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PSY 320 Exam 2 Study Guide

by: Erin Wade

PSY 320 Exam 2 Study Guide PSY 320

Marketplace > Colorado State University > Psychology (PSYC) > PSY 320 > PSY 320 Exam 2 Study Guide
Erin Wade
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Prof Amberg Personality disorders, anxiety disorders, depression, and phobias
Abnormal Psychology
Martha D Amberg
Study Guide
PSY320, abnormalpsychology, exam2, Amberg
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This 18 page Study Guide was uploaded by Erin Wade on Wednesday October 5, 2016. The Study Guide belongs to PSY 320 at Colorado State University taught by Martha D Amberg in Fall 2016. Since its upload, it has received 120 views. For similar materials see Abnormal Psychology in Psychology (PSYC) at Colorado State University.

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Date Created: 10/05/16
PSY 320 Exam 2 Study Guide Chapter 5 Anxiety Disorders (Fight or Flight Response) - Physical and psychological responses - fight a threat or flee - Noticeable effects ● Pupil dilation ● Dry mouth ● Tensing of muscles in neck and shoulders ● Pounding heart ● Breathing is fast and shallow (oxygen needed for muscles) ● Sweating - Hidden effects ● Adrenaline produced ● Liver releases glucose (energy for muscles) ● Blood pressure rises ● Brain gets body ready for action - Activate 2 systems 1. Sympathetic Nervous System ● Uses nerve pathways to initiate reactions ● Release norepinephrine ○ Neurotransmitter responsible for vigilant concentration 2. Adrenal-cortical system ● Uses bloodstream to initiate reactions ● Corticotropin-releasing factor (CRF) ○ Activates the adrenal cortical system ● Adrenocorticotropic hormone (ACTH) ○ Increased production and release of cortisol Posttraumatic Stress Disorder (PTSD) - Diagnostic criteria of DSM-5 requires: a) Exposure (at least 1) ● Directly experience or witness traumatic event ● Learn event happened to someone close ● Experience repeated/extreme exposure to the details of event b) Intrusive symptoms ● Reliving event ● Dreams ● Dissociative reaction (flashbacks) ● Psychological distress and physical reactions to cues that resemble the event c) Persistent avoidance ● Avoid thoughts, or memories of event ● Avoid physical cues (people, places) d) Negative changes in thought and mood associated with event ● Inability to remember key details ● Persistent and exaggerated negative beliefs ● Distorted and negative beliefs of event - lead to guilt ● Persistent negative state ● detachment/estranged from others ● Inability to experience positive emotions e) Changes in arousal and reactivity ● Extreme irritability ● Hypervigilance ● Exaggerated startle response ● Reckless self destructive behavior ● Difficulty concentrating ● Sleep disturbances f) Duration of at least one month g) Significant distress or impairment on social life or occupation h) Not due to physiological effect, substance abuse or other medical condition G and F are on every diagnosis in DSM - Common causes ● Rape ● War ● Natural disasters ● Car or plane crashes ● Terrorist attacks ● Sudden death of loved one ● Kidnapping ● Assault ● Sexual, emotional or physical abuse ● Childhood neglect ● First responders - Theories of why some people get PTSD and others don’t ● Environmental and social factors ○ Severity and duration ○ Proximity to trauma ○ Social support available ● Psychological factors ○ Pre-existing conditions ○ Coping strategies ● Gender and cross cultural differences ○ Women more prone - more documented cases, because rape is #1 cause and men are less likely to admit PTSD issues and more likely to self medicate ○ African americans have higher rates - again, not really a biological reason that African Americans would have more PTSD, there are just more documented cases ● Biological factors ○ Neuroimaging findings - brains of people with PTSD more reactive to emotional stimuli, can’t tell which comes first emotional reactivity or PTSD ○ Biochemical findings ■ Exaggerated physiological response to stress ■ Exposure to extreme or chronic stress during childhood ○ Genetics ■ Vulnerability to PTSD can be inherited ■ Problem with this - child growing up with someone who has PTSD could predispose them to get the disorder, not necessarily genetic - Treatments for PTSD ● Cognitive Therapy ○ Systematic desensitization - associate pleasant relaxed state with anxiety triggering stimuli ● Cognitive restructuring ○ Make sense of bad memories ○ Sometimes memory differs from event ● Stress-inoculation therapy - therapists teach clients skills for overcoming problems that: ○ Increase stress ○ Result from PTSD ● Biological therapies ○ Selective serotonin reuptake inhibitors (SSRIs) - Prozac, Zoloft ○ Benzodiazepines - Xanax Other Trauma Related Disorders - Acute stress disorder - occurs with traumas similar to PTSD ● Lasts no longer than 4 weeks - Adjustment disorder - emotional and behavioral symptoms arise within three weeks Phobias - Unreasonable or irrational fears of specific objects or situations ● Common phobias: ○ Arachnophobia - fear of spiders ○ Ophidiophobia - fear of snakes ○ Acrophobia - fear of heights ○ Agoraphobia - fear of open or crowded spaces ○ Cynophobia - fear of dogs ○ Astraphobia - fear of thunder/lightning ○ Claustrophobia - fear of small spaces ○ Mysophobia - fear of germs ○ Aerophobia - fear of flying ○ Trypophobia - fear of holes ● Categories according to DSM-5 ○ Animal type ■ Snakes & spiders ○ Natural environment type ■ Heights ○ Situation type ■ Claustrophobia ○ Blood-injection-injury type ■ Germs & disease ■ Dentist & doctor - Theories of Phobias ● Behavioral ○ Negative reinforcement - anxiety is reduced by avoidance ○ Classical conditioning - conditioning to certain objects or situations ■ Little Albert ● Biological ○ Related people share phobias - Treatment of Phobias ● Exposure to extinguish fear ○ Systematic desensitization - start with it far away from you (mentally and then physically) ○ Modeling - showing that other people are calm and okay with situation ○ Flooding - have them face fear right away ● Applied tension technique ○ Tension increases blood pressure to keep from fainting ● Biological treatment - Benzodiazepines Social Anxiety Disorder - Anxiety in social situations ● Rejected, judged, or humiliated in public ● Focus on avoiding such events ● More common in women ● Develops often in adolescence - Treatment for Social Anxiety Disorder ● Selective serotonin reuptake inhibitors (SSRIs) ● Serotonin-norepinephrine reuptake inhibitors (SNRIs) ● Cognitive-behavioral therapy ○ Identifying negative cognitions and dispute them ○ Role playing ● Mindfulness-based interventions Panic Disorder - Panic attacks - short extremely intense periods when someone experiences many anxiety symptoms ● Symptoms: ○ Racing heart ○ Difficulty breathing - compressed ○ Sweating ○ Racing thoughts ○ Hyperventilating ○ Trembling/shaking ○ Trouble sleeping - intrusive thoughts ● Panic attacks become common and unprovoked ● Worry about having panic attacks and change behaviors as result - like not going out in public because they don’t want to have a panic attack in front of someone ● Fear of having a life threatening illness - think they are having a heart attack sometimes - Theories of Panic Disorder ● Heritability 43-48% ● Triggers: ○ Hyperventilating ■ Ex: being out of breath from running can be like opening the floodgates for all the other symptoms ○ Ingest caffeine ○ Breathing into a paper bag - breath in CO2, makes it harder to breath ● Involvement of limbic system ○ Amygdala, hypothalamus, hippocampus ○ Locus Ceruleus ■ Dysregulation of norepinephrine system ■ Pathway to limbic system - Cognitive factors ● Misinterpret body sensations in a negative way ○ Walk up five flights of stairs will make you a little short of breath and heart beat faster - misinterpret it to be more concerning ● Snowballing catastrophic thinking ● Believe bodily symptoms have harmful consequences ● Heightened awareness of cues signaling panic attack ○ Conditioned cues - Treatments for Panic Disorder ● Biological treatments ○ Medication affecting serotonin and norepinephrine systems ■ Benzodiazepine ● Cognitive-behavioral therapies ○ Relaxation and breathing exercises ○ Identifying the catastrophizing cognitions ○ Systematic desensitization therapy Generalized Anxiety Disorder - Symptoms ● Anxious all the time ● Worrying about life ● Typically begins in childhood ● More common in women - Theories of Generalized Anxiety Disorder ● Experiencing intense negative emotions ● Heightened reactivity to emotional stimuli in amygdala - amygdala is being overstimulated ● Make maladaptive