psychopathology final exam

What defines a personality disorder?

a mental health condition defined by long term inflexible patterns of thinking, feeling, and behaving that deviate significantly from norms. These ingrained, maladaptive patterns usually emerge in adolescence, cause distress in social/work life and affect emotional regulation and relationship functioning.

criteria to diagnose a personality disorder

displays a long-term rigid and wide range pattern of inner experience and behavior that leads to dysfunction in at least 2 of the following realms:

1. cognition (ways of perceiving and interpreting self, other people, and events)

2. emotions (range intensity, appropriateness of response)

3. social interactions

4. impulsive control

How many clusters of personality disorders in the DSM?

Cluster A B and C

Odd or Eccentric - Cluster A of personality disorders in DSM

paranoid, schizoid, and schiztypical

Dramatic, emotions, or erratic behavior - Cluster B of personality disorders in DSM

antisocial borderline, narcissitic, and histornic

Anxious or fearful cluster - Cluster C of personality disorders in DSM

avoidant, depedent, and obsessive compulsive

Paranoid Personality disorder

• Cluster A

• deep distrustful and suspicious of others

• may think others are lying, using them, or trying to harm them

• hold grudges

• read hidden insults into harmless comments

• be jealous or suspicious without good reason

• “everyone is out to get me”

Schizoid personality disorder signs

• in cluster A

• detached from relationships and shows little emotion

• may prefer being alone

• not want close relationships

• seem emotionally cold or flat

• not care much about praise or criticism

• “i do not really want relationships”

schizotypal personality disorder signs

• cluster A

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

• Individuals believe unrelated events pertain to them in important ways (ideas of reference)

  • thinking news reports have secret messages for them

• Odd beliefs or magical thinking that influences behavior (e.g. telepathy, “sixth sense”)

  • Think they can read minds or predict future

• Unusual perceptual experiences

  • Sensing presence of absent people

  • Hearing their name being called when alone

• Speech may include unusual phrasing

• Behavior or appearance that is odd, eccentric, or peculia

• Lack of close friends 

• Slightly more common in males than females

Antisocial personality disorder signs

• main criteria: violates others’ rights and shows little remorse

• may lie, steal, manipulate, or break laws

• act aggressively or impulsively

• be irresponsible

• lack of guilt or remorse

• usually must be 18 or older with evidence of conduct disorder before age 15

• “I hurt people or break rules and do not care”

borderline personality disorder signs

• main criteria: unstable relationships, mood, identity, and fear of abandonment

• may fear being abandoned

• have intense, unstable relationships

• feel empty

• have rapid mood shifts

• act impulsively

• self harm or threaten suicide

• switch between idealizing and devaluing people

• “i hate you, don’t leave me”

histronic personality disorder signs

• main criteria: excessive emotion and attention

• act dramatic or theatrical

• use appearance to get attention

• be overly flirtatious or seductive

• think relationships are closer than they are

• “look at me”

narcisstic personality disorder signs

• cluster B

• main criteria is grandiosity, need for admiration, and lack of empathy

• feel superior or special

• need constant praise

• exaggerate achievements

• expects special treatment

• envy others or believe others evny them

• lack empathy

Avoidant personality disorder cluster C

• main criteria is social inhibition, feelings of inadequacy, and fear of rejection

• avoid social situations because fear of critcism

• feel not good enough

categorical versus diemsional approach to personality disorders

• DSM is very categorical right now. dimensional would be a better approach

• personality disorders trait specified and specify what traits the person is showing and to what degree.

• Big 5 theory of personality traits (OCEAN)

  • O = openness

  • C - conscientiousness

  • E = extraversion

  • A= agreeableness

  • N.= neuroticism

Separation anxiety disorder

• Main symptoms: extreme fear or anxiety about being away from a parent/caregiver or home. 

• Key difference: main issue is fear of being separated from attachment figures

disruptive mood dysregulation disorder

• main symptoms: severe, repeated temper outbursts plus a constant irritability or angry mood

• key difference: chronic irritability and explosive mood outbursts, not just defiance

oppositional defiant disorder

• main symptoms: angry, argumentative, defiant behavior towards authority figures

• key difference: ODD if mainly defiance and hostility, but it does not usually involve serious hard or major rule breaking

conduct disorder

• main symptoms: serious violation of the rules or rights of others

• key difference: more severe than ODD because it involves aggression, cruelty, stealing, destruction, or serious rule violations

ADHD

• main symptoms: problems with attention, hyperactivity, and impulsivity

• key difference: mainly about attention, impulse control, and activity level, not purposefully being bad or defiant

autism

main symptoms: difficulties with social communication plus restrictive or repetitive behaviors

