Psy3032 - Abnormal Psychology Week 9 - Personality Disorder

Front 1

Personality disorders are defined by problems with what two areas?

Back 1

forming a stably positive sense of self, and sustaining close and constructive relationships

Front 2

In what three ways are the traits in a personality disorders different from normal traits?

Back 2

they are extreme, inflexible, and maladaptive

Front 3

The symptoms of personality disorders are characterised in what two ways?

Back 3

they are pervasive and persistent

Front 4

The presence of a personality disorder predicts what for many different conditions?

Back 4

poorer treatment outcomes

Front 5

How many personality disorders are in the DSM-IV-TR?

Back 5

10

Front 6

How many perosnality disorders are proposed for the DSM-5?

Back 6

6

Front 7

Which four perosnality disorders in the current DSM-IV-TR are being left out of the DSM-5?

Back 7

paranoid, schizoid, histrionic, and dependant

Front 8

Which six personality disorders are being maintained for the DSM-5?

Back 8

Obsessive-compulsive, narcissistic, schizotypal, antisocial and borderline

Front 9

What 5 concerns with the DSM-IV-TR prompted change in the DSM-5?

Back 9

1. half of people who met criteria for one PD met criteria for another;
2. some current PD's are very rare in the community;
3. many people with seemingly serious perosnality problems don't fit any current PD diagnosis;
4. great deal of variability in the nature and severity among people with the same diagnosis;
5. the definition of PD suggests stability over time which is not the case

Front 10

What are the three steps proposed for personality assessment in the DSM-5?

Back 10

levels of personality functioning, personality disorder types, and personality trait domains and facets

Front 11

How many trait domains and facet ratings are proposed for the third step of assessment of personality in DSM-5?

Back 11

5 trait domains and 25 facet ratings

Front 12

What are the two broad types of impairment assessment are in the first step of the personality assessment process in the DSM-5?

Back 12

disturbance's in one's self or identity, and interpersonal disturbances

Front 13

What two areas of self are assessed in the level of personality functioning in the DSM-5?

Back 13

Identity and self-direction

Front 14

What two areas of interpersonal functioning are assessed in the level of personality functioning in the DSM-5?

Back 14

Empathy and intimacy

Front 15

How many points of the likert scale for assessing the overall degree of impairment in the level of personality functioning in the DSM-5?

Back 15

4

Front 16

What degree of impairment in the levels of personaity functioning in the DSM-5 is required to move to stage two personality disorder type?

Back 16

moderate level

Front 17

What is assessed in stage two of the DSM-5 proposed personality assessment?

Back 17

an evaluation of whether the porplems with impairment fit with one of the six DSM-5 PD types

Front 18

What alternate diagnosis can be given in the DSM-5 when the impairment problems do not fit with on of the six DSM-5 PD types?

Back 18

PD trait specifed

Front 19

What three issues must the clinician consider before assigning a PD type?

Back 19

1. is it unusual in the cultural context;
2. characteristics must be stable;
3. is the behaviour pervasive across aspects of the persons life

Front 20

What are the five personality trait domains in the DSM-5?

Back 20

negative affectivity, detachment, antagonism, disinhibition, and psychoticism

Front 21

What are the 5 personality trait facets in the negative affectivity domain?

Back 21

anxiousness, emotional labilitiy, hostility, perserveration, restricted activity, submissiveness

Front 22

What are the 5 personality trait facets in the detachment domain?

Back 22

anhedonia, depressivity, intimacy avoidance, suspiciousness, and withdrawal

Front 23

What are the 5 personality trait facets in the antagonism domain?

Back 23

attention seeking, callousness, deceitfulness, grandiosity, and manipulativeness

Front 24

What are the 5 personality trait facets in the disinhibition domain?

Back 24

distractibility, impulsivity, irresponsibility, and rigid perfectionism

Front 25

What are the 5 personality trait facets in the psychoticism domain?

Back 25

eccentricity, perceptual dyregulation, unusual belifs/experiences

Front 26

What are the 4 criteria for a PD in DSM-5?

Back 26

1. significant impairments in self and interpersonal functioning;
2. at least one pathological personality trait domain or facet;
3. personality impairments are persistent and pervasive;
4. personality impairments are not explained by developmental stage. sociocultural environment, substance abuse, another psychological condition, or a medical condition

Front 27

What are the 8, of which 4 must be present, for the diagnosis of Obessive-compulsive PD in the DSM-IV-TR?

