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38 Cards in this Set
- Front
- Back
What is a personality?
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The sum total of an individual’s ENDURING PATTERNS of perception, cognition, and action in the interpersonal world. A habitual and predictable style of thinking, feeling, and acting, arising from the integration of constitution, early life experience, development, and interpersonal, social, and cultural influences.”
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Temperament:
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the inborn mood state
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Character:
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individual’s personal qualities that reflect his/her attitude and level of adherence to social and moral values
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Social Construction
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how the person relates to the world, which is CULTURE DEPENDENT & interactive between the individual & environment
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What is a personality disorder?
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“A CHRONICALLY MALADAPTIVE PATTERN OF INTERPERSONAL FUNCTIONING; habitual patterns of thought, feeling, and action that repeatedly result in significant social impairment and/or personal distress.”
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personality disorder course
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Personality disorders usually begin developing in early childhood and persist, often to a large extent, THROUGHOUT LIFE. They are PERVASIVE, and usually impact most or all aspects of a person’s life.
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personality disorder treatment
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Due to their persistent and insidious nature, personality disorders typically require LONG TERM PSYCHOTHERAPY to help restructure the personality. They are difficult to treat. Some have had limited success with medications.
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A personality disorder can be conceptualized as a personality ORDER OR ORGANIZATION. It is an ADAPTIVE RESPONSE to early events in which the individual does not yet have adequate internal resourses or coping skills
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ID
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Basic Want
Pleasure Principle |
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Ego
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Mediates between internal and external worlds
Creative ways of getting needs met |
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Superego
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Social values/morals
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Defense Mechanisms
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Repression – forget it protend it didn’t happen
Denial Projection Reaction Formation-kid annoys you so you love them to death Displacement – kick the dog when mad at your boss Rationalization – talk themselves into or out of things Regression – go back to child-like state Sublimation – take more aggressive impulse or primative and turn it into something positive |
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Melanie Klein – splitting
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Primitive way to organize experience
Good/bad; male/female – need to see that there is shades of grey. |
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Psych-Social Development
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Trust
Autonomy Initiative Industry Identity Intimacy Generativity Ego Integrity |
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Stages of Separation-Individuation
Margaret Mahler |
Normal Infant Autism
Symbiosis Separation-Individuation -Hatching -Practicing/Ambitendency -Rapproachment On the Road to Object Constancy |
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Percent of pop. w/ diagnosable personality disorder
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10-13%
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Axis?
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personality disorders are coded on Axis II. They can also have traits that are on Axis II as well
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Patient Presentation of patient with personality disorder
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Effective functioning is limited by the disordered personality and the resulting PERCEPTUAL DISTURBANCE and IMPARED JUDGEMENT; responses to the environment tend to be chronically inadequate, leading to perpetual difficulties
Patients will likely have a series of interpersonal failures socially, and possibly occupationally |
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Odd/ Eccentric cluster of personality disorders
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Schizoid
Paranoid Schizotypal |
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Dramatic/Erratic cluster of personality disorders
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Histrionic
Antisocial Borderline Narcissistic |
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Anxious/Fearful cluster of personality disorders
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Avoidant
Dependent Obsessive-Compulsive |
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Schizoid Personality
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Withdraws from emotional interactions due to lack of desire to relate; socially isolative; few relationships
Flat/constricted affect; a sense of coldness or aloofness; indifferent Bright; smart, intelligent Lacks motivation Seems to have little energy Slow/monotonous speech More common in men Possible link to schizophrenia or OCD (can be repetitive); may be at risk for schizophrenia |
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Treatment Implications of Schizoid Personality
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Patient may be out of touch with his/her body
Information provided during H&P may be limited & lack important details May need to use structured interviewing; open-endedness or empathy may not yield results |
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Paranoid Personality
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Doesn’t trust/always on guard; hyper-vigilant; believes people are out to get him/her; constant environmental scanning (The best defense is a good offense)
Distance themselves by perceiving or misinterpreting others as hostile Fearful of being controlled, dominated, indebted to anyone, so tends to be a loner Intelligent, but perceptions are distorted Can be viewed as a type of self-centeredness or grandiosity; therefore low self-esteem/inferiority likely to be core issues |
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Schizotypal Personality
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Typically considered by others to be “odd” or “strange”; on the “eccentric” side
