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37 Cards in this Set
- Front
- Back
Diagnosing a PD
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-personality traits must be "inflexible, maladaptive, and cause significant functional impairment or subjective distress
-inner experience and behavior that deviates markedly from the expectations of the individuals culture. |
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Cluster A
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(Odd, Eccentric)
Paranoid, Schizoid, Schizotypal |
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Cluster B
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(Dramatic, Emotional, Erratic)
Antisocial, borderline, histrionic, narcissistic |
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Cluster C
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(Anxious, Fearful)
Avoidant, Dependent, Obsessive-Compulsive |
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PDs are:
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-Chronic-dating back to childhood or adolescence (features present for 1 year if under 18)
-Enduring patterns across situations |
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Paranoid PD Presentation
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-Need to be self sufficient and autonomous
-need to control those around them -Projection -seek to confirm negative beliefs -hypersensitive to criticism |
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Paranoid PD Presentation (Continued)
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-premorbid traits include social isolation, hypervigilance, social anxiety, peculiar thoughts, angry thoughts, angry hostility, and idiosyncratic fantasies
-children- may appear odd -fanatic members of groups -rigid, controlling, critical, blaming, prejudice -lengthy and litigious disputes |
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Schizoid Presentation
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-intellectualization
-passively detached from environment -appear to lack capacity for pleasure and pain -do not tend to obtain gratification from self or others |
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Working with Schizoid clients
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-reliable, stable therapeutic relationship that mirrors the client
-therapist must be more active at first -must assess tolerance for social relatedness and desire -client:frustration, helplessness, boredom, may not value therapy |
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Antisocial Personality Disorder Presentation
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-disregard for and violation of other's rights
-deceitful and manipulative -symptoms are less evident beginning in middle age, may have learned to channel personality style in less public ways -consequences rarely play a part in their decision making process, impulses are directly expressed |
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Borderline Personality Disorder presentation
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-disturbance in self-image manifests as frequent shifts in career and sexual identity
-impulsivity: unsafe sex, substance abuse, other risky behavior -most commonly diagnosed age 19-34 (most people don't meet full criteria by age 40) |
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BPD Intervention
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-Goal: balance polarities
-begin with clear boundaries and goal of helping client to be more independent -therapist should be supportive within those limits -form stable identity by reducing vacillations between extremes -help client tolerate anxiety to choose a better response -self-soothing, communicating emotions |
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Dialectical Behavior Therapy for BPD
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-Combines CBT with assumption that acceptance of client is necessary
-3 stages of DBT -Group skills training -Individual outpatient therapy -telephone consultations for in between session coaching |
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BPD Intervention (continued)
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-a real alliance takes time
-begin supportive then move to supportive confrontation -confont all good or all bad to help client integrate splits -help client define self and more solid identity -help connect behavior to early history (psychodynamic can be helpful) |
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Histrionic PD Presentation
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-women overdiagnosed
-often have borderline, dependent, or narcissistic traits -adolescents: may be flamboyant, flirtatious, attention-seeking -Adults: form new relationships, but have difficulty sustaining them -may fall in love quickly -rapidly may be attracted to another person -not reliable or responsible -employment history erratic -impulsive decisions |
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Narcissistic PD Overview
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-Pervasive pattern of grandiosity, need for admiration, and lack of empathy
-very vulnerable to threats to self-esteem -may react defensively with rage, disdain, or indifference when actually feeling shock, humiliation, or shame |
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Narcissistic Personality Disorder Course and Presentation
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-Stable Course
-Seemingly well adjusted and successful and occupation and relationships in young adulthood -Relationships with family, coworkers, partner may become strained over time -may experience setbacks due to not addressing criticism -may feel empty and lonely at older age |
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Avoidant Personality Disorder Overview
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-Pervasive pattern of timidity, inhibition, inadequacy
-may have strong desire for close relationships, but feels too insecure -may also meet criteria for DPD -clingy in relationships |
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Avoidant Personality Disorder Course and Presentation
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-have social phobia in childhood
-adolescence is usually very difficult -occupational success may not be impaired -usually don't have good social skills -tend to be shy, inhibited and timid -reluctant to express their feelings |
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Dependent Personality Disorder Overview
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-Pervasive and excessive need to be taken care of
-often have low self esteem, are self critical, and self denigrating -Deference, politeness and passivity varies with culture -dependence must be maladaptive to diagnose |
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Dependent PD Course
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-excessively submissive as children and teens
-job functioning usually impaired or unsatisfactory -prone to MDD, Dysthymic Disorder, anxiety disorders -symptoms may decrease with reliable, empathic partner |
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Dependent PD Presentation
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-Intense need for reassurance
-Self esteem dependent on presence of relationship -often drive partner away which validates their worst fears, they then seek an even less reliable partner to quickly fill the void |
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OCPD Overview
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-preoccupation with orderliness, perfectionism, mental, and interpersonal control
-devotion to work and productivity varies with culture -resembles OCD, but does not usually occur |
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OCPD Course and Presentation
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-Childhood:well behaved, responsible, conscientious
-likely to have lots of success in careers -relationship with partner and children is likley to be strained due to being detached yet authoritarian -coworker relationships may be strained due to perfectionism, domination, worrying, and anger |
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OCPD comorbidities
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-prone to anxiety and physical disorders due to high levels of stress
-mood disorders may result from realization of own difficulties with work and family sacrifices made |
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PPD vs Psychotic or other PDS
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-paranoid ideation is not psychotic or bizarre, lacks other delusions
-paranoid personality traits may be evident in other disorders also |
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Schizoid PD vs Schizotypal or Avoidant
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-all involve social isolation and withdrawl
-Schizotypal includes intense social anxiety and cognitive-perceptual abberations -Schizoid: absence of an intense desire for social relationships, indifference toward opinions of others |
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Schizotypal PD vs Avoidant
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-both have social anxiety and introversion, but in schizotypal social anxiety does not diminish with familiarity
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Schizotypal PD vs Schizophrenia
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-Schizotypal lacks deterioration in functioning
-schizotypal can eventually move to schizophrenia |
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Antisocial PD vs substance abuse
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-can co occur
-antisocial must begin before age 15 -can be lots of overlap |
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BPD vs Axis I
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-must assess past symptoms and personality pattern
-symptoms must be evident since adolescence -BPD has impulsivity and anger control |
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Histrionic vs Narcissistic
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-NPD desires admiration while HPD desires any kind of attention they can get
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NPD vs Avoidant Personality Disorder
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-narcissistic is more grandiose, exploitation is more likely to be passive
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Avoidant PD vs Social phobia
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-look for personality pattern
-difficult to distinguish |
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Avoidant PD vs Dependent PD
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-Avoidant PD is clingy once in relationship
-APD is shy to get involved while DPD has a lot of urgency |
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Dependent PD vs Histrionic or Borderline
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-DPD are more self-effacing, docile, and altruistic
-HPD more assertive and flamboyant -BPD more dysfunctional and dysregulated emotionally |
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OCPD vs NPD
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-OCPD: work for its own sake
-NPD: work for its status and recognition -OCPD: doubts and self criticism -NPD: overly self assured |