Back 27

1. preoccupation with rules, details, and organisation to the extent that the point of the acitvity is lost;
2. extremem perfectionism interferes with task completion;
3. excessive devotion to work to the exclusion of leisure and friendships;
4. inflexibility about moral and values;
5. difficulty disregarding worthless items;
6. reluctance to delegate unless others conform to one's standards;
7. miserliness;
8. rigidity and stubborness

Front 28

An intense need for order and control describes which PD?

Back 28

Obsessive-compulsive PD

Front 29

What traits and facets must be present to meet the DSM-5 criteria for obsessive-compulsive PD?

Back 29

1. Disinhibition - characterised by rigid perfectionism;
2. Negative Affectivity - characterised by perserveration

Front 30

What are the 9, of which 5 must be present, for the diagnosis of Narcissistic PD in the DSM-IV-TR?

Back 30

1. grandiose view of one's importance;
2. preoccupation with one's success, brilliance, or beauty;
3. belief that one is speical and can be understood only by other high-status people; 4. extreme need for admiration;
5. strong sense of entitlement;
6. tendency to exploit others;
7. lack of empathy;
8. envious of others;
9. arrogant behaviour or attitudes

Front 31

Grandiose view of their abilties and are preoccupied with fantasies of great success characterises which PD?

Back 31

Narcissistic PD

Front 32

What traits and facets must be present to meet the DSM-5 criteria for narcissistic PD?

Back 32

Anatagonism - characterised by grandiosity and attention seeking

Front 33

What are the 9, of which 5 must be present, for the diagnosis of Schizotypal PD in the DSM-IV-TR?

Back 33

1. ideas of reference;
2. peculiar beliefs or magical thinking;
3. unusual perceptions;
4. peculiar patterns of thought and speech;
5. suspiciousness or paranoia;
6. innapropriate or restricted affect;
7. odd or eccentric behaviour or appearance; 8. lack of close friends;
9. anxiety around other people, which does not diminish with familiarity

Front 34

Unusual and eccentric thoughts and behaviour, interpersonal detachment and suspisciousness describe which PD?

Back 34

schizotypal PD

Front 35

What traits and facets must be present to meet the DSM-5 criteria for schizotypal PD?

Back 35

1. psychoticism - characterised by eccentricity, cognitive and perceptual dysregulation, and unusual beliefs and experiences;
2. detachment - characterised by restricted affectivity and withdrawal;
3. negative affectivity - characterised by suspiciousness

Front 36

What are the 7, of which 4 must be present, for the diagnosis of Avoidant PD in the DSM-IV-TR?

Back 36

1. avoidance of occupational activities that involve significant interpersonal contact, because of fears of criticism or disapproval;
2. unwilling to get involved with people unless certain of being liked;
3. restrained in intimate relationships because of fear of being shamed or ridiculed;
4. preoccupation with being criticised or rejected;
5. inhibited in new interpersonal situations because of feelings of inadequacy;
6. views self as socially inept or inferior;
7. unusually reluctant to try new activites because they may prove embarrassing

Front 37

Being so fearful of criticism, rejection, and disapproval that they will avoid jobs or relationships to protect themselves from negative feedback describes which PD?

Back 37

Avoidant PD

Front 38

What traits and facets must be present to meet the DSM-5 criteria for avoidant PD?

Back 38

1. Detachment - characterised by withdrawal, intimacy avoidance, and anhedonia;

2. Negative affectivity - characterised by anxiousness

Front 39

Along with 2 other criteria what are the 7, of which 3 must be present, for the diagnosis of Antisocial PD in the DSM-IV-TR?

Back 39

1. Repeated lawbreaking;
2. Deceitfulness, lying;
3. Impulsivity;
4. Irritability and agressiveness;
5. Reckless disregard for own safety and that of others;
6. Irresponsibility as seen in unreliable employment or financial history;
7. Lack of remorse

Front 40

Which PD involves a pervasive pattern of disregard for the rights of others?

Back 40

Antisocial PD

Front 41

Which other term is often used interchangeably with antisocial PD?

Back 41

psychopathy

Front 42

What is the key characteristic of psychopathy?

