W4: Personality Disorders
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W4: Personality Disorders

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Questions and Answers

What is a major characteristic of borderline personality disorder?

  • Instability of interpersonal relationships (correct)
  • Excessive emotionality and attention seeking
  • Consistent self-image
  • Overreacting to only major life events

    • Which of the following symptoms is most associated with borderline personality disorder?

  • Incessant need for attention
  • Craving for excitement
  • Self-dramatization
  • Fear of abandonment (correct)

    • Approximately what percentage of borderline personality disorder patients are female?

  • 90%
  • 30%
  • 75% (correct)
  • 50%

    • Which psychological disorder is characterized by self-image issues and emotional instability?

    <p>Borderline Personality Disorder</p> Signup and view all the answers

    What type of abuse is reported among 40-71% of borderline personality disorder inpatients?

    <p>Childhood sexual abuse</p> Signup and view all the answers

    What does 'splitting' refer to in the context of borderline personality disorder?

    <p>All of the above</p> Signup and view all the answers

    Which cluster of personality disorders includes borderline and histrionic types?

    <p>Cluster B</p> Signup and view all the answers

    How is the attention-seeking behavior of someone with histrionic personality disorder typically described?

    <p>Excessive and dramatic</p> Signup and view all the answers

    Which personality disorder shows an increase in prevalence in the United States over the past 30 years?

    <p>Borderline Personality Disorder</p> Signup and view all the answers

    What is the prevalence of Antisocial Personality Disorder (ASPD) in the United States?

    <p>3%</p> Signup and view all the answers

    What is a significant limitation when comparing personality disorder prevalence across cultures?

    <p>Cultural definitions of personality disorders</p> Signup and view all the answers

    According to Krueger and Hobbs, what aspect of the DSM-5 alternative model is still being debated?

    <p>It is superior to the categorical model</p> Signup and view all the answers

    What percentage of adults in the US are reported to have at least one personality disorder?

    <p>15%</p> Signup and view all the answers

    What factor could impact the inter-rater reliability of personality disorder diagnoses?

    <p>The training of the clinicians</p> Signup and view all the answers

    Which country shows a notably lower prevalence of Antisocial Personality Disorder (ASPD) compared to the United States?

    <p>Taiwan</p> Signup and view all the answers

    Which of the following is NOT a significant clinical correlate associated with personality disorders?

    <p>Physical health issues</p> Signup and view all the answers

    What was the global prevalence of personality disorders (PDs) found in the systematic review and meta-analysis conducted in 2020?

    <p>7.8%</p> Signup and view all the answers

    Which clusters of personality disorders are less common in low-income countries?

    <p>Cluster B and C</p> Signup and view all the answers

    Which cultural value is suggested to potentially protect against certain personality disorders according to the content provided?

    <p>Individualism</p> Signup and view all the answers

    In the context of the research, what is identified as a source of distress related to personality disorders?

    <p>Cultural identity clash</p> Signup and view all the answers

    According to Winsper et al. (2020), which countries showed a higher prevalence of personality disorders?

    <p>High income countries</p> Signup and view all the answers

    What does the term 'niche seeking' refer to in the context of personality disorders and cultural values?

    <p>Finding a distinct identity within a culture</p> Signup and view all the answers

    What did the study by Caldwell-Harris & Aycicegi (2006) explore regarding personality disorders?

    <p>The impact of personal cultural values on personality disorders</p> Signup and view all the answers

    What do personality disorders primarily reflect?

    <p>Difficulties in behavior and perception within a social context</p> Signup and view all the answers

    How do cultural values play a role in the understanding of personality disorders?

    <p>They influence expectations about individual behavior and values.</p> Signup and view all the answers

    What is one effect of cultural conflicts on individuals, according to the research?

    <p>Psychological distress for allocentrics and idiocentrics</p> Signup and view all the answers

    Which of the following best describes allocentrics in an individualistic culture?

