Untitled Flashcards Set

General personality disorder:

• Criterion A: (diagnosis)

  • An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following area: 

    • Cognition (i.e, ways of perceiving and interpreting self, other people, and events)

    • Affectivity (i.e, the range, intensity, lability, and appropriateness of emotional response) 

    • Interpersonal function 

    • Impulse control 

• Personality Disorder (Axis 2) 

  • Criterion B 

    • The enduring pattern is inflexible and pervasive across a broad range of personal and social situations 

    • Doesn’t just show up in one area but multiple 

      • Your behavior is not being explained by your situation- it is something interpersonal 

      • Behavior not flexible enough to behave appropriately in situations (wedding vs. a funeral)

  • Criterion C: 

    • The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important area of functioning (it’s only a problem if it’s a problems) 

    • Interferes with functioning 

  • Criterion D: 

    • The pattern is stable and of long duration and its onset can be traced back at least to adolescents or early childhood 

      • Your personality is not fully yet developed 

      • Cannot be diagnosed with a personality disorder as a child 

• The 3 clusters of Personality disorder: (characteristic) 

  • Cluster A: odd-eccentric 

    • Behaviors similar to Schizophrenia

      • Flat affect, odd thought, or speech patterns

      • Aberrations/disturbances in one’s understanding of reality

    • Differ in their grasp on reality

      • Symptoms do not reach the severity seen in Schizophrenia

    • Comprises three disorders:

      • Paranoid Personality Disorder

        • Paranoia in one aspect/situation (globally normal behavior)

        • Suspicion of other motives (thinkin they are out to get them) 

        • Having Trust issues 

      • Schizotypal personality disorder (cognitive & behavior) 

        • Symptoms of Schizophrenia that are not severe enough to warrant a diagnosis of Schizophrenia

          • Mild perceptual and cognitive distortions:

            • Odd beliefs

            • Unusual perceptual experiences

          • Odd/Eccentric behaviors:

            • Odd speech pattern 

            • No operational definition of odd

          • Discomfort with and deficit in interpersonal relations: 

            • Want close relationships but often avoid them 

      • Schizoid personality disorder (emotional) 

        • Flat affect- not responding in an appropriate way to what one is experiencing 

          • Affective system not functioning properly

        • Interacting with the world based on the way the body feels (anxious, calm, etc) 

        • These individuals can’t always live independently

      • Cluster A: schizotypal personality disorder 

        • Jim very odd beliefs that believed in fairies and that you can feel their presence 

        • As well as thunderstorms might be interpreted by a message not to shower one day 

        • Odd feature of jim behavior breaks out into a silly grin and laughs for no apparent reason

  • Cluster B: Dramatic-emotional (characteristic) 

    • Manipulative and potentially uncaring behaviors

      • Show little regard for others and potentially their own safety

      • low on the spectrum of empathy

    • Emotional Dysregulation

      • Can demonstrate highly erratic emotional responses

    • Inappropriately sexual and seductive behavior:

      • Extreme focus on appearance

    • These disorders are similar in these symptoms but they are functionally different

  • Histrionic personality disorder:

    • Exaggerated emotionality that lacks depth:

      • Emotions are shallow and shift rapidly

    • Discomfort when not center of attention:

      • Constantly seeks reassurance, approval, and praise

    • Inappropriately sexual and seductive behavior:

      • Extreme focus on appearance

    • Cognitive-Behavioral Models (sense of self) 

      • Core Beliefs:

      • Self:

        • If I can’t entertain people they will abandon me

      • Other:

        • If other people don’t respond to me they are rotten

      • Learning History:

        • Selective interpersonal reinforcement by family and peer relationships leads to excessive attention-seeking behaviors

  • Histrionic personality disorder

    • Key thing to remember is that there is a difference between topography (what the behavior look like) and underlying functions 

      • The thing that differentiates disorders among this cluster, or any cluster, is the underlying functions= why the person is doing it what the behavior is trying to achieve 

    • Histrionic shifts in emotion are not comparable to those shifts in Bipolar disorder

      • In BD, mood changes are due to brain chemistry, In HPD, the emotion shifts might last longer and are usually aimed at getting attention or connection from others 

      • However, these shifts tend to be for longer durations

      • What these individuals display to people (topography) is different than what is going on internally (underlying function)

    • “Attention seeking disorder”

      • They will seek any attention, good or bad

        • Differs from narcissism which seeks attention primarily for ego boosts and they are more selective in what they want

      • Ex. kids may act out as a way to receive attention, and the attention is reinforcing, this is similar to how histrionic may act  

    • They tend to have low insight 

      • sensation-seeking

  • Hilde

    • She expresses a senses of superficiality in both her outward and inward expression 

      • “She’s larger than life”

      • “At first they may draw people in but as relationship progress those involved start to realize there is not much below the surface

    • Her husband struggles to feel seen and heard in their relationship because it's all about Hilde 

    • She starts to suspect he’s having an affair – it couldn’t possibly be her fault –low insight

    • She doesn’t believe what she’s doing is bad 

      • In the past, her charm and appearance did all the work for her, but now something has changed

    • Hilde’s upbringing

      • She was praised her her appearance, not her intellect

      • What is reinforced or punished by others in our environment calibrates our sense of self worth

        • Hilde’s personality trait that could have blossomed remain dormant bc they were not reinforced, rather they were punished

      • Had a history of reinforcement during a critical period of her development for certain behaviors that are now maintained in her adult life 

