Psychology Test 3

treatment of schizoid personality disorder

- rarely seek treatment unless crisis - teaching how to experience emotions - social skills training

treatment of paranoid personality disorder

- reluctant to seek treatment (because they don't trust people) - focus on developing alliance - cognitive techniques to challenge mistaken assumption - do not stay in treatment very long

paranoid personality disorder description

- tendency to misinterpret people's actions as threatening - suspicious - rigid and quick to anger - trouble in interpersonal relationships - difficulty relaxing - hypervigilant - possible psychotic symptoms under stress

urban residence

Some evidence to suggest risk for schizophrenia higher in urban areas

obsessive compulsive personality disorder causes

Some genetic contribution •Environmental influences as well, such as well, such as parental reinforcement of neatness and orderliness

cluster c (anxious or fearful disorders)

avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder

dialectical behavior therapy

involves helping people cope with the stressors that seem to trigger suicidal behaviors

autism

kids who have ____________ are more likely to have parents that have schizoid type personality disorders

cluster A

odd/ eccentric

cluster A (odd or eccentric disorders)

paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder

both sides

parent- child relationship is manipulative on ________________ •pattern delinquent kids hanging out with other delinquents since those individuals will hang out with them

winter months

there's a connection between being born in the _____________ and babies born that end up developing schizophrenia - may be flu exposure - increases the risk

schizoid

"relationships are messy, undesirable"

narcissistic

"since I am special, I deserve special rules"

antisocial

"I am entitled to break rules"

paranoid

"I cannot trust people"

borderline

"I deserve to be punished"

dependent

"I need people to survive, be happy"

avoidant

"If people knew the real me, they will reject me"

schizotypal

"it's better to be isolated from others"

histrionic

"people are there to serve or admire me"

obsessive-compulsive

"people should do better, try harder"

schizotypal personality disorder treatment

- 30-50% meet criteria for clinical depression - teach social skills or adjust to solitude - medications for schizophrenia, but problem with side effects

elements of a personality disorder

- Enduring pattern of inner experience & behavior that deviates from social norms (two or more): - Cognition - Affectivity - Interpersonal Functioning - Impulse Control - Inflexible and pervasive - Causes distress or impairment in life (with some people it doesn't cause them distress but everyone else around them) - Stable since childhood and adolescence

personality defined

- Traits that are unique to the individual - Influence cognition, emotions, and behavior - Stable over time - Flexible and change in response to experience - Develop over time Never going to find two people who have the exact same personality In childhood and adolescence we try out personalities because they are malleable, by adulthood personalities stabilize This is why personality disorders aren't prescribed before adulthood (although it might read emerging personality disorder)

causes of schizoid personality disorder

- fewer dopamine receptors in people who score higher on measures of detachment - childhood shyness has been found to be a precursor, although also for anxiety disorder

abnormal personality traits

- flat emotion wise (affectivity), may use other people to reach their goals (interpersonal functioning), aggression and deceitfulness (impulse control) - One key feature of personality disorder is it being draining for people to hang around them because they use others (emotionally or otherwise)

schizotypal personality disorder causes

- may be one phenotype of schizophrenia genotype - diagnosed more in relatives of schizophrenia

schizotypal personality disorder description

- pattern of deficits and discomfort with interpersonal relationships - cognitive and perceptual distortions - unusual and idiosyncratic speech - deficient in social skills and unusual dress - few interpersonal relationships ex: feel like someone is watching them or out to get them

schizoid personality disorder

- pattern of detachment from social relationships - restricted range of emotions in social settings - lack intimacy and do not derive satisfaction from social relationships - do not respond to social cues and are unaffected by others - extreme introverts and prefer solitary activities

causes of paranoid personality disorder

- possible weak genetic influence - more common in relatives of schizophrenia - upbringing

avoidant personality disorder etiology

- possibly born with a difficult temperament - leads to rejection by parents or at least insufficient early, uncritical love - this rejection develops into low self esteem and social alimentation that persists into adulthood - studied requiring AVPSs to describe their upbringing have found results supporting this formulation - but these studies have some limitations

