Personality Disorders Flashcards
Histrionic Personality Disorder
Clinical Description & Diagnosis
- Pervasive pattern of excessive emotionality and attention-seeking.
- Begins in early adulthood and is present in various contexts.
- Requires five or more specific symptoms:
- Uncomfortable when not the center of attention.
- Inappropriate sexually seductive or provocative behavior.
- Shifting, shallow, and exaggerated expression of emotion.
- Excessively impressionistic and vague speech.
- Suggestible (easily influenced).
- Considers relationships more intimate than they are.
- Constantly seeks reassurance and approval, becoming upset when ignored or not praised.
- Impulsive with difficulty delaying gratification.
- Views situations in global, black-and-white terms.
DSM-5-TR Criteria
- A pervasive pattern of excessive emotionality and attention-seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Is uncomfortable in situations in which he or she is not the centre of attention
- Interaction with others is often characterised by inappropriate sexually seductive or provocative behaviour
- 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-dramatisation, theatricality and exaggerated expression of emotion
- Is suggestible (i.e. easily influenced by others or circumstances)
- Considers relationships to be more intimate than they actually are.
Aetiology
- Largely unknown due to limited research.
- Often co-occurs with antisocial personality disorder.
- Possible sex-typed alternative expression of the same unidentified underlying condition.
- Potentially a female variant of psychopathy.
Management
- Focus on attention-seeking and long-term negative consequences.
- Address problematic interpersonal behaviors.
- Limited evidence that treatment is effective.
Narcissistic Personality Disorder
Clinical Description & Diagnosis
- Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.
- Begins in early adulthood and presents in various contexts.
- Requires five or more specific symptoms:
- Grandiose sense of self-importance (e.g., exaggerates achievements and talents).
- Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
- Requests excessive admiration and has a sense of entitlement.
- Interpersonally exploitative (takes advantage of others).
- Lacks empathy.
- Shows arrogant, haughty behavior or attitudes.
- Often experiences depression.
DSM-5-TR Criteria
- A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Has a grandiose sense of self-importance (e.g. exaggerates achievements and talents, expects to be recognised as superior without matching achievements)
- Is 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 associate with, other special or high-status people (or institutions)
- Requests excessive admiration
- Has a sense of entitlement (i.e. unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations)
- Is interpersonally exploitative (i.e. takes advantage of others to achieve his or her own ends)
- Lacks empathy: is unwilling to recognise or identify with the feelings and needs of others
- Is often envious of others or believes that others are envious of him or her
- Shows arrogant, haughty behaviours or attitudes.
Aetiology
- Largely unknown.
- Parents fail to model empathy early in a child’s development.
- Child remains self-centered.
- Endless search for the ideal person to fulfill their empathic needs.
- Sociological view:
- Product of the 'me' generation.
- Greater emphasis on short-term hedonism, individualism, competitiveness, and success.
Management
- Limited research.
- Focus on grandiosity, hypersensitivity to evaluation, and lack of empathy.
- Cognitive therapy:
- Replace fantasies with realistic goals.
- Coping strategies for dealing with criticism.
- Treat co-morbid depression.
- Little evidence that treatment is effective.
Cluster C Personality Disorders (Anxious or Fearful)
- Includes Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders.
Avoidant Personality Disorder
Clinical Description & Diagnosis
- Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism.
- Begins in early adulthood and present in various contexts.
- Presence of four or more specific symptoms:
- Avoids activities or relationships due to fears of criticism, disapproval, or rejection.
- Not willing to get involved with people unless certain of being liked.
- Shows restraint in relationships or social situations because of the fear of being shamed.
- Views self as socially inept, unappealing, or inferior to others.
- Reluctant to take personal risks or engage in new activities because they may be embarrassing.
- Important to distinguish from schizoid personality disorder
- Asocial because they are apathetic, affectively flat, and uninterested in relationships
- Interpersonally anxious.
- Low self-esteem.
- Pessimistic about the future.
DSM-5-TR Criteria
- A pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection
- Is unwilling to get involved with people unless certain of being liked
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
- Is preoccupied with being criticised or rejected in social situations
- Is inhibited in new interpersonal situations because of feelings of inadequacy
- Views self as socially inept, personally unappealing or inferior to others
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
Causes & Management
- Will be covered during tutor classes.
Dependent Personality Disorder
Clinical Description & Diagnosis
- Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.
- Begins in early adulthood and present in various contexts.
- Presence of five or more specific symptoms:
- Difficulty making everyday decisions without excessive advice and reassurance from others.
- Needs others to assume responsibility for major areas of their life.
- Difficulty expressing disagreement with others because of fear of loss of support or approval.
- Goes to excessive lengths to obtain nurturance and support from others.
- Urgently seeks another relationship as a source of care and support when a close one ends
- Submissive, timid, and passive.
- Important to distinguish from avoidant personality disorder
- Responds to feelings of inadequacy by avoiding relationships
DSM-5-TR Criteria
- A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
- Needs others to assume responsibility for most major areas of his or her life
- Has difficulty expressing disagreement with others because of fear of loss of support or approval (Note: Do not include realistic fears of retribution.)
- Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgement or abilities rather than a lack of motivation or energy)
- Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
- Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to take care of him or herself
- Urgently seeks another relationship as a source of care and support when a close relationship ends
- Is unrealistically preoccupied with fears of being left to take care of him or herself.
Causes & Treatment
- Will be covered during tutor classes.
Obsessive-Compulsive Personality Disorder
Clinical Description & Diagnosis
- Pervasive pattern of preoccupation with orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency.
- Begins in early adulthood and present in various contexts.
- Presence of four or more specific symptoms:
- Preoccupied with details, rules, or lists, to the extent that the major point of the activity is lost.
- Perfectionism that interferes with task completion.
- Excessively devoted to work and productivity, to the exclusion of leisure activities and friendships.
- Unable to discard worthless objects (even with no sentimental value).
- Shows rigidity & stubbornness.
- Fixation on doing things the ‘right’ way.
- Procrastinate and ruminate about minor and important details.
- Poor interpersonal relationships.
- Only distantly related to obsessive-compulsive disorder (OCD)
- Obsession and compulsions are absent/rare.
- Often seen among gifted children, serial killers and paedophiles
DSM-5-TR Criteria
- A pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Is preoccupied with details, rules, lists, order, organisation or schedules to the extent that the major point of the activity is lost
- Shows perfectionism that interferes with task completion (e.g. is unable to complete a project because his or her own overly strict standards are not met)
- Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
- Is over-conscientious, scrupulous and inflexible about matters of morality, ethics or values (not accounted for by cultural or religious identification)
- Is unable to discard wom-out or worthless objects even when they have no sentimental value
- Is reluctant to delegate tasks or to work with others unless they submit to exactly his or 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 stubbornness.
Causes & Treatment
- Will be covered during tutor classes.
DSM-5-TR Personality Disorder Clusters
- Cluster A: Odd or eccentric disorders.
- Examples: Paranoid, Schizoid, Schizotypal personality disorders.
- Cluster B: Dramatic, emotional, or erratic disorders.
- Examples: Antisocial, Borderline, Histrionic, Narcissistic personality disorders.
- Cluster C: Anxious or fearful disorders.
- Examples: Avoidant, Dependent, Obsessive-Compulsive personality disorders.
Reading Material
- Statistics and Development (p. 521 - 523)
- Personality Disorders under Study (p. 525)
- Antisocial personality disorder – only the sections on Conduct Disorder (p. 535), Genetic Influences (p. 535 – 536), Neurobiological Influences (p. 536), Arousal Theories (p. 536 – 538)