        •  Those old behaviors that were once adaptive in another environment don’t make sense 

  •  Cluster B: Dramatic- emotional 

    • Antisocial personality disorder: 

      • Psychopathy/sociopath is not the same thing as 

        • ASPD-  is a DSM diagnosis that tries to capture psychopathy but only capture some features 

      • Characterized by a disregard for and violation of the rights of other (core of this definition) 

        • Failure to conform to social norms with respect to lawful behavior 

        • Deceitfulness 

        • Impulsivity or failure to plan ahead 

        • Irritability and aggressiveness

        • Reckless disregard for safety of others 

        • Consistent irreparability 

        • Lack of remorse for behaviors 

          • This feature that really gets a psychopath

    • Early history: how this disorder was understood in the past 

      • Moral insanity: (early term ASPD)

        • Moral insanity: (early term ASPD)

          • Not psychotically deranged (they don't hear voices or lose touch with reality) 

          • Not deficit in reasoning abilities (they can think and reason normally)  

          • “Constitutionally deficient in moral faculties” (seemed like they were born without a moral compass- they just don’t care about right or wrong, and they don’t feel guilt for hurting others)

    • Antisocial personality disorder DSM 3:

      • Even though people recognized psychopathic traits for a while, it came out fist in the DSM-II

      • ASPD is overly focused on criminality, and the idea of defining psychopathy on the grounds of criminality is misguided

      • Diagnosis focused on antisocial behaviors and social deviance → problematic b/c there are lots of things that influence criminality, so you tend to view criminal behavior as an individual responsibility 

        • Just because you engage in criminal behavior doesn’t mean you’re a psychopath

          • Eg: acts of aggression

      • Critiqued for de-emphasis on trait and personality characteristics (and instead focuses most on behavior, which can be socially determined)

        • A lot of psychopaths may not break the law or get caught, so it is important to focus on traits like high impulsivity (these individuals more likely to get caught), high constraint (limit)

      • Psychopath:

        •  Term similar to ASPD, but includes: 

          • Grandiosity, arrogance, superficiality 

          • An inability to form emotional bonds 

            • Includes a lack of understanding of how social relationships and interpersonal closeness works 

          • A lack of anxiety 

            • Low level of baseline arousal, even in the face of risk in order to “feel something,” the experience must be high in intensity 

            • Some personality traits on their own can be useful or healthy but when combined together it can be problematic

    • Prevalence: overrepresented in criminal and substance abuse settings: 

      • 76% of prisoners diagnosed with ASPD 

        • Most of them were not psychopathic (demonstrating the problem with ASPD def since it was was categorized as criminal behavior)

    • Community samples:

      • 8% of men 

      • 3% of women  

    • Genetic contribution:

      • The environmental factors don’t seem to have a strong as an influence as the genetic factors (psychopathic traits an amenable to environmental influence, but have a strong genetic basis) 

    • Early learning environment (1) 

      • Characterized by either: 

        • Passive or neglectful parenting attitudes (don’t really pay attention to the child) 

        • Overly harsh parenting styles (strict, punishing, abusive)

    • Early learning environment (2) 

      • Passive or neglectful parenting attitudes: 

        • No demands for responsible and non-aggressive behaviors 

          • When parents don’t teach or expect responsible, kind, or respectful behavior, the child never learns how to act properly 

        • Children who receives little response- contingent attention for (+) behaviors might engage in (-) behaviors for attention 

          • If a child only gets attention when they do something bad (and get ignored when they behave well), they might keep doing bad things just to get noticed 

    • Early learning environment (2) 

      • Harsh parenting styles: 

        • Use of aggression for discipline 

          • Modeling conflict and problem-solving (the child learns from watching their parents) 

          • Develop hostile information processing style in social interaction (the child believe someone is out to get them as a result they often react with anger and aggression in social situations) 

    • Learning and performance deficits 

      • Deficits in acquiring learning responses: 

        • Incapable of profiting from reward/punishment: 

          • Psychopaths performed as well as controls when incorrect responses resulted in loss of cigarettes or money 

          • Not responsive to shock or positive or negative social comments 

      • Psychopaths don’t learn from rewards or punishments like most people do. They don’t care much about losing something or being praised, so it’s hard to teach them to change their behavior using normal methods 

    • Learning and performance deficits (2) 

      • Deficits in acquiring fear responses: 

        • Psychopaths slow to develop conditioned response to fear 

          • Inclined to ignored painful shocks that control learned to avoid 

          • Less influences by fear reaction 

            • Behaviors unfettered by psychological deterrents such as anxiety and fears of consequences 

      • Psychopaths have trouble learning fear. Most people learn to be afraid of something if it’s paired with pain or punishment 

      • Psychopaths don't learn this fear reaction as easily. They don’t make the connection between the warning sign and the pain

      • Psychopath don't ignore things other would avoid, even when they get painful shocks, they don’t try as hard to avoid them like other do 

      • Psychopaths are not guided by fear or anxiety, they don’t seem to feel much fear, guilt, or worry (so they don't feel anxious about getting in trouble) 

    • Chronic low levels of arousal: 

      • Aversive physiological state resulting from a lack of novel/rewarding stimuli 

        • Lower baseline levels of arousal and rapid adaptation to novel stimuli 

          • ASDP individuals spend less time attending to boring material 

        • Higher initial attention to novel stimuli, rapid habituation 

Need to increase arousal levels, ASPD individuals will engage in higher-risk sensation-seeking