(paranoid) schizophrenia

According to her family, Angela began to exhibit changes in her behavior near the end of high school. She began to withdraw from friends and family, and spent most of her time in her bedroom alone. She enrolled in college, but dropped out after two semesters. Now, at age 24, Angela finally disclosed to her family that she is being followed by aliens who are able to disguise themselves as people. They follow her everywhere and are recording her conversations and actions, and plan to impregnate her to create an alien-human hybrid baby. Angela explained she is able to hear their conversations about her, often laughing at her and criticizing her decisions, through a transmitter placed in her skull. She is afraid they will abduct her any day, since she is aware of their plans.

schizoaffective disorder (bipolar type)

Alexandra, a 27-year-old single female, suffers from a severe mental illness. For the past few years, she has believes the CIA is persecuting her because she has become aware of their plot to kill the President. She believes they call her pretending to be telemarketers so they can track her whereabouts. In addition, she has episodes in which she has increased energy and spends all night and day writing in her notebook about the plot to kill her. She also becomes involved in nonstop projects at home, although accomplishes nothing. During these periods, Alexandra doesn't sleep and claims she is not tired. She was taken to a psychiatrist, who prescribed medication. Her mood, energy, and sleep have stabilized and she has been without these symptoms for one month. Alexandra's persecutory beliefs, however, are unchanged.

paranoid personality disorder

Arun had done reasonably well as an undergraduate biology major and was now a graduate student in genetics. He was often concerned that fellow students were stealing his ideas or cheating off his papers, but he never filed any formal complaints. He started suspecting that his major professor had brought him to the university to take credit for his work and claim it as his own. One day, Arun gave his mentor a contract guaranteeing that the supervisor would not steal any of Arun's intellectual property. When the supervisor wouldn't sign, Arun was convinced he was out to get him. Arun started locking up his written work and bought extra security for his laptop. When his supervisor confronted him about his behavior, Arun interpreted it as yet another attempt to get access to his work.

avoidant personality disorder treatment

Behavioral interventions for anxiety and social skills training have been found effective •Similar approach to dealing with social phobia •Systematic desensitization for identified problem areas •Behavioral rehearsal for anxiety evoking situations

depersonalization and derealization

Both ___________________________________ ◾Persistent and recurrent experiences of depersonalization, derealization, or both ◾Feeling is unreal and discontinuous from previous state ◾Reality testing remains intact •Feel as if things were different •Not hallucinations or delusions (if someone has always felt this way then it's not dissociative) ◾Transient depersonalization and derealization episodes are very common among general population ◾Prevalence rate of disorder is less ◾Lifetime prevalence estimates .8% to 2.8% ◾Males = females

1.5

DID ◾Prevalence •12-month: _______% •Many more females than males(up to 9:1) •Marked increase in diagnosis in the 1970s ◾Onset normally in childhood ◾Chronic course ◾Much debate about diagnosis •Is it real? •Are therapists reinforcing playing the role? ◾Using techniques to encourage buried memories (hypnosis) ◾Symptoms emerge after treatment begins

treatment

DID _____________________ ◾Use of hypnosis and barbiturates in interviewing ◾One goal of treatment is integrate the alters into a single apersonality (fusion) •Makes sense—alters were developed to cope with some situation ◾Can also involve confronting the trauma •Concern over inducing more dissociation

identity

DID clinical presentation has loss of _______________ •Two or more distinct personality states •Discontinuity in sense of self and sense of agency •Alteration in affect, behavior, consciousness, memory, cognition, and/or sensory-motor functioning ◾Gaps in recall •Personal life events •Lapses in dependable memory •Discovery of evidence of things they have no recollection of doing ◾Not part of a broadly accepted cultural or religious practice

categorical

DSM-5 is a ____________________ system (but personality is dimensional)