Ideas of reference - suspicious thinking; desire for relationships, but anxious and mistrustful Some odd beliefs/loose associations; magical thinking (“this is a sign”); inhibits social functioning Dress may be peculiar; Speech may be different May have odd “collections” Possible link to schizophrenia (at risk) |
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Treatment Implications of Schizotypal Personality
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Information gathered in the medical interview may be unreliable
More easy-going than the schizoid, cares more about relating; therefore, they may be more receptive if doctor is perceived as warm and caring |
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Histrionic Personality
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Presentation is dramatic, flamboyant, theatrical; driven by a need for attention; seeks approval by providing entertainment
More common in females Exaggerate emotions; poor impulse control Easily taken advantage of because they don’t think things through Little or no insight into their needs or behavior; focus is putting on the next show Seductive in their presentation; manipulative |
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Treatment Implications of Histrionic Personality
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Style is designed to distract from the facts; medical interviewer needs to set boundaries and consistently redirect
Will provide a colorful picture with lots of irrelevant or non-factual information; resist getting “sucked in” to the drama Help ground them in what they need and how to go about getting it |
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Anti-Social Personality
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Also known as “sociopath” or “criminal personality”
Conduct disorder by age 15; typically male Chronic conscious exploitative behavior with no guilt/regret (only getting caught); chronic lying/disregard for others’ rights or consequences Core belief that people are to be used; lack of ability to form interpersonal bonds Core feels empty, which fills him/her with hostility & shame; getting away with things gives a high and relieves the stress Typically grandiose/narcissistic; lacks impulse control Lacks internal boundaries, so no self-control; typically do well in prison due to the structure |
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Treatment Implications of Anti-Social Personality
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Typical reasons for help-seeking are court referral, detoxification, desire for medication, need to use doctor in some way (ie., note to get out of work, avoid military service, etc.) – don’t be “used”
Best treatment is early intervention for conduct disorder |
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Borderline Personality
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Most extreme & impaired personality – “borderline” refers to bordering on psychotic functioning
Marked by extreme instability in mood, impulses, thought processes - history/pattern of intense, short-lived & unstable relationships Core issue is fear of rejection/abandonment; any perception of this leads to rage Feels misunderstood and has a list of complaints as to how they have been wronged Typically female Does not have a cohesive sense of self, what their needs are, or how to get their needs met; therefore, they expect an unrealistic level of attunement and everything is a crisis; others have a sense of “always walking on eggshells” Uses “splitting” or “all or nothing” thinking |
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Treatment Implications of Borderline Personality
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Will have a history of help-seeking in attempts to draw people in
Black and white thinking will make you either the best or worst physician (idealization vs. devaluation) Interviewer must set boundaries & encourage them to help themselves; may get lots of crisis calls – important to document Watch danger to self/other issues |
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Narcissistic Personality
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Marked by excessive grandiosity and entitlement; great need for admiration, recognition & attention
Self-absorbed because empathy is missing from the personality; only their needs are important Isolated & conflicted – wants to be seen, but doesn’t want you to see that they feel totally inadequate and ashamed Will rationalize any perceived failure or weakness Happy in relationship as long as they are being idealized; otherwise will completely devalue others, especially those that see them for what they are Everything s/he does is designed to avoid pain by supporting his/her own inflated self-image Typically male; often have borderline partners |
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Avoidant Personality
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Unlike the Schizoid who is not motivated to relate, the Avoidant actively avoids relationships despite wanting them - a very painful conflict
Social anxieties/fears of rejection are overpowering - they must create distance to feel safe Extremely shy, self-conscious, sensitive to criticism Very low self-esteem is at the core Unclear whether this is the same thing as Social Anxiety Disorder |
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Treatment Implications of Avoidant Personality
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May avoid treatment due to discomfort or embarrassment
Will likely be very uncomfortable in the doctor-patient relationship - Doctor will have to work very hard to have empathy, and create an accepting, safe relationship or patient could filter important information in order to avoid possible rejection |
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Dependent Personality
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Incapable of making even simple decisions without input from another
Tremendous fear of abandonment leading to excessive need to please and be reassured Extreme desperation and neediness tends to push people away or attract abusive partners More likely female; may have Anti-Social partner Makes bad decisions in order to please others, puts self in harms’ way |
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Obsessive-Compulsive Personality
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Overly concerned with perfectionism to maintain sense of control; painful issues such as inadequacy, powerlessness, and dependency are avoided by focusing on order
Rigid/inflexible thinking; black & white thinking (“If I’m not perfect, I’m a total failure”) Prefers structure; things must be done “right” Extremely detail-oriented; misses the forest for the trees Very work-oriented, but doesn’t accomplish much due to perfectionism & focus on detail; hard to follow through on their commitments |
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Treatment Implications of Obsessive-Compulsive Personality
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In the interview, they are opposite of the Histrionic, presenting with little or controlled emotion, and lots of facts and rationalizations
Interviewer must provide structure and guide/redirect interview to stay on track |