Back 42

poverty of both negative and positive emotions

Front 43

What are the three criteria for antisocial PD in the DSM-IV-TR?

Back 43

1. Age 18 or over;
2. Evidence of conduct disorder before age 18;
3. Pervasive pattern of disregard for the rights of other since age 15 as shown by at least 3 of the 7 listed criteria.

Front 44

What traits and facets must be present to meet the DSM-5 criteria for Antisocial PD?

Back 44

1. Antagonism - characterised by manipulativeness, deceitfulness, callousness, and hostility;

2. Disinhibition - characterised by irresponsibility, impulsivity, and risk taking

Front 45

What are the 8, of which 5 must be present, for the diagnosis of Borderline PD in the DSM-IV-TR?

Back 45

1. frantic efforts to avoid abandonment;
2. unstable interpersonal relationships in which otehrs are either idealised or devalued;
3. unstable sense of self;
4. self-damaging, impulsive behaviours in at least two areas, such as spending, sex, substance abuse, reckless driving, being eating;
5. recurrent suicidal behaviour, gestures, or self injurious behaviour;
6. recurrent bouts of intense or poorly controlled abger;
7. during stress, a tendancy to experience transient paranoid thoughts and dissociative symptoms.

Front 46

Impulsivity and instability in relationships and mood describes which PD?

Back 46

Borderline PD

Front 47

What traits and facets must be present to meet the DSM-5 criteria for borderline PD?

Back 47

1. Negative affectivity - characterised by emotional lability, anxiousness, seperation insecurity, and depressivity;

2. Disinhibition - characterised by impulsivity and risk taking; 3. Antagonism - characterised by hostility

Front 48

Prevalence of Obessive-compulsive PD in clinical and general population

Back 48

8.7% in clinical and 1.9% in general

Front 49

Is Obsessive-Compulsive PD more common in men or woman?

Back 49

woman

Front 50

Obsessive-Compulsive PD is most commonly comorbid with which other PD?

Back 50

Avoidant PD

Front 51

Rigidity and controlling behaviours are features of which PD?

Back 51

Obsessive-compulsive PD

Front 52

What are three features in the aetiology of Obsessive-compulsive PD?

Back 52

1. Genetic predisposition;
2. Parental reinforcement of conformity/neatness;
3. Fear of loss of control

Front 53

What are three methods for treating Obsessive-compulsive PD?

Back 53

1. Directed at fear of inadequacy;
2. Redirect compulsive thoughts;
3. Relaxation. Distraction.reality testing

Front 54

Prevalence of Narcissistic PD in clinical and general population

Back 54

2.3% in clincial and >1% in general

Front 55

Is Narcissistic PD more common in men or woman?

Back 55

Men

Front 56

Narcissistic PD is most commonly comorbid with which other PD?

Back 56

Borderline PD

Front 57

What is the primary goal of people with narcissistic disorder to interact with others?

Back 57

to bolster their own self esteem

Front 58

What do people with narcissistic PD show that helps maintain their grandiose beliefs?

Back 58

cognitive bias

Front 59

Failure of parents to model what is implicated in the aetiology of narcissistic PD?

Back 59

empathy

Front 60

The self-psychology model suggests that narcisstic PD masks what?

Back 60

a fragile self-esteem

Front 61

What two parenting dimensions increase the risk of narcissistic PD in the self-psychology model?

Back 61

emotional coldness and an overemphasis on the child's achievements

Front 62

The social cognitive model of narcissistic PD is built around what two basic ideas?

Back 62

1. people with this disorder have a fragile self esteem and;
2. interpersonal interactions are important to them for bolstering self-esteem, rather than for gaining closeness or warmth

Front 63

For a person with Narcissistic PD it is more important for them to be admired or to achieve competitive succes than it is to be what?

Back 63

close to others

Front 64

Why is treatment of narcissistic PD difficult?

Back 64

because they are hypersensitive to evaluation

Front 65

What is the goal for treatment of narcissistic PD?

Back 65

focus on others

Front 66

What is used to help a person with narcissistic PD accept criticism?

Back 66

development of coping strategies

Front 67

Prevalence of Schizotypal PD in clinical and general population

Back 67

0.6% in clinical and 0.6% in general

Front 68

Is Schizotypal PD more common in men or woman?

