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What are the three clusters of personality disorders, according to the DSM-5?
What are the three clusters of personality disorders, according to the DSM-5?
What are the two forms of personality disorder diagnoses presented by the DSM-5?
What are the two forms of personality disorder diagnoses presented by the DSM-5?
The DSM-5 retains the 3-cluster format of the DSM-IV-TR, and also includes an Alternative DSM-5 Model for Personality Disorders in its appendix.
The DSM-5 personality disorder model is solely focused on the individual's internal experiences.
The DSM-5 personality disorder model is solely focused on the individual's internal experiences.
False
Which personality disorder is characterized by a pervasive pattern of distrust and suspiciousness of others, beginning in early adulthood?
Which personality disorder is characterized by a pervasive pattern of distrust and suspiciousness of others, beginning in early adulthood?
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What are some key characteristics of Schizoid Personality Disorder?
What are some key characteristics of Schizoid Personality Disorder?
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Which personality disorder involves unusual thoughts and behaviors, such as magical thinking or ideas of reference, in addition to interpersonal detachment and suspiciousness?
Which personality disorder involves unusual thoughts and behaviors, such as magical thinking or ideas of reference, in addition to interpersonal detachment and suspiciousness?
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Research indicates that Antisocial Personality Disorder is more prevalent among women than men.
Research indicates that Antisocial Personality Disorder is more prevalent among women than men.
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Explain the key aspects of "psychopathy" as a separate concept from Antisocial Personality Disorder (APD).
Explain the key aspects of "psychopathy" as a separate concept from Antisocial Personality Disorder (APD).
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Which personality disorder is characterized by impulsive behaviors, unstable relationships, and intense emotional reactivity often marked by shifts from idealization to anger?
Which personality disorder is characterized by impulsive behaviors, unstable relationships, and intense emotional reactivity often marked by shifts from idealization to anger?
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Borderline Personality Disorder is highly heritable, with studies suggesting a 60% chance of inheriting the condition.
Borderline Personality Disorder is highly heritable, with studies suggesting a 60% chance of inheriting the condition.
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Describe the core features of Histrionic Personality Disorder.
Describe the core features of Histrionic Personality Disorder.
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Which personality disorder is marked by a grandiose sense of self-importance, a need for admiration, and a lack of empathy?
Which personality disorder is marked by a grandiose sense of self-importance, a need for admiration, and a lack of empathy?
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Narcissism is always rooted in a genuine belief of one's superiority.
Narcissism is always rooted in a genuine belief of one's superiority.
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Which personality disorder is most commonly associated with a fear of criticism, social inhibition, and a tendency to avoid social situations?
Which personality disorder is most commonly associated with a fear of criticism, social inhibition, and a tendency to avoid social situations?
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Dependent Personality Disorder is linked to a strong need for reassurance and a difficulty making decisions without excessive advice from others.
Dependent Personality Disorder is linked to a strong need for reassurance and a difficulty making decisions without excessive advice from others.
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Explain the key differentiator between Obsessive-Compulsive Personality Disorder (OCPD) and Obsessive-Compulsive Disorder (OCD).
Explain the key differentiator between Obsessive-Compulsive Personality Disorder (OCPD) and Obsessive-Compulsive Disorder (OCD).
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Which therapy focuses on helping individuals with Borderline Personality Disorder to learn emotional regulation skills, improve social skills, and develop a better understanding of their own and others' feelings?
Which therapy focuses on helping individuals with Borderline Personality Disorder to learn emotional regulation skills, improve social skills, and develop a better understanding of their own and others' feelings?
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Treatment for Schizotypal Personality Disorder often involves a combination of antipsychotic and antidepressant medications.
Treatment for Schizotypal Personality Disorder often involves a combination of antipsychotic and antidepressant medications.
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What are the two primary approaches to psychotherapy for individuals with psychopathy?
What are the two primary approaches to psychotherapy for individuals with psychopathy?
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Which personality disorder is often treated using similar therapies to social anxiety disorder?
Which personality disorder is often treated using similar therapies to social anxiety disorder?
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Study Notes
Chapter 15: Personality Disorders
- This chapter outlines personality disorders, their diagnosis, types, and treatments.
- Personality disorders involve longstanding, pervasive, inflexible, extreme, and persistent patterns of behavior and inner experience.
