Chapter 10 Notes
Chapter 10 Notes PSYC 3014
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This 4 page Class Notes was uploaded by Megan Standiford on Thursday March 24, 2016. The Class Notes belongs to PSYC 3014 at Virginia Polytechnic Institute and State University taught by Dr. John Richey in Winter 2016. Since its upload, it has received 10 views. For similar materials see Abnormal Psychology in Psychlogy at Virginia Polytechnic Institute and State University.
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Date Created: 03/24/16
Chapter 10 What is a personality disorder? 2 defining features o Patient had extreme interpersonal difficulties o Patient has problems with sense-of-self (his/her identity) Was coded on "Axis II" in DSM 4 o In DSM 5, no "axes" at all anymore 3 clusters of personality disorders o Odd/eccentric- A o Dramatic/erratic- B o Anxious/fearful- C Clinical features o The prevalence of personality disorders is fairly high Approx. 13% in the general population o Rampant comorbidity Comorbidity is the rule, not the exception Both within-axis and across-axis o PD patients almost never present for treatment complaining of PD Stable over time Inflexible across situations Onset in adolescence or early adulthood Cluster A Odd/eccentric A pattern of interpersonally odd, or overtly bizarre behaviors Paranoid Personality Disorder o Clinical features First off- this is NOT paranoid schizophrenia Pervasive mistrust Preoccupation with trustworthiness of others Preoccupation with real or imagined insults/threats Quarrelsomeness/hostility Patients underlying assumption is that others are malevolent (out to get them) o Differential diagnosis How is this different from paranoid schizophrenia? Schizoid Personality Disorder o Again, not the same thing as schizophrenia o DSM 5 Criteria Pattern of detachment from social relationships Patient neither desires not enjoys social relationships Emotionally indifferent or cold Not better accounted for by schizophrenia o Distinguished from other Cluster A by Prominence of social/interpersonal deficits Absence of cognitive/perceptual distortions Schizotypal Personality disorder o Again, not eh same thing as schizophrenia o DSM 5 Criteria Social/interpersonal deficits with cognitive or perceptual distortions Odd beliefs Suspiciousness or paranoid ideation Not better accounted for by schizophrenia No hallucinations of delusions o Behavioral syndrome that represents the genetic liability for schizophrenia o Depending on life events, Schizotypal PD may progress to schizophrenia Cluster B Dramatic/erratic Histrionic personality Disorder o Clinical features Superficially dramatic Manipulative and shallow Insatiably attention-seeking o Secondary features Self image is gregarious Cognitive style is flighty o DSM 5 Criteria Patient is uncomfortable in situations where he/she is not the center of attention Inappropriate provocative or sexually seductive behavior Rapidly shifting and shallow expression of emotion Considers relationships to be more intimate than they actually are Narcissistic Personality Disorder o Clinical features Excessive self love Grandiose fantasy Desire for uniqueness o Characterized by excessive Grandiosity Lack of empathy Feelings of superiority Demands immediate compliance from others o Two forms Overt: Oblivious, outwardly grandiose Covert: Hypersensitive to evaluation by others, inhibited, outwardly modest o What's underneath? The "vulnerable narcissist" Antisocial Personality Disorder o "Psychopath" o Clinical Features Intelligence, Superficial Charm Callous, unemotional traits Lack of empathy, remorse o DSM 5 Criteria Impairments in self-functioning Egocentrism Goals based on personal gratification Impairments in interpersonal functioning Lack of empathy Lack of intimacy o Often times, these traits can be seen early in development o Severe childhood conduct disorder is thought to be a precursor to ASPD o Psychopathy is a juxtaposition of severe underlying pathology against the overt appearance of mental health o "Cleckley Psychopath" The "successful" psychopaths who live among us Borderline Personality Disorder o Pervasive pattern of instability in social relationships o Frantic efforts to avoid real or imagined abandonment o Profound emotional reactivity o The term "borderline" is an antiquated and outdated term o Originally meant to refer to the 'border' between neurosis and psychosis o Highly comorbid Depression Substance dependence o Sense of emptiness Lack of identity o Idealization or devaluation of friends/family "splitting" - when patient o "stormy" interpersonal relationships o Internal emotional turmoil Emotional "lability" o Sometimes accompanied by extreme behaviors Cutting Self injury Excessive sexuality o Suicide attempts can be attempts to manipulate others However, rates of suicide are elevated in BPD o Key Question Why might a disorder characterized by instability result in these kinds of behaviors? These behaviors are attempts to regulate negative emotions Cluster C A pervasive pattern of inhibited/fearful behaviors Anxious/Fearful Pervasive pattern of social inhibition Limited social relationships o Patient desires to have relationships Avoidant Personality Disorder o What axis 1 disorder does this remind you of? Social Anxiety Disorder DSM 5 criteria Social inhibition Feelings of inadequacy Fear of negative evaluation Patient will also avoid "positive' or novel situations Not just situations where the possibility of negative evaluation is high Dependent Personality Disorder o Pervasive and excessive need to be taken care of o Leads to Submissive behavior "clingy-ness" Fears of separation o Clinical features Some empirical association with overprotective parenting o A unique problem in therapy The patient can develop dependence on the therapist Therefore, part of the treatment is to promote independence from the therapist Obsessive compulsive personality disorder o A pervasive pattern of preoccupation with orderliness perfectionism, and control o Comes at the expense of efficiency, interpersonal flexibility, and openness o Not the same thing as OCD o OCPD patients typically do not have ritualistic behaviors or true obsessions o Clinical features Intellectual rigidity Inability to relax Moralistic/dogmatic/rude Intense drive to avoid being "wrong"
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