Back 68

Men

Front 69

Why is it common for people diagnosed with schizotypal PD likely to be comorbid with Avoidant PD?

Back 69

because both involve interpersonal attachment

Front 70

What is the heritability of schizotypal PD?

Back 70

61%

Front 71

A small proportion of people with schizotypal PD develop what other disorder?

Back 71

schizophrenia

Front 72

What don't Schizotypal PD people have that people with schizophrenia have?

Back 72

hallucinations and delusions, psychosis as they can reality test, and they feel others rather than see them

Front 73

What percentage of people with schizotypal PD have comorbid MDD?

Back 73

30 to 50%

Front 74

What neurobiological features are found in people with schizotypal PD are also found in people with schizophrenia?

Back 74

enlarged ventricles and reduced temporal lobe grey matter

Front 75

A combination of what three methods are used for treating schizotypal PD?

Back 75

a combination of antipsychotic medication, community treatment, and social skills training

Front 76

Prevalence of Avoidant PD in clinical and general population

Back 76

14.7% in clinical and 1.2% in general

Front 77

Is Avoidant PD more common in men or woman?

Back 77

Females

Front 78

Avoidant PD is commonly comorbid with which other PD's and at what rate?

Back 78

80% have comorbid borderline or schizotypal PD

Front 79

Avoidant PD commonly co-occurs with which other Axis 1 disorder?

Back 79

social anxiety disorder

Front 80

The heritability of Avoidant PD is?

Back 80

27-35%

Front 81

Compared to schizoid PD, why are people with avoidant PD asocial?

Back 81

because of interpersonal anxiety not because they are apathetic or disinterested in relationships

Front 82

What are 5 treatment options for Avoidant PD?

Back 82

1. Behavioural interventions aimed at building social skills and reducing anxiety;
2. Exposure therapy;
3. Role Paly;
4. Modeling;
5. Cogntive therapy

Front 83

What is the prevalence of Antisocial PD in males vs females?

Back 83

3% in males and 1% in females

Front 84

What two factors or highly correlated with the prevalence of antisocial PD?

Back 84

low SES and urban living

Front 85

What percentage of people with antisocial PD have a comorbid disorder?

Back 85

75%

Front 86

What is the most common comorbid disorder for people with antisocial PD?

Back 86

substance abuse

Front 87

What is the PCL-R?

Back 87

Psychopathy Check List - Revised

Front 88

Who was the author of the Mask of Sanity and what is it about?

Back 88

Harvey Cleckley - psychopathy

Front 89

Superficial charm is asscoaited with what type of Personality trait?

Back 89

psychopathy

Front 90

What three forms of evidence are collected to complete the PCL-R?

Back 90

interviews, criminal records and social work reports

Front 91

Does the diagnosis of psychopathy require the onset of symptoms before age 15?

Back 91

no

Front 92

What three facets of the family environment predict anti social behaviour?

Back 92

high negativity, low warmth, and prenatal inconsistency

Front 93

People with psychopathy have deficits in what repsonse?

Back 93

fear response

Front 94

Why might there be deficits in fthe fear response in people with psychopathy?

Back 94

because they have low autonomic arousal demonstrated by lower skin conductance and cortisol levels

Front 95

People with psychopathy may be unresponsive to threats when they are pursuing what?

Back 95

reward

Front 96

What technique seems to increase the liklihood of people with pychopathy to reflect on negative feedback and behave less impulsively?

Back 96

pausing before responding to stimuli

Front 97

A lack of response to threats is known as what?

Back 97

impulsivity

Front 98

What are the two issues involved with treating people with antisocial PD?

Back 98

rarely identify with needing treatment and can be manipulative with therapist

Front 99

What is the most common treatment strategy for children at high risk of antisocial PD?

Back 99

parenting training using antisocial and prosocial behaviours

Front 100

What are the three risks for ceasing treatment for antisocial PD?

Back 100

high degree of family dysfunction/stress, low SES, and parental history of AD, CD as a child

Front 101

What percent of people with borderline PD commit suicide?

Back 101

7.50%

Front 102

What proportion of people with borderline PD self harm?

Back 102

two-thirds

Front 103

When does borderline PD tend to improve?

Back 103

30' s and 40's

Front 104

Prevalence of Borderline PD in clinical and general population

Back 104

9.3% in clinical and 2.7% gernal

Front 105

What percentage of people with borderline PD are female?

