Problem 5

Question 1

Personality

Answer 1

Refers to all the ways we act, think, believe and feel that make each of us unique

Question 2

Personality trait

Answer 2

Refers to a complex pattern of

a) behavior
b) thought
c) feeling

that is stable across time + situations

Question 3

5-factor model of personality

Answer 3

Suggests that everyones personality is organized along 5 broad dimensions/factors of personality (The big 5)

1. Emotionality
2. Extraversion
3. Openness to experience
4. Agreeableness
5. Conscientiousness

–> each has a number of facets/dimensions

Question 4

The DSM 4 treats personally disorders as if they were entirely different from “normal” personality traits.

How ?
Name the main differences to DSM 5.

Answer 4

1. Lists 10 personality disorders which are grouped into 3 Clusters
2. PDs are placed on Axis II of the diagnostic disorders
   - -> instead of acute disorders
3. Categorical, not dimensional
   e. g.: Cluster A,B,C and NOS

Question 5

Cluster A

odd + eccentric

Answer 5

Contains the

a) Schizoid
b) Schizotypal
c) Paranoid

personality disorders, suggesting that these peoples behaviors are strange + unusual

Question 6

Cluster B

dramatic + erratic

Answer 6

Contains the

a) Antisocial
b) Borderline
c) Histrionic
d) Narcissistic

personality disorders, suggesting that these peoples behaviors are impulsive + unstable

Question 7

Cluster C

anxious + fearful

Answer 7

Contains the

a) Avoidant
b) Dependent
c) Obsessive-compulsive

Personality disorders, suggesting that these peoples behaviors are nervous + worried

Question 8

Cluster NOS

Not otherwise specified

Answer 8

Contains

a) Depression
b) Passive-Aggressiveness

–> most prevalent personality disorders

Question 9

Narcissistic personality disorder

NPD

Answer 9

Involves acting in a grandiose manner + seeking admiration from others, while depending on ones self evaluation (=never relying on others)

–> shallow in emotional expression + relationships with others, combined with a lack of concern for others

Question 10

Prevalence of Narcissistic PD ?

Gender differences ?

Answer 10

1. Very rare, with a lifetime prevalence of 1%

2. More prevalent in men

Question 11

Cognitive theory/approach of NPD

Answer 11

Narcissistic PD develops as a result of indulgence + overvaluation by significant others during childhood

Question 12

Treatment options for Narcissistic PD ?

Answer 12

Exploratory collaborative approach (Cognitive technique)

1. to develop more realistic expectations of ones abilities
2. Identifying patients regulatory patterns
   - -> range between healthy + pathological patterns
3. Challenging ones self-aggrandizing ways of interpreting situations

BUT: Usually don’t seek treatment except for when they develop depression or interpersonal problems

Question 13

Comorbidity of NPD

Answer 13

1. Substance abuse
2. Mood disorder
3. Suicidality

–> can obscure the regular signs of NPD

Question 14

Multifactural Etiology of NPD

Answer 14

1. Inheritance (40%)
2. Temperament
3. Psychological trauma
4. Age-inappropriate role assignments

Question 15

Is NPD treatable ?

Answer 15

1. Narcissistic traits can be changed over time, but change is only temporal
2. Patients usually tend to drop out as soon as mood swings or depressions lessen

–> no enduring change (50% remission)

Question 16

Psychodynamic approach

Answer 16

Symptoms of NPD are maladaptive strategies for managing emotions + self views

–> individuals did not develop realistically positive view of themselves + adaptive strategies for handling stress as children and thus rely on praise + domination of others for their self esteem

AND: as a result, they rely on praise and domination of others for their self-esteem

Question 17

What factors can influence narcissistic self regulation + competence in social interactions ?

Answer 17

1. Deficiencies in emotion processing + recognition
   - -> less accurate
2. Comprised emphatic functioning
   - -> losing sight of whose feelings belong to whom
3. Motivation/ Agency + self-regulation

Question 18

Are therapeutic treatments effective ?