- They create instability in the individual's sense of self and relationships.
Chapter Outline
- DSM-5 retains the three-cluster format of the previous DSM-IV-TR.
- An alternative model for personality disorders is included in the DSM-5 appendix.
- The reasons for the change relate to diagnostic criteria, rarity of some diagnoses, and better capturing subsyndromal symptoms.
Personality Disorder Clusters
- Clusters are categorized based on clinical similarities.
- Odd/Eccentric: Paranoid, Schizoid, Schizotypal
- Dramatic/Erratic: Antisocial, Borderline, Histrionic, Narcissistic
- Anxious/Fearful: Avoidant, Dependent, Obsessive-Compulsive
Key Features of DSM-5 Personality Disorders
- Shows key features of each cluster.
- Includes whether each disorder is included in the alternative DSM-5 model.
Odd/Eccentric Cluster
- These disorders display some similarity to schizophrenia but are less severe.
- Examples include Paranoid, Schizoid, and Schizotypal Personality Disorders.
Diagnostic Criteria for Paranoid Personality Disorder
- Individuals show signs of distrust and suspiciousness in multiple contexts.
- These contexts include unjustified suspicions of harm, deception, and exploitation.
- Unwarranted doubts about loyalty are indicative.
Diagnostic Criteria for Schizoid Personality Disorder
- Individuals demonstrate aloofness and flat affect from early adulthood.
- There's a lack of desire for or enjoyment of relationships.
- They often prefer solitude and show little interest in sex, activities, or friendships.
Diagnostic Criteria for Schizotypal Personality Disorder
- Characterized by unusual thinking, eccentric behaviors, and interpersonal deficits.
- Examples include ideas of reference, peculiar beliefs, unusual perceptions, and suspiciousness.
- The behavior and symptoms are often present from early adulthood.
Schizotypal Personality Disorder (Continued)
- Similar to schizophrenia, with similar cognitive and neuropsychological deficits, enlarged ventricles, and less temporal gray matter.
- High heritability (~60%).
Dramatic/Erratic Cluster
- This cluster encompasses antisocial, borderline, histrionic, and narcissistic personality disorders.
Antisocial Personality Disorder
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Pervasive disregard for the rights of others, exhibited through patterns of irresponsible behaviors and lack of remorse.
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Evidence of conduct disorder before age 15 is common.
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More common in men than women.
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Comorbid substance use is frequently observed.
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Included in etiology research, conducted mostly with criminals, with differing measurements between APD and psychopathy.
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Antisocial behavior possesses a heritable component (~40-50%).
Diagnostic Criteria for Antisocial Personality Disorder
- Characterized by repeated law-breaking, deceitfulness, impulsivity, irritability, aggression, reckless disregard for safety, irresponsibility, and lack of remorse.
- These characteristics are present from at least age 15.
Psychopathy (Sociopath)
- Predates the DSM diagnosis, emphasizing deficits in internal thought processes and a poverty of emotion.
- Focuses on thoughts and feelings.
- Characterized by a lack of shame, remorse, and anxiety, and failure to learn from mistakes.
- Positive emotions are often used to manipulate others.
Etiology of Antisocial Personality Disorder
- Research conducted in criminal populations challenges direct comparison to non-criminal populations.
- Genetic risk for ASPD, psychopathy, conduct disorder, and substance abuse is evident.
- Lack of warmth, high parental negativity, inconsistent parenting, poverty, and exposure to violence in the family predict the development of APD.
- Family environment interacts with genetic predispositions.
- Fearlessness, lack of anxiety, low baseline levels of skin conductance, reduced reactivity to aversive stimuli, and lack of empathy are important etiological factors.
Borderline Personality Disorder (BPD)
- Characterized by impulsive, self-damaging behaviors, unstable relationships, and emotional reactivity.
- Feelings toward others frequently shift dramatically and unpredictably, often alternating between idealization and contempt.
- Strong efforts to avoid abandonment, an unstable sense of self, anger control problems, chronic feelings of emptiness, recurrent suicidal gestures, and transient psychotic or dissociative symptoms are typical.
Borderline Personality Disorder (BPD) (Continued)
- Comorbidity with other conditions (PTSD, Major Depressive Disorder, substance-related disorders, eating disorders, and schizotypal PD) is common.