assumptions - assume world is bad place ● Detecting possible threats in the environment ○ Unconscious cognitions ● Deficiency of gamma-aminobutyric acid ○ Excessive firing of neurons through many areas of the brain ■ Chronic, diffuse symptoms of anxiety ○ Modest heritability Separation Anxiety Disorder - Anxious and upset is separated from primary caregivers ● Not diagnosed unless ○ Symptoms persist for at least 4 weeks ○ Significantly impair the child’s functioning - Theories of Separation Anxiety Disorder ● Biological factors ○ Tendency toward anxiety is heritable ○ Behavioral inhibition - causes children to be ■ Shy, fearful and irritable as toddlers ■ Cautious, quiet, and introverted as school-age children ● Psychological and sociocultural factors ○ Learn to be anxious from parents - Treatments for Separation Anxiety Disorder ● Cognitive-behavioral therapies - Teach skills ○ Coping and challenging cognitions that feed anxiety ○ Relaxation exercises ○ Challenge fears about separation ■ Self-talk to calm ● Drugs used are antidepressants, anti anxiety, stimulants and antihistamines Obsessive Compulsive Disorder - Obsessions - Persistent thoughts, images, ideas, or impulses ● Uncontrollably intrude upon consciousness ● Cause significant anxieties or distress - Compulsions - Repetitive behaviors of mental acts that an individual feels he or she must perform - Releases STRESS from obsession - DSM Criteria A) Persistence of Obsessions, compulsions, or both ● Obsessions: 1 & 2 ○ ● Compulsions: 1 & 2 ○ B) Time consuming - over hour a day or causes distress in social function C) Not attributable to substances or medical condition D) Not better explained by other condition - Common types of ​obsession​ in OCD ● Contamination ○ Body fluids ○ Germs/disease ○ Environmental contaminants ○ Dirt ● Losing Control ○ Fear of acting on an impulse to harm oneself or others ○ Fear of violent or horrific images in one’s mind ○ Fear of blurting out obscenities or insults ○ Fear of stealing things ● Harm ○ Fear of being responsible for something terrible happening ● Obsessions related to perfectionism ○ Concern about evenness or exactness ○ Concern with a need to know or remember things ● Unwanted sexuaal thoughts ○ Forbidden or perverse sexual thoughts or images ○ Forbidden or perverse sexual impulses about others ● Religious Obsessions (Scrupulosity) ○ Concern with offending God, or concern about blasphemy ○ Excessive concern with right/wrong morally ● Hoarding - closely related to OCD, but is classified as a separate diagnosis in the DMS-5 - Common types of ​compulsions​ in OCD ● Washing and Cleaning ○ Excessive showering, bathing, grooming or hand washing ○ Excessive cleaning household items or other objects ○ Prevent or remove contact with contaminants ● Checking ○ Checking that you did not/will not harm self or others ○ Checking that you did not make a mistake ○ Checking physical condition or body ● Repeating ○ Rereading or rewriting ○ Repeating routine activities or body movements ■ Repeating activities in “multiples” (ex: doing a task three times because three is a “good,” “right,” number) ● Mental compulsions ○ Mental review of events to prevent harm (to oneself or others, to prevent terrible consequences) ○ Praying to prevent harm (to oneself or others, to prevent terrible consequences) ○ Counting while performing a task to end on a “good,” “right,” or “safe” number ○ “Cancelling” or “Undoing” (Ex: replacing a “bad” word with a “good” word to cancel it) ● Other compulsions ○ Putting things in order or arranging things until it “feels right” ○ Avoiding situations that might trigger your obsessions - Theories of OCD and Related Disorders ● Biological Theories ○ Focus on a circuit in the brain involved in motor behavior, cognition, and emotions ○ Response to drugs is good ○ Genes help determine who is vulnerable to OCD ● Characteristics of people who develop OCD: ○ Depressed or generally anxious much of the time ○ Tendency toward rigid, moralistic thinking ○ Believe they should be able to control all their thoughts ○ Trouble accepting that everyone has horrific notions occasionally ● Compulsions develop largely through operant conditioning - negatively reinforced because compulsions help relieve anxiety from obsessions - Treatments for OCD and Related Disorders ● Biological treatments - antidepressants, serotonin-enhancing drugs ○ Have significant side effects - sometimes worse than the original problem ● Cognitive-behavioral treatments ○ Exposure and response prevention - exposes the client to the focus of the obsession, preventing compulsive responses to the resulting anxiety ○ Challenges individual’s moralistic thoughts, excessive sense of responsibility, and maladaptive cognitions - OCD Mythconceptions (Misconceptions) ● We are all a little bit OCD sometimes ● Not a big deal - they just need to learn to relax ● Is just being a neat freak - cleaning, hand washing ● People with OCD can’t live a productive life Chapter 6 Somatic Symptoms Disorders - Soma - Body ● Preoccupation with health and/or body appearance and functioning ● No identifiable medical condition - Types of DSM-V Somatoform Disorders ● Illness anxiety disorder ● Somatic symptoms disorder ● Conversion disorder ● Fictitious disorder - Illness Anxiety Disorder ● Worry that they have or will develop a serious illness ○ No serious physical symptoms ○ Physical complaints ■ Very alarmed and concerned ■ Usually seek medical care, or sometimes avoid the doctor because they don’t want to be told it’s all in their head ○ Not faking it, they believe it so much that they really do feel the pain ● Theories of Somatic Symptom Disorder and Illness Anxiety disorder ○ Cognitive factors ■ Dysfunctions beliefs about illness - might think of being sick as a beneficial thing (like getting special attention when you’re sick) ■ Increased attention to physical change (my hand fell asleep) ■ Catastrophize symptoms (my hand is tingling, maybe I have a tumor) ● Treatment of Somatic Symptoms Disorder and Illness Anxiety disorder ○ Psychodynamic therapies ■ Provide insight into emotions that link to physical symptoms ○ Behavioral therapies ■ Learn and eliminate reinforcements ○ Cognitive therapies ■ Challenge physical symptoms to avoid catastrophizing them ○ Belief systems ■ Engage in therapy to work on the physical symptoms - Conversion disorder ● Lose neurologic functioning in a certain body part ○ Ex: Glove anesthesia - lose feeling to part of your hand, like wearing a glove that wiped out physical sensation ● Theories of Conversion Disorder ○ Freudian ■ Transfer of psychic energy attached to repressed emotions ■ Primary gain - reduced anxiety because attention is shifted from sexual frustration to physical ailment ■ Secondary gain - attention ○ Behavioral ■ Alleviates stress by removing individual from the environment (If you have a lot of stress about medical school and then you wake up and can’t feel your hand then you can’t do school and have to focus on something else for a little while) ■ La belle indifference - unconcerned by loss ● Therapy for Conversion Disorder ○ Psychoanalytic ■ Express painful emotions or memories linked to symptoms ○ Behavioral ■ Relieve anxiety centered on the initial trauma (stressor) ■ Reducing benefits (reinforcing sickness) - Fictitious Disorder ● Munchausen's syndrome ○ Deliberately faking symptoms of an illness to gain medical attention ■ Don’t just fake it, but do things to actually make themselves sick ○ Munchausen’s syndrome by proxy ■ Falsifying illness in another person (primary caregiver making their child or elderly people sick on purpose) ○ Malingering - faking a symptom or a disorder in order to avoid an unwanted situation or to gain something other than attent​ his is not a disorder) ■ Ex: faking a problem in order to get out of military service Dissociative Disorders - Derealization - loss of sense of the reality of the external world - Depersonalization - loss of sense of own reality - 4 types ● Depersonalization disorder ● Dissociative amnesia ● Dissociative fugue ● Dissociative Identity disorder - Dissociative Identity Disorder (multiple personality) ● Many personalities (alters) coexist in one body ○ Personalities or fragments are dissociated - alters can be different ages, races, genders, etc. ● Switch personalities - alters created because they are lacking other coping strategies ● Auditory hallucinations (from inside heads) ● 97% severe child abuse ● Simulated by malingers - sometimes people fake it ○ Eager to demonstrate symptoms ● Treatment ○ Integrate all alters into one cohort ○ Rebuild capacity to trust healthy relationships ○ Neutralize cues that activated switch to alters ○ Confront