    <p>They experience stress due to cultural misalignment.</p> Signup and view all the answers

    What is meant by idiocentrics in a collectivist culture?

    <p>People who value individual achievement above community.</p> Signup and view all the answers

    Which term refers to how personality disorders relate to cultural expectations?

    <p>Cultural psychology</p> Signup and view all the answers

    What aspect of personality disorders does the phrasing 'is perceived to behave by others' emphasize?

    <p>Social perception</p> Signup and view all the answers

    How do culture-specific traits influence personality disorders?

    <p>They affect the evaluation of behavior and value judgments.</p> Signup and view all the answers

    What is a primary characteristic of personality disorders as defined in the DSM-5?

    <p>They are enduring patterns that deviate markedly from cultural expectations.</p> Signup and view all the answers

    Which of the following statements reflects a challenge of the categorical model of personality disorders?

    <p>There is extensive co-occurrence of different personality disorders.</p> Signup and view all the answers

    What notable change was made regarding personality disorders from DSM-IV to DSM-5?

    <p>The removal of the multiaxial system.</p> Signup and view all the answers

    Which cluster includes personality disorders characterized by being odd or eccentric?

    <p>Cluster A</p> Signup and view all the answers

    How does antisocial personality disorder primarily manifest?

    <p>As a pervasive pattern of disregard for the rights of others.</p> Signup and view all the answers

    What is a resulting issue from poor inter-rater reliability regarding personality disorder diagnoses?

    <p>Difficulties in achieving consistent diagnostic outcomes.</p> Signup and view all the answers

    What strategy was ultimately retained by the American Psychiatric Association regarding personality disorder classification?

    <p>The previous categorical approach.</p> Signup and view all the answers

    Which personality disorder is characterized by acute discomfort in close relationships and eccentricities?

    <p>Schizotypal personality disorder.</p> Signup and view all the answers

    How is a personality disorder defined in terms of its onset?

    <p>Begins in adolescence or early adulthood.</p> Signup and view all the answers

    What is the term used to describe the common diagnosis when a personality disorder does not fit other specific criteria?

    <p>PD NOS</p> Signup and view all the answers

    Which of the following issues is NOT associated with the categorical model of personality disorders?

    <p>High inter-rater reliability.</p> Signup and view all the answers

    How does the DSM-5's approach differ regarding the boundaries between personality disorders and other mental disorders?

    <p>It now recognizes overlapping features.</p> Signup and view all the answers

    What is one of the primary reasons for critiquing the DSM-5's dimensional model proposal for personality disorders?

    <p>It is considered too complex for clinical practice.</p> Signup and view all the answers

    What is one of the key characteristics of personality disorders as defined by the DSM-5?

    <p>They can lead to significant distress or social impairment.</p> Signup and view all the answers

    Which factor is recognized as a limitation of the categorical model for diagnosing personality disorders?

    <p>It allows for an overly simplistic view of personality.</p> Signup and view all the answers

    In which cluster of personality disorders is Avoidant Personality Disorder categorized?

    <p>Cluster C</p> Signup and view all the answers

    What methodological issue is highlighted when considering the inter-rater reliability of personality disorder diagnoses?

    <p>High variability exists across different raters.</p> Signup and view all the answers

    According to the information, what is a consequence of the arbitrariness in diagnostic cut-offs in personality disorders?

    <p>It may lead individuals to receiving multiple diagnoses.</p> Signup and view all the answers

    What is one reason the American Psychiatric Association chose to retain the categorical model over the dimensional model in DSM-5?

    <p>It was easier for clinicians to understand and apply.</p> Signup and view all the answers

    What does the 5 Factor Model (OCEAN) specifically assess in terms of personality disorders?

    <p>The extremes of personality dimensions contributing to personality pathology.</p> Signup and view all the answers

    Which of the following statements is true regarding the removal of the axis that separated PDs from clinical disorders in DSM-5?

    <p>It blurred the lines between personality disorders and other mental illnesses.</p> Signup and view all the answers

    What is included in Criterion A for the Alternative Model for DSM-5?