Answer 18

No, due to disconnect between own feelings and feelings perceived in others

–> talk and relate in ways that control interaction

e.g.: “speak at clinician not to”, thus clinician can’t reach them

Question 19

Alexithymia

Answer 19

Refers to the inability to

a) identify + describe feelings in words
b) differentiating feelings from bodily sensations caused by emotional arousal

Question 20

What do narcissists gain from relationships ?

Answer 20

Positive attention + sexual satisfaction

–> finding a way to receive the benefits of a relationship without enduring the costs

Question 21

How do narcissists maintain/lead relationships ?

Answer 21

1. Maintaining a relationship with a partner by using charm, extraversion + confidence
   - -> gives narc positive attention, esteem + sexual resources
2. Not letting the relationship become too intimate instead they disengaging in
3. Covertly seeking out other potential romantic partners
   - -> thus maintaining power + freedom in existing relationship, gain esteem and sexual access from additional partners + easy transition to another relationship

=> Corresponds to ludus
(game-playing love style)

Question 22

Narcissism

Answer 22

Refers to a normal personality trait that differs between people

–> associated with high unstable self-esteem + relying on several strategies to minion the inflated self beliefs

Question 23

Narcissism is a crucial moderator of … ?

Answer 23

Agressiveness + angry reactions to rejection

–> violence is a strategy for gaining respect, thus NPDs have a lower threshold for social rejection

Question 24

Difference between high vs low self esteem individuals when it comes to love ?

Answer 24

1. HSI
   - -> less likely to experience manic love + associated to eros (love style)
2. LSI
   - -> experience love more intensely/ manic

Question 25

There are 6 distinct love styles. Name them and their meaning.

Answer 25

1. Eros (Non-NPD) - -> physical passion + desire for rapidly escalating romantic involvement 2. Ludus (NPD) - -> game-playing, aversion to partner dependence 3. Storge - -> emphasis on companionship and trust in relationships 4. Pragma - -> pragmatic/practical approach to romantic relationships 5. Mania - -> painful obsession with love object 6. Agape - -> selfless regard for the well-being of the romantic partner

Question 26

Biological theory of NPD

Answer 26

Prefrontal gray matter (GM) volume differences suggest deficits in 1. empathic functioning b) emotion regulation + processing c) development of self-referential processing bias --> indifference to fearful + sad stimuli

Question 27

In early versions of the hybrid model, NPD was not included as a specific personality disorder type. Why was that ?

Answer 27

1. It has extensive comorbidity with other mental disorders | 2. Narcissism is a trait that appears in many other conditions

Question 28

What are the differences between the DSM 5 section II NPD vs section III NPD ?

Answer 28

1. Section III explicitly acknowledges both grandiose (inflated) + deflated (vulnerable) presentations --> Section II only presents grandiose presentation 2. Section III recognizes grandiosity and feelings of entitlement may be either overt or covert --> Section II only focuses on overt presentation

Question 29

Limitations of DSM 4

Answer 29

1. Some symptoms do not really show much tendency to co-occur --> 2 persons diagnosed with the same disorder might not have any symptoms in common 2. Two disorders might have overlapping symptoms and may be diagnosed together --> people might me diagnosed with 2 or more disorders 3. "Clusters" of disorders do not match factor analysis results 4. A personality disorder should be seen as a continuum, not as a category => because having it is a matter of degree

Question 30

Principle of least interest

Answer 30

Suggests that the person with the least interest has more control over the relationship --> NPDs act on this

Question 31

Narcissistic injury

Answer 31

Occurs when narcissists react negatively to perceived or real criticism or judgment, boundaries placed on them, and/or attempts to hold them accountable for harmful behavior ex.: divorce, job firing --> rejection

Question 32

Narcissistic mirroring

Answer 32

Needing to be seen by their surrounding the same way they see themselves ex.: admiration, attention --> what they need

Question 33

Narcs can usually be in 2 different states, meaning overt vs covert. Specify these states and their meaning.

Answer 33

1. Overt Grandiosity 2. Covert - -> Vulnerability