lacking in trust tend not to want to participate in research studies.

Schizoid Personality Disorder

is a mental health condition characterized by a long-term pattern of detachment from social relationships and a limited range of emotional expression in social settings.

Schizoid personality traits have a heritability rate of:

55%.

Schizotypal Personality Disorder

is a mental health condition characterized by a pervasive pattern of social and interpersonal deficits, marked by acute discomfort with close relationships, and cognitive or perceptual distortions, along with eccentric behavior.

What is the link between Schizotypal Personality Disorder and heritability?

Moderately heritable; has a genetic and biological association with schizophrenia.

histrionic Personality Disorder

is a mental health condition characterized by excessive emotionality and attention-seeking behavior.

Histrionic Personality Disorder has a high comorbidity rate with…

borderline, antisocial, narcissistic, and dependent personality disorder diagnoses.

When it comes to Histrionic Personality Disorder, cognitive theorists…

emphasize the importance of maladaptive schemas revolving around the need for attention to validate self-worth.

Narcissistic Personality Disorder

is a mental condition characterized by an inflated sense of self-importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.

What are the 2 subtypes of Narcissistic Personality Disorder?

Grandiose and Vulnerable.

Grandiose NPD

traits related to extreme grandiosity, aggression, and dominance

▪ Strong tendency to overestimate one’s own abilities and

accomplishments and to underestimate those of others

Vulnerable NPD

Very fragile and unstable sense of self-esteem

▪ Arrogance and condescension is a façade for intense

shame and hypersensitivity to rejection and criticism

▪ May avoid interpersonal relationships for fear of

rejection or criticism

According to the Five-factor Model, Grandiose NPD is

Exceptionally low in neuroticism and high in extraversion.

According to the Five-factor Model, Vulnerable NPD has

very high levels of negative affectivity/neuroticism.

What does the Five-factor model say about BOTH grandiose and vulnerable NPD?

High levels of interpersonal antagonism/low agreeableness, low altruism, and tough-mindedness.

Grandiose NPD is NOT associated with:

childhood abuse, neglect, or poor parenting; some evidence of association with parental overvaluation.

Vulnerable NPD IS associated with:

emotional, physical, and sexual abuse, and with intrusive, controlling, cold parenting styles.

Antisocial Personality Disorder

is a mental health condition characterized by a long-term pattern of disregarding and violating the rights of others.

What are the environmental factors of Antisocial Personality Disorder?

Low family income, inner-city living, poor supervision by parents, having a young mother, being raised in a single-parent family, conflict between parents, having a delinquent sibling, neglect, large family size, and harsh discipline from parents.

What is the Developmental Perspective of Antisocial Personality Disorders (ASPD)?

It has its roots in childhood, especially for boys.

• The number of antisocial behaviors exhibited in childhood

is the single best predictor of who will develop an adult

diagnosis.

• ADHD is often a precursor

Borderline Personality Disorder

is a mental health condition characterized by intense mood swings, unstable relationships, and impulsive behaviors.

What is the central characteristic of Borderline Personality Disorder (BPD)?

Affective instability: unusually intense emotional responses to environmental triggers, slow return to a baseline emotional state.

Impulsivity

Rapid response to environmental triggers without thinking (or caring) about long-term consequences.

High levels of impulsivity combined with extreme affective instability often leads to…

erratic, self-destructive behaviors such as risky sexual behavior or reckless driving.

Around ___ of the population may qualify for the diagnosis of BPD.

1 - 2 %

Up to 75 percent of people with BPD have cognitive symptoms, including:

episodes in which they experience psychotic-like symptoms such as hallucinations, paranoid ideas, or severe dissociative symptoms.

