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55 Cards in this Set

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Another term for ASPD
2) An approach to psychotherapy with borderline patients
1) Psychopathy 2) Dialectical behavior therapy.
1) Schizoid 2) An enduring pattern of discomfort w/ other people coupled w/ peculiar thinking and beh, which takes teh form of perceptual and cog disturbances.
1) An enduring pattern of thinking and beh characterized by pervasive indifference to interacting with others and a diminished range of emotional exp and expression. 2)Schizotypical personality disorder
1) Furthered the psychodynamic view of borderline personality disorder by devel reliable, descriptive terms to allow reliable diagnosis. 2) Kernberg
1) Gunderson 2) Advocates a psychodynamic theory of borderline personality disorder focusing on the faulty devel of ego structure.
1) Proposed that there are two forms of antisocial beh 2) Cleckley
1) Moffitt 2) Wrote early descriptions fo psychopathy.
1)Developed a treatment for borderline personality disorder called Dialectical Beh Th. 2) Antisocial and histrionic...
1) Linehan. 2) There may be an etiological link, both reflect a common, underlying tendency toward lack of inhibition and both form shallow, intense relationships with others.
1) Would be a more complete description of each person: 2) Which personality disorder is most likely to be represented in inpatient and outpatient treatment setting?
1) dimensional over categorical. 2) Borderline (More prevalent among women along w/ dependent personality disorder.)
1) Research has shown that low doses fo antipsychotic medications are effective in alleviating symptoms of: 2) The difference btwn impulsive and compulsive beh is that the original goal for impulsive beh is to experience ___ while for compulsive beh it is to avoid __. 3) Borderline PD is often comorbid with what Axis I disorder?
1) schizotypal personality disorder 2) Pleasure vs anxiety. 3) depression
1) The dsm-IV category of ASPD does not include traits relating to ___ that the Cleckley description included. 2) Physical abuse in childhood inc the risk for ___ in adulthood and sexual abuse inc risk for:
1) Emotions and interpersonal beh. 2) Antisocial vs borderline.
1) Depression is most often diagnosed w/: 2) The most personality disorder in both in/outpatient treatment settings:
1) Borderline PD 2) Borderline.
1) Features of ASPD: 2) According to the five-factor model of personality, the willingness to cooperate and emphasize w/ other people is:
1) Failure to conform to social norms, deceitfulness, irrability and aggressiveness, NOT emotional instability. (No effective treatment for ASPD) 2) agreeableness
The axis I disorder most often diagnosed w/ borderline PD: 2) The most common PD in in/outpatient treatment settings:
1) Depression 2) borderline
1) A fine, downy hair on the face or trunk of the body. 2) Encourages pursuing one's own values instead of adopting prescribed social roles. 3) Structural family theory
1) Lanugo 2) Feminist Theory 3) Views parents' interference w/ adolescent autonomy & avoidance fo marital conflict as central issues in anorexia nervosa.
1) The storage of abnormally large amounts of fat in fat cells throughout the body. 2) Hilde Brauch
1) Hyperlipogenesis 2) Asserted that a struggle for control and perfectionism is the central psychological issue in the devel of eating disorders.
1) Developed a CBT for bulimia nervosa //
((Bulimia may be culture-bound))
1) Christopher Fairburn.
1) Type of effective prevention program: 2) CNS depressants used for relieving anxiety 3) Used to decrease anxiety or agitation
1) Targeting at-risk women in their late teens 2) Anxiolytics 3) Tranquilizers
1) Used to calm people or reduce excitement 2) Heroin 3) CNS depressants used to help people sleep.
1) Sedatives. 2) A synthetic opiate often injected, inhaled or smoked. 3) Hypnotics
1) Opiates used clinically to decrease pain. 2) One of the active ingredients of opium, very similar to heroin. 3) Codeine
1) Narcotic analgesics 2) Morphine 3) One of the active ingredients of opium, available in small quantities in Canada in over-the-counter medication.
1) Older term to describe substance use problems 2) Naturally-occurring stimulant drug extracted from the leaf of a tree at high elevations
1) Addiction 2) Opiates
1) Cues assoc w/ the administration of a drug function as a conditioned stimulus and elicit a conditioned response opposite the direction of the drug's effect. 2) Down regulation; when brain receptors adapt to drug
1) Behavioral conditioning mechanisms. 2) Pharmacodynamic tolerance vs metabolic tolerance (liver produces more enzymes)
1) A medication used in Europe to treat alcoholism, not yet approved by the FDA 2) Naltrexone
1) Acamprosate 2) A newly approved medication to treat alcholism demonstrated to reduce relapse rates.
