Lecture 6 - Personality Disorders

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What are personality disorders?
Enduring, maladaptive patterns of behaviours and cognitions that deviate markedly from what is expected and accepted.
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How prevalent are personality disorders?
1/5 people in the UK has a personality disorder.
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How many different personality disorders are defined in DSM-5?
10 distinct disorders, grouped into 3 'clusters'
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Which is the most common of the 3 clusters?
A (3.6%) > C (2.7%) > B (1.5%)
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What are the 3 characteristics of the healthy self?
Identity, self-direction, positive interpersonal relationships
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What do personality disorders have high comorbidity rates with?
Anxiety, mood and substance disorders.
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How do personality disorders relate to the Big Five model?
High neuroticism is related to all personality disorders, high extraversion - histrionic PD, low extraversion - avoidant PD
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Describe Cluster A personality disorders.
'Odd' or eccentric personality disorders.
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What are the 3 Cluster A personality disorders?
*Schizotypal, Schizoid, *Paranoid
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Describe schizotypal personality disorder.
Extreme discomfort with close relationships, odd beliefs, unusual perceptual experiences, general social anxiety.
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What is schizotypal PD's relationship to schizophrenia?
Similar abnormalities in brain structure, first degree relatives of schizophrenics are 10x more likely to show Cluster A PDs.
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Describe pararoid PD.
Suspicious of others, feelings not a reflection of reality, hypersensitive of others' words, interpret others' behaviour as negative/threatening.
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Describe Cluster B personality disorders.
Dramatic, emotional or erratic PDs.
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What are the 4 Cluster B personality disorders?
Antisocial, *Borderline, Histrionic, *Narcissistic
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Describe borderline personality disorder.
Intense and unstable relationships, fear of abandonment, impulsive behaviours, paranoia and delusions, mood instability, unstable self-image, sensitive to environment, self-harm, anxiety, poor coping with stress.
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What are some potential causes of BPD?
Abuse, insecure attachment, impulsivity trait, reduced volume of brain areas responsible for emotions and decision-making.
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Describe narcissistic PD.
Grandiosity, seeks/demands adoration of others, exploitative in interpersonal relationships, lacks empathy, arrogant.
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Describe Cluster C personality disorders.
Anxious or fearful PDs.
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What are the 3 Cluster C PDs?
*Obsessive compulsive, Avoidant, *Dependent
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Describe obsessive compulsive PD.
Overly concerned with details and order, perfectionism, excessively devoted to work, inflexible and over-conscientious, difficulty collaborating with other people.
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What are the differences between OCD and OCPD?
OCPD have insight, where OCD doesn't, treatment-seeking behaviours, fixation with procedures for everyday tasks
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Describe dependent PD.
Need for others to take care of them, trouble making everyday decisions without advice, lack of self-efficacy, relationship-seeking, preoccupied with fears of being left alone.
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How can dependent PD be treated?
Clarification-orientation psychotherapy. Aims to; 1) clarify the dysfunctional schemas, 2) processing then modifying the schemas
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What are the 3 potential causes of personality disorders?
1) genetic and heritability influences, 2) development and childhood experiences, 3) biological influences
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According to a twin study by Torgersen et al. what is the heritability of PDs?
Estimates of 60%; BPD - 40%, avoidant PD - 35%
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How prevalent are PDs in Norway compared to the UK? (Cultural influences)
Far more avoidant, dependent and schizoid PD, less than half as many with antisocial and BPD.
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What are some childhood factors that have been linked to PDs?
Childhood abuse, parenting behaviours: low levels of affection, neglect, lack of nurturing.
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Which researchers proposed the neuropsychological model of psychopatholog?
Siever and Davis (1991)
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How does Siever and Davis' biological model explain PDs?
Links higher/lower levels of neurotransmitters to the effected behaviour/cognitions and thus to the cluster implicated.
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Patients with which PDs would be difficult to engage in treatment and why?
E.g. antisocial PD and narcissistic PD, because they are ego-syntonic.
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Which kind of therapy is used to treat BPD?
Dialectical behaviour therapy - problem-solving and acceptance of the experience of the moment.
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How prevalent are personality disorders?

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How many different personality disorders are defined in DSM-5?

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Which is the most common of the 3 clusters?

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What are the 3 characteristics of the healthy self?

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