Psych Test 3

personality disorders

personality disorders

persistent pattern of emotions, cognitions and behavior that results in enduring emotional distress for the person affect and others and may cause difficulties with work and relationships

person that has probs with everyone→ personality disorder

do not feel subjective distress

Weird- cluster a- appear odd/eccentric- paranoid, schizoid, schizotypal

Wacky- cluster b- appear dramatic, emotional or erratic- antisocial, borderline, histrionic

worried- cluster c- appear fearful or anxious- avoidant, dependent and obsessive compulsive

paranoid personality disorder

distrust and suspiciousness of others- interpret motives as malevolent

• thinks that others are exploiting, harming or deceiving person

• preoccupied with unjustified doubts abt loyalty and trustworthiness of frineds

• reluctant to confide in others bc of fear that info will be used maliciously

• reads hidden demeaning or threatening meanings

• persistently bears grudges; unforgiving of insults/slights

• perceives attacks that are not apparent to others, quick to react angrily or counterattack

• recurrent suspicion regarding fidelity of partner

goal or personality disorder treatment

help improve fxning

schizoid personality disorder

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

• neither desires nor enjoys close relationships, including being part of a family

• chooses solitary activities

• has little if any interest in having sexual experiences with another person

• takes pleasure in few if any activties

• lacks close friends or confidants other than first-degree relatives

• appears indifferent to the praise or criticism of others

• shows emotional coldness, detachment, or flattened affectivity

schizotypal personality disorder

pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced cpacity for close relationship as well by cognitive or perceptual distortions and eccentricities of behavior

• ideas of reference (events or coincidences as having significance

• odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms

• unusual perceptual experiences

• odd thinking and speech

• suspiciousness or paranoid ideation

• inappropriate or constricted affect

• behavior of appearance that is off, eccentric, or peculiar

• lack of close friends or confidants other than first degree relatives

• excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid dears rather than negative judgments abt self

antisocial personality disorder

a pervasive disregard for and violation of the rights of others

• Failure to conform to social normas with respect to lawful behaviors- repeated acts that are ground for arrest 

• Deceitfulness- lying, use of aliases, conning 

• Impulsivity or failure to plan ahead 

• Irritability and aggressiveness, repeated physical fights or assaults 

• Reckless disregard for safety of self or others

• Consistent irresponsibility- failure to sustain work behavior or honor financial obligations 

• Lack of remorse 

• 18 yo, evidence of conduct disorder before 15 yo 

• Lots of prisoners

psychopathy and sociopathy

hare- glibness/superficial charm, grandiose sense of self worth, pathological lying, conning/manipulative, lack of remorse or guilt, callous lack of empathy

actual inability to experience empathy

bc of situational factors- squashed ability to experience empathy

recidivism

must convince them how to make staying lawful will be beneficial for them

conduct disorder

violation of rights of others or societal norms/rules

• aggression to people or animals

• destruction of propeerty- fire setting

• deceitfulness or theft0 broken into house/building/car, lies/cons to obtain goods or avoid obligations, stolen items of nontrivial value without confronting victim

  • serious violation of rules

borderline personality disorder

pervasive pattern of instability of interpersonal relationships, self- image and affects, and marked impulsivity

• frantic efforts to avoid real or imagined abandonment

• pattern of unstable and intense interpersonal relationships- alternating btwn idealization and devaluation

• identity disturbance- unstable self-image or sense of self

• impulsivity in at least 2 areas that are self damaging

• recurrent suicidal behavior/mutilating behavior

• affective instability- marked reactivity of mood, intese but short

• chronic feelings of emptiness

• inappropriate or intense anger/difficulty controlling anger

• transient stress- related paranoid ideation or severe dissociative symptoms

• DBT- focus on emotional regulation

histrionic personality disorder

pervasive pattern of emotionality and attention seeking

• uncomfortable in situations in which he or she is not center of attention

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

• displays rapidly shifting and shallow expression of emotions

• consistently uses physical appearance to draw attention to self

• has a style of speech that is excessively impressionistic and lacking in detail