    <p>Moderate or greater impairment in identity, self-direction, empathy, and intimacy</p> Signup and view all the answers

    Which of the following broad domains are recognized under Criterion B in the AMPD?

    <p>Negative affectivity, detachment, psychoticism, antagonism, and disinhibition</p> Signup and view all the answers

    What is a significant methodological concern regarding the efficacy of the AMPD?

    <p>Uncertainty whether it is superior to the categorical model</p> Signup and view all the answers

    What factor contributes to the increased reported prevalence of personality disorders in the US?

    <p>Improved diagnostic criteria and cultural acceptance of seeking help</p> Signup and view all the answers

    Which of the following characteristics is true regarding global prevalence of personality disorders?

    <p>Global prevalence is around 8%, with higher occurrence in high-income countries</p> Signup and view all the answers

    Which of the following factors could potentially lead to increased psychopathology according to research findings?

    <p>Misalignment with cultural norms and values</p> Signup and view all the answers

    According to Winsper et al. (2020), what cultural aspect correlates with lower prevalence of personality disorders?

    <p>Collectivism and cultural protection mechanisms</p> Signup and view all the answers

    Which is not included in the DSM-5 definition of personality disorders?

    <p>Enduring pattern of thinking, feeling, behaving</p> Signup and view all the answers

    Which are reasons that the DSM-5 Categorical Model for diagnosis is problematic?

    <p>Extreme Heterogeneity</p> Signup and view all the answers

    What is the most common diagnosis in Personality Disorders?

    <p>Personality Disorder Not Otherwise Specified</p> Signup and view all the answers

    Which PD is characterised by emotional detachment and social disinterest?

    <p>Schizoid</p> Signup and view all the answers

    Which personality disorder is characterised by eccentric thinking and transient psychosis-like states?

    <p>Schizotypal</p> Signup and view all the answers

    Which cluster of personality disorders is most associated with childhood abuse?

    <p>Cluster B</p> Signup and view all the answers

    How do people with Antisocial Personality Disorder (ASPD) respond to alcohol consumption compared to controls?

    <p>ASPD experience a large increase in aggressive responding, compared to non-ASPD who experience a slight decrease in aggressive responding</p> Signup and view all the answers

    The 2 Categories of Criteria of AMPD are:

    <p>Impaired personality functioning</p> Signup and view all the answers

    Which PDs have increased in the US over the past few decades?

    <p>BPD</p> Signup and view all the answers

    In the US, what is the prevalence of Personality Disorders (PDs)?

    <p>15% of people</p> Signup and view all the answers

    In the context of BPD, what does 'splitting' refer to?

    <p>Shifting between idealising and devaluing others</p> Signup and view all the answers

    Why do people with BPD self-harm?

    <p>To relieve extreme negative emotions</p> Signup and view all the answers

    Theories associating BPD and disorganized attachment style propose BPD symptoms reflect:

    <p>approach-avoidance conflict towards their caregiver</p> Signup and view all the answers

    What percentage of people with BPD will die from suicide?

    <p>8-10%</p> Signup and view all the answers

    Dialectical Behavior Therapy for BPD involves:

    <p>Teaching patients how to manage intense emotions adaptively</p> Signup and view all the answers

    What is considered the best treatment option for Personality Disorders (PDs)?

    <p>Long-term psychotherapy</p> Signup and view all the answers

    Study Notes

    Personality Disorders (PDs): Concepts and Controversies

    • PDs are enduring patterns of thinking, feeling, acting, and relating that deviate from cultural norms, are pervasive, inflexible, and lead to distress or impairment.
    • The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) uses a categorical model for PDs, which has been criticized for its shortcomings, including:
      • Extensive co-occurrence of PDs
      • Heterogeneity within diagnostic categories
      • Poor inter-rater reliability
      • High prevalence of "Personality Disorder Not Otherwise Specified" (PD NOS)
      • Arbitrary diagnostic cut-offs
    • Despite a proposed shift to a dimensional model in DSM-5, the American Psychiatric Association (APA) ultimately decided against it, citing its complexity for clinicians.
    • DSM-5 removed the axis that separated PDs from other clinical disorders.