• key difference: mainly about social communication differences and repetitive/restricted behaviors, not mood, defiance, or attention alone

how would a clinician diagnose a childhood disorder?

interview the child, teacher, parents, not interview their friends

what is a common form of therapy a clinician would use when treating a child?

play therapy where children play various games, draw pictures, etc with the therapist

Schizophrenia - positive symptoms

• “pathological excesses” or bizarre additions

• delusions

• disorganized thinking and speech

• heightened perceptions and hallucinations

• inappropriate affect

schizophrenia - negative symptoms

• “ pathological deficits”

• characteristics that are lacking in a person

• poverty of speech

• blunted or flat affect

• apathy

• social withdrawal

difference between a hallucination and a delusion

• hallucinations involve perception (hearing, tasting, smelling things that others do not

• delusions involve a belief (savior of world, someone’s spying on me)

types of hallucinations

• auditory (most common)

• tactile (feel)

• somatic (feel inside body)

• visual

• gusatory (taste)

• olfactory (smell)

types of delusions

• delusions of persecution (being plotted or discriminated against, spied on, threatened)

• delusions of reference ( attach a special meaning to the actions of others, objects, events)

• delusions of grandeur (believe themselves to be great inventors, religious saviors, etc)

• delusions of control (believe thoughts, feelings, actions, are being controlled by others)

difference between schizophrenia, schizophreniform, and schizoaffective

• schizophrenia involves psychotic symptoms that last at least 6 months

  • positive symptoms, negative symptoms, mainly a psychotic disorder and symptoms are 6 months or longer

• Schizophreniform

  • same symptoms as schizophrenia but lasts for more than 1 month but less than 6

• schizoaffective

  • schizo symptoms plus a mood disorder (depression or mania)

signs of poor schizo prognosis

• male

• young onset

• poor support system

• single, divorced, widowed

• family history of schizo

• signs of favorable are the opposite

The 4 D’s

• deviance

• distress

• dysfunction

• danger

what is deviance?

• thoughts and behaviors that differ significantly from what society says about proper functioning

• defined by norms and culture

• behaviors seem weird

whats distress?

• someone feels anxious or upset about their problems

• knows something is wrong

• subjective and internal

• may seek out help or treatment

whats dysfunction?

• a persons behavior causes problems for them in relationships, work, school, etc

• friends and relatives are concerned

• internal

whats danger?

• person behaves in ways that are reckless or dangerous to self or others

• person may injure self, starve, threaten suicide

• reckless behavior and disregard for own safety

• may threaten to harm others

biological model

explains disorders through genetics, brain chemistry, brain structure, hormones, or nervous system

psychodynamic model

focuses on unconscious conflicts, childhood experiences, and inner emotions streuggles

behavioral model

explains abnormal behavior as learned through conditioning reinforcement, punishment, or modelling

cognitive model

focuses on negative thoughts, irrational beliefs, and distorted thinking patterns

humanistic model

focuses on self worth, personal growth, free will, and reaching ones potential

sociocultural model

looks at how family, culture, society, gender, race, poverty, and environment affect mental health

difference between psychologist and psychiatrist

psychiatrist can perscribe medication and have an MD, psychologists cannot

what is the most common mental disorders in the US?

anxiety disorders

generalized anxiety disorder

constant excessive worry about many things

panic disorder

repeated panic attacks and fear of having more

phobias

intense fear of a specific object or situation

social anxiety disorder

fear of being judged, embarassed, or rejected socially

agoraphobia

fear of situations where escape may be difficult

seperation anxiety disorder

extreme fear of being away from an attachment figure

difference between an obsession and a compulsion

obsession is a mental or thoughts that cause distress and the compulsion is the act/ behaviors to ease the distress from obsession

operant conditioning and classical conditioning

• operant = rewards and punishments

• classical = conditioned through associations (Pavlov’s dog)

anxiety and depressions best friends

anxiety = avoidance and depression = inaction

difference between acute stress disorder and PTSD

• acute stress disorder: symptoms last 3 days to a month after trauma

• PTSD: symptoms last more than a month after trauma

sympathetic and parasympathetic nervous system

• sympathetic: fight or flight. activates the body during distress or danger

• parasympathetic: calm and relaxes body

symptoms associated with PTSD

• reexperiencing

• avoidance (of reminders of trauma like people, places, thoughts, conversations)

• negative changes in cognition/mood (guilt, shame, numbness, sadness, anger)

• hyperarousal (constantly on edge, easily startled, irritable, restless)