traumas - Dissociative Amnesia ● Blocking out of critical personal information ● Usually of a traumatic or stressful nature ● Not caused by physical or medical reasons ● Localized amnesia ○ No memory of specific events (usually traumatic) ○ Loss localized to specific window of time ● Selective amnesia ○ Can recall only small parts of events from a defined period ■ More specialized than localized amnesia - don’t lose the whole chunk of time, just bits of it ● Generalized amnesia ○ Amnesia encompasses entire life ○ Distinct from organic caused amnesia (caused by brain damage etc.), dissociative generalized amnesia is caused by trauma ● Systematized amnesia ○ Loss of memory for a specific category of information ■ Ex: missing all memories about a specific family member due to trauma - Dissociative Fugue (DMS V) ● Sudden unexpected travel away from home ● Inability to recall past ○ Confusion about personal identity or assumes new identity ● Life Stressor usual antecedent ○ Wars, disasters, emotional stress, heavy alcohol abuse, medical causes-epilepsy, head trauma ● Spontaneous, rapid recovery ● Can last months, brief if due to medical cause ● Signs that this is not malingering - when they remember their old life and try to go back to it ● Fugue state is fairly rare, recurrences are rare (might be sign of malingering if it happens a lot) - Depersonalization/Derealization Disorder ● Detachment from mental processes or body (outside observer) ○ Can be induced by some medications - more emotionally distressing ○ Other causes - more truly disconnected, sort of don’t care ● Causes - Significant stressor, sleep deprivation or drugs ● Diagnosis - episodes frequent and distressing and interfere with the ability to function ○ Often history of childhood emotional, physical, or sexual abuse Mood Disorder - Anhedonia - lost interest in life - Changes in appetite, sleep, and activity ● Typically sleep more ● Typically less active ● Appetite can go either way - Psychomotor retardation or agitation - Disturbed reality ● Negative affective state ● Some have delusions and hallucinations - Table 7.2 - Subtypes of Major depressive episodes in textbook - Diagnosing Depressive Disorders ● Major Depressive Disorder ○ Depressive symptoms two + weeks ○ Major depressive disorder, single episode ○ Major depressive disorder, recurrent episodes ● Persistent depressive disorder ○ Depressed mood for at least two years ● Premenstrual dysphoric disorder ○ Increase distress during the premenstrual phase ○ Not as common as people think ● Prevalence and course of depressive disorders ○ High in young adults ○ Low over age 65 ■ Difficult to diagnose ● less willing to report symptoms because in their time it wasn’t okay to talk about ● Serious medical illness ● History of depression more likely to die young ○ Low among children ○ Women report more depressive symptoms ○ Long-lasting and recurrent problems ○ Recover with treatment - Criteria for Manic Episodes ● Period of elevated, or irritable mood- excess energy ● Inflated self-esteem ● Decreased sleep ● Racing thoughts ● Distracted ● Goal directed activity ● Excessive behavior - Criteria for Bipolar I and Bipolar II Disorders ● Bipolar I disorder ○ Depression ○ Mania ● Bipolar II disorder ○ Severe depression ○ Hypomania - mania with less severe symptoms ● Cyclothymic disorder - less severe, but more chronic bipolar condition - Symptoms of Mania ● Rapid cycling - 4+ episodes within 1 year ○ 1 cycle is the start of depression to the end of mania ○ Typically longer periods of depression than mania - Disruptive mood dysregulation disorder ● Temper outbursts out of proportion to situation ● Inconsistent with developmental level (kids and teenagers react more extremely than adults because it is part of their developmental process) - Creativity and Mood Disorders ● Mania benefits certain settings ● Writers, artists, and composers have a high prevalence of mania and depression ● Mood disorders substantially impair thinking and productivity - Theories of depression ● Biological theories of depression ○ Neurotransmitter theories - dysregulation of neurotransmitters and receptors ■ Dopamine, norepinephrine, serotonin ○ Neuroendocrine factors ■ Hormonal dysregulation ● Psychological/Behavioral theories ○ Stress reduces positive reinforcers and lead to depression ○ Learned helplessness