Lecture 16

Question 1

What is the APA definition of personality disorder?

Answer 1

o “Enduring patterns of inner experience and behaviour that deviate markedly from the expectations of the individual’s culture, are pervasive and inflexible”

Question 2

What are the 4 areas that deviance can be reflected in?

Answer 2

o Cognition
o Affect
o Interpersonal functioning
o Impulse control

Question 3

What are the features of deviant cognition?

Answer 3

o Perception
o Interpretation
o Formation of images and attitudes

Question 4

What are the features of deviant affectivity?

Answer 4

o Range
o Intensity
o Appropriateness of emotions

Question 5

What are the features of deviant interpersonal functioning?

Answer 5

o Relating to others (Dyads-Triads-Groups)

o Handling interpersonal situations

Question 6

What are the features of lack of control?

Answer 6

o Impulses

o Gratification of needs

Question 7

How are personality disorders deviations?

Answer 7

• Extreme or significant deviations from the way an individual in a given culture perceives, thinks, feels, and relates to others
  o Deviant from the culture’s normative range – culturally appropriate in the cultural context

Question 8

When do personality disorders generally onset?

Answer 8

• Onset in adolescence or early adulthood

Question 9

Are personality disorders stable/unstable?

Answer 9

Stable

Question 10

How long can personality disorders go on for?

Answer 10

Long duration

Question 11

Do personality disorders have only one specific trigger?

Answer 11

o Not limited to one specific “triggering” stimulus, stressor or situation

Question 12

What is the evolutionary perspective of personality disorders?

Answer 12

-	The evolutionary perspective 
	o	Ineffectiveness
		♣	Suboptimal functioning in:
			•	Self-preservation
			•	Ecological adaptation
			•	Reproductivity
		♣	Inflexible strategies that lead to pervasive fitness reduction or failure
	o	Uncooperativeness
		♣	Frictional features that frustrate social goals, resulting in fitness costs

Question 13

What are the 3 considerations of a general differential diagnosis of a personality disorder?

Answer 13

• General differential diagnosis
  
  1. Symptoms are not better accounted for by other mental (clinical) disorders (mainly psychoses, anxiety, depression or PTSD)
     ♣ Mimicry of personality traits
     ♣ Personality disorders should be premorbid
     • Shouldn’t be a consequence of a clinical disorder
  2. Not result of substance use (not exclusive associations)
  3. Not result of general medical condition (physiological effects)

Question 14

How many specified personality disorders are in the DSM-V?

Answer 14

5

Question 15

What are the 3 personality clusters?

Answer 15

• Cluster A (odd/eccentric)
• Cluster B (dramatic/emotional)
• Cluster C (anxious/fearful)

Question 16

What are the features of Cluster A personalities?

Answer 16

• Symptoms similar to schizophrenia (atypical psychoses)

- High levels of (elements of) introversion and psychoticism

Question 17

What are the features of Cluster B personalities?

Answer 17

• Highly variable behaviour, exaggerated emotional display

- High levels of trait impulsivity, BAS

Question 18

What are the features of Cluster C personalities?

Answer 18

• High interpersonal deficits

- High levels of insecure attachment traits (anxiety deregulation), BIS

Question 19

What are the 3 Cluster A personality types?

Answer 19

1. Paranoid
2. Schizoid
3. Schizotypal

Question 20

What is the Paranoid (Cluster A) personality type?

Answer 20

♣ Distrust and suspiciousness of others
♣ Unforgiving, preoccupied with unjustified doubts
♣ Optimal criterion: Suspect, without sufficient basis, that others are exploiting, harming or deceiving them

Question 21

What is the Schizoid (Cluster A) personality type?

Answer 21

♣ Detachment from social relationships
♣ Restricted range of emotional expressions and anhedonia
• Extreme introversion – detach from others and self’s emotions
♣ Optimal criterion: Neither desires nor enjoys close relationships, including being part of a family

Question 22

What is the Schizotypal (Cluster A) personality type?

Answer 22

♣ Cognitive disturbances, odd thinking
♣ Excessive social anxiety, inappropriate affect
♣ Considered to be precursor to schizophrenia and some consider if there are no schizotypal traits then there will be no later schizophrenia
♣ Optimal criterion: Odd thinking and speech: Behaviour or appearance that is odd, eccentric or peculiar

Question 23

How are optimal criteria useful in personality disorder diagnoses?

Answer 23

• Use optimal criterion as a useful mnemonic
  o Take patient’s symptoms that they’re communicating, form impression of what disorder it could be, use optimal criterion then form diagnosis

Question 24

What are the 4 Cluster B personality types?

Answer 24

1. Antisocial
2. Borderline
3. Histrionic
4. Narcissistic

Question 25

What is the Antisocial (Cluster B) personality type?

Answer 25

♣ Disregard and violation of other’s rights ♣ Failure to conform to social norms ♣ Optimal criterion: Criminal, aggressive, impulsive, irresponsible behaviour ♣ Psychopath vs. sociopath • “Psychopathic” exists as a classification • Continuum: psychopathy sociopathy o Sociopath is a psychopath that acts their traits in a social setting • “Sociopathy”, as a construct, no longer exists • Narcissism – element of psychopathy

Question 26

What is the Borderline (Cluster B) personality type?

Answer 26

♣ Interpersonal and emotional instability/impulsivity ♣ Chronic feeling of emptiness, suicidal behaviour ♣ Optimal criterion: (Unreasonable) expectations of meeting personal goals, and/or maintaining close relations

Question 27

What is the Histrionic (Cluster B) personality type?

Answer 27

♣ Excessive, emotionality (theatricality) and attention-seeking ♣ Suggestible, attention to physical appearance, inappropriate sexuality (nymphomania) • “Nymphomania” used to be considered a disorder, now just a symptom ♣ Optimal criterion: Uncomfortable in situations in which they are not the centre of attention

Question 28

What is the Narcissistic (Cluster B) personality type?

Answer 28

♣ Grandiosity (in fantasy or behaviour) and need for admiration ♣ Preoccupied with success and power, interpersonally exploitive ♣ Optimal criterion: Grandiose sense of self-importance, need for admiration and lack of empathy

Question 29

What are the 3 Cluster C personality types?

Answer 29

1. Avoidant 2. Dependent 3. Obsessive-Compulsive

Question 30

What is the Avoidant (Cluster C) personality type?

Answer 30

♣ Social inhibition and feelings of inadequacy ♣ Preoccupied with fear of being criticised, shamed or ridiculed ♣ Optimal criterion: Avoids occupational activities that involve significant interpersonal contact, fearing criticism, disapproval or rejection

Question 31

What is the Dependent (Cluster C) personality type?

Answer 31

♣ Submissiveness and clinging behaviour ♣ Unrealistic fear of being left alone, needs constant reassurance ♣ Optimal criterion: Needs others to assume responsibility for most major areas of his/her life

Question 32

What is the Obsessive-Compulsive (Cluster C) personality type?

Answer 32

♣ Perfectionism and mental or interpersonal control ♣ Preoccupied with details, rules, order; excessive devotion to work ♣ Not the same as OCD • Compulsion has different focus than OCD – compulsive on content, not repetition • “Conscientiousness gone haywire” ♣ Optimal criterion: Shows perfectionism that interferes with task completion