1) Proposed that there are two types of alcholism, type 1 with later onset, psy depen, and the absense of antisocial personality traits, and type II which is predominately among men, has an earlier onset, and co-occurs w/ antisocial beh. 2) George Vaillant
1) Robert Cloninger 2) Conducted a longitudinal study of alcoholism among inner-city adolescents and college students.
1) Developed a cog beh view of the relapse process and a relapse prevention model for treatement of substance use 2) CNS stimulant
1) Alan Marlatt 2) Cocaine
1) The current legal limit of alcohol concentration for driving in most states: 2) MDMA
1) 100 mg percent 2) Hallucinogenic substance which can damage brain neurons permanently and has been linked w/ some fatalities.
1) The most promising neurochemical explanation of alcoholism currently focused on this nt:
1) Serotonin
Commonalities in Diagnosis of Different Personality Disorders
An enduring pattern of inner experience and behavior that deviates markedly from cultural expectations in at least two of following:
Cognition (e.g., self image, view of others)
Affect (e.g., emotion regulation, empathy)
Interpersonal functioning (e.g., relationship quality)
Impulse control (e.g., criminality, self injury)

Coded on Axis II not Axis I in DSM IV
Idea: Ongoing, underlying pattern; Axis I diagnosis can co-occur
Mental retardation is only other Axis II diagnois
Important Aspects of Personality Disorders
Rigid, inflexible, maladaptive patterns of relating to oneself and one’s environment
More subtle and less incapacitating than many Axis I disorders
Etiology/development often is uncertain
Personality disorders rarely diagnosed in children
Most often untreated
Ego syntonic (as opposed to ego dystonic)
Often not experienced or self-identified as a problem
Unreliable – clinicians frequently disagree on diagnosis
Quip: When do you diagnose PDs? When treatment fails…
If ego syntonic, can we identify with self report?
How can you define abnormal personality without defining normal personality? (The big five…); Dimensions and categories Where is cut point for abnormal?
(What is cut off for high blood pressure?)
Very little systematic research on
Effective treatment
Cluster A Example: Paranoid PD
Pervasive distrust and suspiciousness; see others as having malevolent. Four of
Suspects others are exploiting, harming, deceiving
Preoccupied with doubts about friends loyalty or trustworthiness
Reluctant to confide in others (information will be used against me)
Sees hidden meaning and threats in benign remarks
Persistently bears grudges
Perceives attacks not apparent to others and quickly counterattacks
Recurrent suspicions about sexual fidelity
Cluster B (Greatest Interest) Example 1: Narcissistic PD
A pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:

Has a grandiose sense of self-importance
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).
Requires excessive admiration.
Has a sense of entitlement, i.e. unreasonable expectations of especially favorable treatment.
Is interpersonally exploitative, i.e. takes advantage of others to achieve his or her own ends.
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
Is often envious of others or believes that others are envious of him or her.
Cluster B Example 2: Borderline PD
A pervasive pattern of instability in relationships, self-image, and affect, marked by impulsivity including 5 of
frantic efforts to avoid abandonment
unstable and intense interpersonal relationships
identity disturbance
impulsivity in areas that are self-damaging
recurrent suicidal behavior or gestures
affective instability / marked reactivity of mood
chronic feelings of emptiness
inappropriate, intense anger
transient, stress-related paranoid ideation
Cluster B Example 3: Antisocial PD
Disregard for and violation of the rights of others, including 3 or more of
failure to conform to social norms (re laws)
irritability and aggressiveness
reckless disregard for safety of self or others
consistent irresponsibility (e.g., failure to work)
lack of remorse
plus evidence of conduct disorder before age 15
Cluster B Example 4: Histrionic PD
Excessive emotionality and attention seeking including 5 of following

1. Is uncomfortable in situations in which he or she is not the center of attention (often denied; see self as “life of the party”)
2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior (not just appearance)
3. Displays rapidly shifting and shallow expressions of emotion (designed to attract attention – not mood disorder – possibly manipulative or to provoke others).
4. Consistently uses physical appearance to draw attention to self.
5. Has a style of speech that is excessively impressionistic and lacking in detail (vague; quick judgments without careful reasoning; e.g., “He’s such a wonderful person!”)
6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.
7. Is suggestible, i.e., easily influenced by others or circumstances (e.g., might develop memories or symptoms suggested by clinician)
8. Considers relationships to be more intimate than they actually are (e.g., quickly develop romantic relationships that do not last).