theory​ - Uncontrollable negative event is most likely to lead to depression ■ If people are unable to handle/get away from negative thing they eventually give in ● Cognitive theories ○ Negative cognitive triad - negative views of self, world, future ○ Reformed learned helplessness theory - cognitive factors influence helplessness and become depressed following a negative event ■ Cognitive processes create negative outlook and make people think what is the point even if they could have overcome negative event ○ Ruminative response style - thinking as a contributor to depression, dwell on negative aspects and thinking ● Treatment for depression ○ Cognitive Behavioral Therapy (CBT) ■ Pay attention to thinking processes and behavioral responses and work on replacing distorted perceptions and negative reactions with more constructive ones Suicide - Self-inflicted ● Intention to die, not to just hurt themselves - Completed suicide - ended in death - Suicide attempt - the process that may or may not end in death - Suicidal ideation - suicidal thoughts that occur before any attempts are made - Stats ● 34,598 people die by suicide a year in the US ○ 94 a day ● Almost twice as many people die by suicide (34,598) in the US than homicide (18,361) - Demographics ● Rare in children ● Increases in early adolescence (hard time trying to fit in) ● More reported attempts in females ○ Often choose methods that aren’t as lethal (pills, poison, least messy methods) ● More completed suicides in men ○ Chose methods that more often end in death (guns) ● Hispanic females have high rates ● Older males at high risk for suicide (more risk factors - friends dying, economic hardship, debilitating illnesses) ○ Most elderly women have more helpful relationships, so they are at lower risk ○ Older men have less friends/connections to family, so if one of the few connections dies it is more impactful ○ Highest risk is European American men over 85 - Suicide and College ● Over 1,000 students on college campuses (people living in dorms etc.) commit suicide per year ● Suicide 2nd leading cause of death between 25 to 34 and 3rd between 15 to 24 ● One in 10 college students has made a plan for suicide - Aspects promoting suicide ● Psychological disorders ○ Depression ○ Bipolar disease/Manic depression ● Stressful life events ○ Violence and sexual abuse ○ Loss of a loved one ○ Economic hardship ○ Physical illness - Nonsuicidal self-injury (NSSI) - significantly injuring oneself without intention to die ● Cry for help ● Something very dangerous that could potentially kill them, but they are not planning on dying - Historical perspectives on suicide ● Durkheim’s theory ○ Egoistic suicide - feels alienated from others ○ Anomic suicide - experience severe disorientation from society ○ Altruistic suicide - believe that taking own life will benefit society in some way (when people have some type of debilitating disease, they may think that taking their own lives will relieve pressure on other people to take care of them) ● Social ties and integration into society help prevent suicide - Suicide Contagion ● Suicide cluster - nonrandom group of suicide completions and attempts ○ People who knew someone who died ○ Linked by media exposure - when people feel like they knew someone who died (celebrity suicides) ○ Suicide pact - there was usually someone they knew who committed suicide and then the pact is created ● Suicide contagion - modeling behavior from friend or admired celebrity Personality disorders - Personality ● Determines how one feels, interacts, and perceives events ● Personality trait - pattern of behavior, thought, and feeling that is stable across time and across many situations ● Personality disorder - fundamental deficits in people in: ○ Who they are - lacking certain characteristics or traits that affect how they view themselves, how others view them ○ Their ability to have relationships - Steps in diagnosing personality disorder ● Level of functioning - sense of self or relationships with others ● Pathological personality traits ● Meet criteria for personality disorder - Core personality traits (everyone falls somewhere on continuum) ● Negative affectivity - ability to be even-tempered and calm, secure, and able to handle stress (want to have negative affectivity) ● Detachment - appropriately outgoing and