    PD Clusters

    • Cluster A (Odd/Eccentric):
      • Paranoid
      • Schizoid
      • Schizotypal (characterized by 'bizarre' thinking)
    • Cluster B (Dramatic/Emotional/Erratic):
      • Antisocial Personality Disorder (ASPD):
        • Requires three out of seven criteria, leading to variations in presentation.
        • More prevalent in males.
        • Higher prevalence in individuals with alcohol use disorder, substance abuse, and in prison and forensic settings.
        • Research suggests that ASPD is associated with increased aggression.
        • Individuals must have a history of conduct disorder before age 18.
      • Borderline Personality Disorder (BPD):
        • Approximately 75% of individuals with BPD are female.
        • Strong association with childhood sexual abuse (up to 71% of BPD patients).
      • Histrionic Personality Disorder:
        • More common in females.
        • Characterized by attention-seeking behavior.
        • Controversial diagnosis, often co-occurring with BPD, NPD, and ASPD.
      • Narcissistic Personality Disorder (NPD):
        • Varied functionality amongst individuals with NPD.
        • More common in males.
    • Cluster C (Anxious/Fearful):
      • Avoidant
      • Dependent
      • Obsessive-compulsive (one of the most common PDs, but least studied)

    Dimensional Approaches to PDs

    • The Five Factor Model (FFM) proposes that personality pathology exists at the extremes of personality dimensions (Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism).
    • Individuals with BPD demonstrate significant variability in their FFM profiles, suggesting heterogeneity within the disorder.
    • Personality dimensions provide valuable information for clinicians, such as predicting patient behavior (e.g., low conscientiousness may indicate lack of engagement in therapy, such as completing homework).
    • The Alternative Model for Personality Disorders (AMPD) proposes a hybrid model incorporating both personality functioning and traits to identify PDs.
      • Criterion A: Impaired personality functioning (self and interpersonal), including impairment in identity, self-direction, empathy, and intimacy.
      • Criterion B: Pathological personality traits, categorized into five broad domains:
        • Negative affectivity
        • Detachment
        • Psychoticism
        • Antagonism
        • Disinhibition
    • Research on the AMPD model indicates:
      • Meaningful correlations/associations with other variables
      • Improved inter-rater reliability
      • Strong psychometric properties.
    • However, it remains unclear whether AMPD is superior to the categorical model (Widiger & Hines, 2022).

    PD and Culture

    • Increases in BPD and ASPD diagnoses in the United States over recent decades may be attributed to changes in diagnostic criteria, increased cultural acceptance of treatment seeking, or other factors.
    • There are significant cross-national differences in ASPD diagnoses, potentially related to varying levels of stigmatization, cultural differences in acceptable behavior, and individualism versus collectivism.
    • The US National Epidemiological Survey estimates that approximately 15% of individuals have a PD, likely due to high research activity and diagnostic focus.
    • It is challenging to determine true PD prevalence globally.
    • A global study by Winsper et al. (2020):
      • Estimated the global prevalence of PDs at approximately 8%.
      • Found higher prevalence in high-income nations.
      • Cluster B and C PDs were less common in low-income countries.
      • These differences may be attributed to cultural influences, such as protective factors, or individualism versus collectivism.
    • Certain cultures may perceive PDs as more maladaptive than others.
    • Leising et al. (2009) suggest that distress associated with PDs may be related to a poor fit with one's cultural context.
    • Niche seeking (finding a subculture that aligns with one's personality) could be a strategy to reduce distress related to cultural mismatch.
    • Caldwell-Harris and Aycicegi (2006) found that individuals who do not conform to either individualistic or collectivist societies are more likely to experience psychopathology, as demonstrated in a Turkish and US self-report survey.

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