Cluster C Example: Obsessive Compulsive
Preoccupation with orderliness, perfectionism, and mental and interpersonal control
Preoccupied with details, rules
Perfectionism that interferes with task completion
Excessively devoted to work
Overconscientious, scrupulous, inflexible
Unable to discard things
Reluctant to delegate without exacting detail
Miserly spending
Rigid, stubborn
Anorexia: Other Issues
Reactions to starvation
Sexual issues
Occasional binge-eating or purging
Control – source of pride
Ego syntonic
Medical complications – including 10% mortality
Bulimia Nervosa: DSM IV
Recurrent binge-eating (normal weight)
Recurrent compensatory behavior (vomiting, laxatives, fasting, exercise)
Occurs 2X/wk for 3 months
Self-evaluation unduly influenced by weight
Bulimia Nervosa: Other
Depression – common; target of treatment sometimes
Lack of control/struggle for control – secretive, ashamed
Ego dystonic
Medical complications
A Prevention Trial
481 adolescent girls showing body dissatisfaction
Four interventions (3 hours each)
Discussion, reading, writing to counteract thin ideal
Healthy weight
Eating problems come from lack of healthy habits
Expressive writing
Write about emotional concerns (placebo control)
Assessment only
Assessment can be an intervention
**See charts**
.5% feemales
3% in adolescent/young adult females
20% occasional binge and purge
10 to 1 female to male
Age of onset: ***AN early adolescence; BN later, young adults
AN and BN
Anxiety disorders
Western, higher SES, white
Epidemiology cont.
Course (with treatment)
AN: 75% near normal weight; 50% eating issues continue
BN: 50% symptom free; 20% still bulimic; 30% eating issues
Control: AN = perfectionist; BN = lack of, social sensitivity
Etiology cont
Dietary restraint – normalize eating as big treatment
Genetics – 23% MZ vs 9% DZ
Hypothalamus dysfunction…
Bulimia – fairly good research
Cognitive behavior therapy – normalize eating; perfectionism
Interpersonal therapy – allegiance effect
See Figure 10-6
Antidepressant – less effective than therapy
Groups (for above)
Anorexia – no clear treatment
Immediate – life threat; hospital
Long-term – therapy; family if younger
No clear medication
Some Important Terms
Substance dependence
aka addiction, physiological dependence
Substance abuse
Interferes with functioning in important ways
Psychological dependence (not in DSM)
Craving, planning
Can occur with dependence or abuse
Substance Dependence
Need increasing amounts or
Same amount has diminished effect
Withdrawal syndrome
Differs by drug
Alcohol – tremors, nausea, sweating, anxiety, insomnia
Delirium tremens (DTs) – confused, hallucinations
Substance Dependence (cont.)
Taken for longer or in larger amounts
Desire or efforts to cut down
Time spent pursuing substance use
Interferes with functioning
Continued despite awareness of consequences
Some Issues
Distinction between abuse and dependence often is quantitative
Not defined by set number of times drug is used
Alcohol: 1-2 drinks/day considered “safe”
Binge drinking: 5 or more drinks at one time
Fourth year 5th?
Blood alcohol .08% = legally drunk in VA
Michigan Alcohol Screening Test
Some Issues
Antisocial personality disorder (Type 2)
Male problem
Type 1 – no ASPD
Comorbidity between alcohol and depression or anxiety
Alcohol expectations (p. 372)
Makes future brighter
Enhances pleasure
Enhances sex
Enhances power & aggression
Enhances social assertiveness
Reduces tension
**Class: CNS Depressants vs CNS Stimulants:
Alchohol, Barbiturates, Benzod, Methaqualone 2) Stim: Amphetamine, Cocaine, Methamphetamine, Nicotine, Caffeine
Opiates vs cannabinoids
Heroin, Opium, morphine, methadone, codeine 2) marjuana, hashish
1) LSD, mescaline, psilocybin, phencyclidine, mdma
Sexual and Gender Identity Disorders
Sexual Dysfunctions
inhibitions of desire and interference with physiological responses leading to orgasm
sexual arousal associated with unusual objects and situations
Gender Identity Disorder
strong and persistent identification with the opposite gender; discomfort with own gender
Normal Sexuality
As with all abnormal behavior, need to understand normal to define abnormal
Species typical needed to understand individual differences
Sex as a taboo topic
Kinsey – scandalous
Michael, Gagnon, & Laumann – denied federal funding
Sex is everywhere today
Yet we still have trouble talking about it
In class
In relationships
Peplau, Current Directions
Men link aggression and sex more
Women’s sexuality more malleable
Men have more sexual desire
Women emphasize committed relationships
Questions if gender differences are real:
What is societal function of marriage?
Of waiting for sex?
Has female intrasexual competition increased?
1) Recurrent or persistent genital pain assoc w/ sexual intercourse in either a male or female.
Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interfers w/ sexual intercourse.
Relationship of perpetrator to victim:
1) 46% victim was in love w/. 2) 22% knew well 3) 19% acquaintance 4) 9% spouse 5) 4% stranger