• shows self- dramatization, theatricality and exaggerated expression of emotion

• is suggestible

• considers relationships to be more intimate than they actually are

narcissistic personality disorder

pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy

• grandiose sense of self - importance

• preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love

• believes that he or she is “special” and unique and can only be understood by, or should be associated with other special or high-status people/institutions

• requests excessive admiration

• has a sense of entitlement

• interpersonally exploitative (takes advantage of others)

• lacks empathy; is unwilling to recognize or identify with the feelings and needs of others

• often envious of others or believes that others are envious of him/her

• shows arrogant, haughty behaviors or attitudes

• usually not coming in for treatment

avoidant personality disorder

pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation

• avoids occupational activities that involve significant interpersonal contact bc of fears of criticism, disapproval or rejection

• unwilling to get involved with people unless certain of being liked

• shows restraint within intimate relationships bc of fear of being shamed or ridiculed

• preoccupied with being criticized or rejected in social situations

• inhibited in new interpersonal situations bc of feelings of inadequacy

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

• unusually reluctant to take personal risks or to engage in new activities bc they may prove embarrassing

dependent personality disorder

pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation

• has difficulty making everyday decisions without an excessive amt of advice and reassurance from others

• needs others to assume responsibility for most major areas of his/her life

• has difficulty initiating projects or doing things on his/her own

• goes to excessive lengths to obtain nurturance and support from others to the point of volunteering to do things that are unpleasant

• feels uncomfy or helpless when alone bc of exaggerated fears of being unable to care for him/herself

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

• unrealistically preoccupied with fears of being left to take care of him/herself

obsessive compulsive personality disorder

pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency

• preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the acitivity is lost

• shows perfectionism that interferes with task completion

• excessively devoted to work and productivity to the exclusion of leisure activities and friendships

• overconscientious, scrupulous and inflexible abt matters of morality, ethics or values

• unable to discard worn-out or worthless objects even when they have no sentimental value

• reluctant to delegate tasks or to work with others unless they submit to exactly his/her way of doing things

• adopts a miserly spending style towards both self and others; money is viewed as something to be hoarded for future catastrophes

• shows rigidity and stubborness

• ultimate rigid personality

• work-a holic

OCD vs OCPD

ocd- they are anxious and coping

ocpd- this is the right way to do things, im right, theses are the rules, need to have things a certain way bc of stubborness

reasoning is different

schizophrenia

must have either delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

• significant portion of time since onset ; the level of functioning in one or more major areas such as work, interpersonal relations, or self-care is below the level achieved prior to onset

• Persist for at least 6 months

• Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out

• Not attributable to substance use

• If ASD- dx if prominent delusions or hallucinations in addition to other required symptoms are present for at least 1 month

hallmark is the mismatch of emotion to situation

catatonia

a disorder of movement involving immobility or excited

agitation

hebephrenia

a silly and immature emotionality, a characteristic of some types of schizophrenia

paranoia

irrational beliefs that they are especially important (delusions of

grandeur) or that other people are seeking to do them harm

dementia praecox

Latin term meaning premature loss of mind; an early label for what is now called schizophrenia- emphasizing the disorder’s frequent appearance during adolescence

associative splitting

a separation among basic functions of human personality (cognition, emotion, perception) seen by some as the defining characteristic of schizophrenia

psychotic behavior

hallucinations and loss of contact with reality

positive symptoms

a more overt symptom such as a delusion or hallucination displayed by some with schizophrenia 

delusions

a psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality 

hallucination

a psychotic symptom of perceptual disturbance in which something is seen, heard, or otherwise sensed although it is not actually present 

negative symptoms

a less outgoing symptom, such as flat affect or poverty of speech, displayed by some with schizophrenia 

avolition

an inability to initiate or persist in impt activities(apathy) 

alogia

a deficiency in the amt or content of speech

anhedonia

inability to experience pleasure, associated with some mood and schizophrenic disorder 

flat affect

an apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected

disorganized speech

a style of talking often seen in people with schizophrenia, involving incoherence and a lack of typical logic patterns

inappropriate affect

an emotional display that is improper for the situation

catatonic immobility

a disturbance of motor behavior in which the person remains motionless, sometimes in an awkward posture for extended periods

schizophreniform

must have 2 or more of following:

• delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

• An episode lasts at least 1 month but less than 6 months

• Schizoaffective, depressive, bipolar w/psychotic features ruled out

• Disturbance not form substance use

• Specify-

• Good prognostic features- 2 of the following: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning, confusion or perplexity, good premorbid social/occupational functioning, absence of blunted or flat affect

• Without good prognostic features: 2 or more of the above features have not been present

time criteria is distinguishing factor

schizoaffective disorder

An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia

• The major depressive episode must include Criterion A1: depressed mood

• Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness

• Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness

• Not attributed to the effects of a substance

psychotic at the same time as major mood episodes

delusional disorder

• Presence of 1 or more delusions with a duration of 1 month or longer

• Criterion A for schizophrenia has never been met

• Apart form the impact of the delusions or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd

• If manic or mde have occurred, these have been brief relative to the duration of the delusional periods

• Not attributable to substance use

many types

• erotomanic, gradiose, jealous, persecutory, somatic, mixed, unspecified

erotomanic type

delusion that another person is in love with the individual

grandiose type

delusion of having some great (but unrecognized) talent or insight or having made some important discovery

jealous type

delusion that the individual’s spouse or lover is unfaithful

persecutory type

delusion that the individual is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals

somatic type

delusions that involve bodily functions or sensations

mixed type

no delusional theme predominates

unspecified type

cannot be clearly determined or not described by the specific types

other delusion onset possibilities

substance/medication induced, brief psychotic disorder, psychotic disorder associated with another medical condition

ASD

• Persistent deficits in social communication and social interaction across multiple contexts-

• Social emotional reciprocity- abnormal social approach; failure of normal back and forth conversation; reduced sharing of interests, emotion, and affect; failure to initiate or respond to social interactions

• Nonverbal communicative behaviors used for social interaction- poorly integrated verbal and nonverbal communication; abnormalities in eye contact and body language deficits in understanding or use of gestures, lack of facial expressions and nonverbal communication

• Developing, maintaining, and understanding relationships- difficulties adjusting behavior to suit various social contexts, difficulties sharing imaginative play and in making friends, absence in interest in peers

• restricted, repetitive patterns of behavior, interests, or activities

  • stereotypes or repetitive motor mvmts, use of objs or speech

  • insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior

  • highly restricted, fixated interests that are abnormal in intensity or focus

  • hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment

ADOS and ADIR is interview schedule and autism testing

Origin ideas for ASD

genetic

• complex, moderate heritability

• numerous genes on a number of chomosomes have been implicated

• many genes, each one having relatively small effect

• families with 1 child with ASD have a 20% change of having another (100x risk in general pop)

• oxytocin receptor gene- bond with others → deficient

  amygdala of abt the same size but fewer neurons

• younger children with ASD have larger amygdala- more anxiety and fear, more stress→ causes cortisol to damage the amygdala → less neurons in adulthood

intellectual disability

Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing

• Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments such as home, school, work, and community

• Onset of intellectual and adaptive deficits during the developmental period

neurocognitive disorder

major and mild

both significant decline in cognitive fxning

modest (mild)- do not interfere with capacity for independence in everyday activities

major- interfere with independence in every day activities

MOCA- screening measure for cognitive impairment
starts with higher level of fxning and then decline

ex:

• Alzheimer's disease

• Vascular neurocognitive disorder- progressive brain disorder (blood vessel damage resulting in loss of oxygen or nutrients to brain tissue)

• Head trauma- chronic traumatic encephalopathy (CTE)

• Frontotemporal neurocognitive disorder- overarching term: Pick’s disease

• Traumatic brain injury (TBI)- symptoms that persist at least a week following trauma: executive dysfunction (problems planning complex activities), problems with learning and memory

• Lewy Body- microscopic deposits of a protein that damages brain cells over time

• Parkinson’s disease

• HIV

• Huntington’s disease

• Prion Disease (proteins that reproduce themselves and damage brain cells)- no

  DNA OR RNA that can be destroyed: e.g., Creutzfeldt-Jacob disease

treatment

• no good treatments, focus on prevention