trusting of others (want to be in the middle) ● Antagonism: ○ Positive - Honesty, appropriate modesty, concern ○ Negative - Deceitfulness, grandiosity, callousness Cluster A - will not be tested on Cluster B - Dramatic and Erratic ● Problems with being overly emotional and having unpredictable thinking or behavior - Antisocial Personality Disorder ● Pervasive pattern of disregard for and violation of the rights of others ○ Must be over 15 ○ Have 3 of the following ■ Failure to conform to society’s rules and regulations ■ Deceitfulness and conning others for personal profit or pleasure ■ Impulsivity or failure to plan ahead ■ Irritability or aggressiveness as indicated by repeated fights or assaults ■ Reckless disregard for safety of self or others ■ Consistent irresponsibility ■ Lack of remorse - Borderline Personality Disorder ● Benchmarks ○ Out-of-control emotions ○ Hypersensitivity to abandonment ○ Tendency to cling too tightly to other people ■ Holding on to people too tightly can push them away ○ History of hurting oneself - not suicidal, no intent to kill themselves ● Pathological personality traits ○ Unstable self-concept and moods - dependent on others to validate them ○ High antagonism ○ Negative affectivity ● Characterized by: ○ Fundamental deficits in identity and in interpersonal relationships ○ Unstable self concept - periods of extreme self-doubt alternating with grandiose self-importance ● Theories of Borderline Personality Disorder ○ Cognitive theory ■ Childhood abuse, neglect, and instability contribute to difficulties in regulating emotions and in attaining a positive stable identity through several mechanisms ○ Psychoanalytic theory ■ People never learned to fully differentiate their view of themselves from their views of others. Makes them extremely reactive to others’ opinions of them and to the possibility of abandonment ○ Neurobiological theory ■ Smaller amygdala and hippocampus results in difficulty in regulating moods ■ Structural and metabolic abnormalities in the prefrontal cortex ● Resulting in dysregulation of emotional reactions and control of impulsive behavior ○ Biological theory ■ Symptoms are heritable ● Treatment for Borderline Personality Disorder ○ Dialectical behavior therapy ■ Gaining more realistic and positive sense of self independant from other people ■ Learning adaptive skills for solving problems and regulating emotions ■ Correcting dichotomous thinking (thinking that is extremely one side or the other, no grey areas) ○ Cognitive therapy treatments ■ Systems training for emotional predictability and problem solving (STEPPS) ● Shows greater improvement in negative affect, impulsivity, and functioning - Narcissistic Personality Disorder ● Associated with ○ Self-importance and arrogance ○ Seeking constant, unwarranted, admiration from others ○ Relying on self-evaluations and seeing dependency on others as weak and dangerous ● Results in high rates of substance abuse and of mood and anxiety disorders ● Theories of Narcissistic Personality Disorder ○ Psychodynamically oriented theory ■ Symptoms are maladaptive strategies for managing emotions and self-views ○ Cognitive theory ■ Result of unrealistically positive assumptions about self-worth developed because of indulgence and overvaluation by others during childhood ■ People develop the belief that they are unique or exceptional as a defense against rejection by important people in their lives ● Treatments for Narcissistic Personality Disorder ○ Cognitive techniques help develop: ■ Realistic expectations of their abilities ■ Sensitivity to the needs of others ■ Learning to challenge their initially self-aggrandizing interpretations of situations ○ Majority of the affected people don’t seek treatment - Histrionic Personality Disorder ● Pervasive pattern of excessive emotionality and attention seeking ○ Uncomfortable when they are not the center of attention ○ Often inappropriate sexually seductive behavior ○ Rapidly shifting and shallow expression of emotion ○ Consistently uses physical appearance to draw attention to self ○ Speech excessively impressionistic and lacking in detail ○ Self-dramatization and exaggerated emotion ○ Suggestible - change opinions etc. depending on situation ○ Considers relationships to be more intimate than they are


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