Borderline Personality Disorder - Comorbidity:

• Unusual in that it tends to be comorbid with both internalizing

disorders (such as mood and anxiety disorders) and externalizing

disorders (such as substance use disorders)

• Substantial co-occurrence with other personality disorders, especially

schizotypal, narcissistic, and dependent disorder

Causal Factors of Borderline Personality Disorder - Biological Factors:

Risk of having a BPD diagnosis is four times higher in biological

relatives of patients with BPD

– Genes may account for 40 percent of the variance in the disorder

– Research focus is on genes related to serotonin and dopamine

systems

Causal Factors of Borderline Personality Disorder - Environmental Disorders

• Child maltreatment and other extreme early life

experiences.

▪ Associated with increased neuroticism and greater

openness, as well as less extroversion, agreeableness,

and conscientiousness

▪ May create long-term dysregulation of the HPA axis and

shape brain development

• Increased amygdala activation in emotion-inducing

situations, as well as reduced prefrontal regulation

Avoidant Personality Disorder

a long-term pattern of behavior characterized by extreme shyness, feelings of inadequacy, and hypersensitivity to negative evaluation.

What is the relationship of Avoidant Personality Disorder to other disorders?

• Possibly an extreme form of generalized social anxiety disorder

• Similar to schizoid personality disorder except that there is a

desire for social relationships

What are the two most prevalent and stable features of Antisocial Personality Disorders?

Feeling inept and socially adequate.

Dependent Personality Disorder

a mental health condition characterized by an excessive need to be taken care of by others, leading to submissive and clinging behavior.

What disorders is Dependent Personality Disorders comorbid with?

mood disorders, anxiety disorders, eating disorders, and somatic symptom disorders.

Obsessive-Compulsive Personality Disorder

a personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and control, often at the expense of flexibility, openness, and efficiency.

Unlike OCD, Obsessive-Compulsive Personality Disorders does not have…

true obsessions or compulsive rituals.

What is the Five-factor dimensional approach to Obsessive-Compulsive Personality Disorder?

• Excessively high levels of conscientiousness, leading to extreme

devotion to work, perfectionism, and excessive controlling

behavior

• High on assertiveness (a facet of extraversion)

• Low on compliance (a facet of agreeableness)

Personality Disorders are difficult or easy to treat?

Difficult to treat - enduring, pervasive, inflexible patterns of behavior and inner experience.

What are some goals with treating Personality Disorders?

Reducing subjective distress, changing specific dysfunctional behaviors, and changing whole patterns of behavior or the entire structure of the personality.

What techniques from Cognitive Therapy are used to treat personality disorders?

Monitoring automatic thoughts, challenging faulty logic, and assigning behavioral tasks to challenge dysfunctional beliefs.

What is Dialectical behavior therapy (DBT)?

Cognitive and behavioral therapy specifically adapted for BPD.

What are some characteristics of Dialectal Behavior Therapy (DBT)?

• Encourages patients to accept negative affect without engaging in self-destructive or other maladaptive behaviors

• Problem-focused and based on a clear hierarchy of goals

• Prioritizes decreasing suicidal and self-injurious behavior and increasing coping skills

• Combines individual and group components as well as phone coaching

What is the goal of Transference-Focused Therapy?

Strengthening weak egos, with a particular focus on the primary primitive defense mechanism of splitting.

What is Mentalization?

A new therapeutic approach developed by Bateman and Fonagy that helps patients develop skills to accurately understand their own feelings and emotions as well as others’ feelings and emotions.

What are some treatments of Cluster C disorders?

• Active and confrontational short-term therapy shows

improvement.

• Cognitive-behavior and psychodynamic therapies

have also been shown to result in significant and

lasting treatment gains.

• Antidepressants from the MAO I and SSRI categories

may sometimes help in treating avoidant personality

disorder

Psychopathology was initially called …

Sociopathic Personality

Psychopathy can be best understand by which four dimensions?

1. Interpersonal

2. Affective

3. Lifestyle

4. Antisocial

What are the biological differences between “successful” and “unsuccessful” psychopaths?

• Differences in cardiac reactivity and information

processing

• Differences in brain structure and function, including

prefrontal cortex and amygdala