Back 105

75%

Front 106

What five disorders is BPD mostly comorbid with?

Back 106

PTSD, MDD, bipolar, bulimia, and substance use

Front 107

Which other disorder is BPD most comorbid with?

Back 107

substance abuse

Front 108

Heritability of BPD?

Back 108

60%

Front 109

People with BPD show increased activation of which brain structure?

Back 109

amygdala

Front 110

Which system is implicated in BPD?

Back 110

serotonergic system

Front 111

People with BPD show decreased activation and structural changes in which brain structure?

Back 111

prefrontal cortex, specifically anterior cingulate cortex

Front 112

The connectivity between which two brain structures seems disrupted in people with BPD?

Back 112

the prefrontal cortex and the amygdala

Front 113

People with BPD are much likely to report what events in the childhood?

Back 113

parental separation, verbal abuse, and emotional abuse

Front 114

Who developed the diathesis-stress theory for BPD?

Back 114

Linehan

Front 115

The object relations theory of BPD aetiology asserts that inconsistent childhood experiences causes what?

Back 115

splitting - extreme dichotmous views

Front 116

What are the two main factors of the diathesis-stress theory for BPD?

Back 116

emotional dysregulation and invalidation

Front 117

Explain the cycle that occurs in the diathesis-stress theory of BPD development?

Back 117

the child has emotion dysregulation and demands from other, this elicits and invalidating repsonse from parents such as punishment causing the child to supress the emotions which leads to an emotional outburst due to inability to regulate emotions

Front 118

What is the main challenge of treating people with BPD?

Back 118

the therapist finds it challenging to develop and maintain the therapeutic relationship

Front 119

Antidepressents are used to treat what symptoms in people with BPD?

Back 119

aggressiveness and depression

Front 120

What are the three main psychological treatments for BPD?

Back 120

dialectical behavior therapy, mentalisation-based therapy, and schema-focused cognitive therapy

Front 121

What is aim of DBT for BPD?

Back 121

to stop the black and white thinking

Front 122

DBT stands for what?

Back 122

Dialectical Behaviour Therapy

Front 123

How does DBT work?

Back 123

by combining client-centred empathy and acceptance with cogntive behavioral problem solving, emotion regulation techniques, and social skills training

Front 124

What are the four stages of DBT?

Back 124

Stage 1 - promote greater control of impulsive behaviours;
Stage 2 - learn to modulate extremem emotionality;
Stage 3 - improving relationships and self-esteem;
Stage 4 - promote connectedness and ahppiness

Front 125

What is mentalisation?

Back 125

thinking about their own and other's feelings

Front 126

Why might people with BPD fail to engage in mentalisation?

Back 126

because early insecurity in relationships, coupled with intense trauma, leads the person to defensively avoid thinking about feelings and relationships

Front 127

What is the goal of the therapist in Menatlisation-based therapy for BPD?

Back 127

to foster a more active, thoughtful apporach to relationships and feelings

Front 128

What is the main aim of schema-focused therapy for people with BPD?

Back 128

work with the person identify maladaptive schemas and increase the use of healthy schemas

Front 129

A pervasive distrust and suspiciousness of others describes which PD?

Back 129

Paranoid PD

Front 130

A pervasive pattern of detachment form social relationship and a restricted range of expressions of emotions in interpersonal settting describes which PD?

Back 130

Schizoid

Front 131

A pervasive pattern of excessive emotionality and attention seeking describes which PD?

Back 131

Histrionic PD

Front 132

A pervasive and excessive need to be taken care of that leads to a submissive and clinging behaviour and fears of separation described which PD?

Back 132

Dependent PD

Front 133

When are personality disorders thought to begin?

Back 133

in childhood

Front 134

When did personality disorders begin to receive attention in the research?

Back 134

1980

Front 135

What is the particular problem with diagnosis of personality disorders?

Back 135

comorbidity

Front 136

What are the three most prevalent PD's

Back 136

avoidant, obsessive-compulsive and antisocial

Front 137

What are the least prevalent PD's?

Back 137

schizotypal, narcissistic, and borderline

Front 138

The overal prevalence of PD's in the clincial and general populations

Back 138

0.5 to 2.5% in general pop and 10% to 30% in clinical pop