- Comorbidity predicts a lower chance of symptom remission later in life.
Diagnostic Criteria for Borderline Personality Disorder (BPD)
- Characterized by frantic efforts to avoid abandonment, unstable relationships, self-damaging behaviors, emotional instability, intense anger, feelings of emptiness, and recurrent suicidal or self-harming behaviors.
Etiology of Borderline Personality Disorder (BPD)
- Possesses a genetic component (~60%).
- May be implicated in emotional dysregulation and impulsivity.
- Reduced serotonergic system functioning and increased amygdala activity are observed.
- Key environmental factors include parental separation, emotional abuse, and family environments that invalidate and discount emotional expression within a diathesis-stress framework.
Histrionic Personality Disorder
- Characterized by a strong need to be the center of attention, behavior that is inappropriate sexually, and rapid shifting of emotions.
- Uses physical appearance and often theatrical emotional expression to gain attention.
- Persons with the disorder are often overly suggestible and misread relationships as more intimate than they actually are.
Narcissistic Personality Disorder
- Characterized by a grandiose view of self, preoccupation with fantasies of success, a need for constant attention and adulation, lack of empathy, feelings of arrogance, envy, and entitlement.
- Sensitive to criticism, often becoming enraged when not admired, and seeks out high-status partners.
Diagnostic Criteria for Narcissistic Personality Disorder
- Characterized by a grandiose view of self-importance, preoccupation with fantasies of success, a need for admiration, lack of empathy, arrogance, envy, and tendency to exploit others.
Etiology of Narcissistic Personality Disorder
- Kohut's self-psychology framework proposes that characteristics masking low self-esteem could be a developmental response to parental emotional coldness and emphasis on child achievements, rather than competency or self-worth.
Anxious/Fearful Cluster
- This cluster encompasses avoidant, dependent, and obsessive-compulsive personality disorders.
Avoidant Personality Disorder
- Characterized by a fear of criticism, rejection, or disapproval leading to avoidance of interpersonal situations, restrained behavior, and feelings of inadequacy.
- Common comorbidity with social anxiety and related disorders like taijin kyofusho (a Japanese concept related to interpersonal fear).
Diagnostic Criteria for Avoidant Personality Disorder
- Characterized by avoidance of interpersonal contact, feelings of inadequacy, reluctance to get involved with others, and restraint in intimate relationships.
Dependent Personality Disorder
- Individuals with this disorder experience an excessive need to be taken care of, difficulty making decisions without others, need for others to take responsibility for major life areas, difficulty disagreeing with others to avoid losing their support, and engaging in behaviors to obtain approval from others.
Obsessive-Compulsive Personality Disorder
- Characterized by a perfectionistic focus on rules, details, schedules, and organization, with little time for leisure, family, and friends.
- Reluctant to delegate or make decisions.
- Rigid and inflexible, especially concerning moral principles, but distinct from OCD, which includes obsessions and compulsions.
- Comorbidity is relatively common with Avoidant Personality Disorder, and there's limited research on the etiology of this condition.
Diagnostic Criteria for Obsessive-Compulsive Personality Disorder (OCPD)
- Characterized by an intense need for order, control, preoccupation with rules and details, extreme perfectionism, excessive devotion to work, difficulty discarding items, inflexibility about morals, miserliness, and tendencies for rigidity and stubbornness.
Maladaptive Cognitions Associated with Personality Disorders
- Presents examples of maladaptive cognitions connected to specific personality disorders.
Treatment of Borderline PD
- This disorder is often challenging to treat because interpersonal issues tend to surface in therapy.
- Manipulation attempts by clients are characteristic.
- Medication (antidepressants, mood stabilizers) and therapies (Dialectical Behavioral Therapy, Mentalization-Based Therapy, Schema-Focused Cognitive Therapy) are used.
Treatment of Schizotypal, Avoidant, and Psychopathic Personalities
- Treatments often mirror those for related conditions.
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Description
This chapter focuses on personality disorders, detailing their diagnosis, types, and treatment options. It explores the implications of these disorders on individuals' self-perception and relationships. The chapter also discusses the classification of personality disorders into clusters and introduces changes in diagnostic criteria in the DSM-5.