triarchic model of psychopathy

Disinhibition •Boldness •Meanness

dependent personality disorder

Donna was the younger of two sisters and her mother's favorite "because she was prettier." As a child, Donna was indeed lovely, but very shy and clung to her mother's apron strings. She wet the bed until age 13 and only had sleepovers at her closest friend's house. Donna's mother was very opinionated and domineering. When she drank alcohol, she would get very loud. When it was time to decide about college, despite Donna's good grades, her mother told her that college was a waste of time and suggested she get her realtor's license so she could live at home, save money, and make a good living. Donna agreed and did as her mother instructed. Indeed she was relieved because she was terrified of having to live alone or in a college dorm. At 37 she was still living at home. Some of Donna's brief relationships with men had bordered on the abusive. She never felt like she had the right to stand up for herself and thought she didn't really have opinions about anything. At least the men were there to care for her if she needed them. She spent evenings in her room in tears worrying about her future and what would happen if her mother died and was no longer able to look after her.

dependent personality disorder treatment

Early on they seem ideal—eager to please the therapist •Submissiveness negates one of the most important goals of therapy—to become more independent •Therapy is slow and therapist must be sure the patient does not become overly dependent

schizotypal personality disorder

Everyone on campus knew him as "the pigeon man." When students first saw him, they avoided him by crossing the street. Here was some guy talking to himself (without an ear-bud!). He worked delivering the newspaper and placing signs on doors, and lived in a low rent apartment. His hygiene was minimally adequate. During the day, he sat in the park on a bench surrounded by pigeons, feeding them and carrying on extended conversations with the birds. Sometimes he laughed and other times he looked positively angry at the birds. His case manager confirmed that he did not have hallucinations or delusions and had never met diagnostic criteria for schizophrenia. Yet this odd pattern of behavior had been with him since middle school, where his yearbook caption called him "bird boy."

narcissistic personality disorder clinical description

Exaggerated sense of self-worth that does not reconcile with actual achievement •Sense of entitlement •Arrogance •Lack empathy and are interpersonally exploitative •Envious of others and think others are envious of them •Underlying dependency and vulnerability to others because their self-esteem is very fragile •Impaired interpersonal relationships Lack empathy - or the ability to connect with others emotionally •Talk and act as if they are the greatest thing ever but don't believe that

dependent personality disorder clinical description

Excessive need to be taken care of •Submissiveness, fears of separation, and clinging behavior •Trouble making decisions and allow others to assume responsibility for important aspects of their lives •Have trouble expressing disagreement Go to great lengths to obtain nurturance and support from others •Difficulty initiating—lack self-confidence •Preoccupied with being alone & seek other relationships when one is ended •Make self-sacrifices and tolerate unwanted behavior

histrionic personality disorder clinical description

Excessively emotional and attention-seeking •Feel uncomfortable or unappreciated if not center of attention •Appearance and behavior inappropriately seductive •Charm with enthusiasm and flirtatiousness Shallow and rapidly shifting emotions •Dramatic and impressionistic speech •Easily influenced by others and circumstances •Consider relationships more intimate than actually are •Manipulative in relationships and alienate friends

etiology of ASPD and psychopathy: prefrontal cortex

Insensitivity to potential negative consequences while retaining access to knowledge of social rules and potential outcomes

etiology of ASPD and psychopathy: psychological and social dimensions

Family Functioning •Uninvolved •Inconsistent and harsh parenting •Parent-child transactions Association with delinquent peers •Coercive style leads to rejection •Association with deviant peer accelerates antisocial behavior Socio-economic disadvantage

somatic symptom disorders

For some people, the preoccupation with their health or appearance becomes so great that it dominates their lives

etiology of ASPD and Psychopathy: biological

Genetics •Findings of twin, family, and adoption studies strongly suggest a genetic influence •Underarousal hypothesis •Lower autonomic and cortical arousal → sensation seeking •Fearlessness hypothesis •higher threshold for fear

psychopathy characteristics

Glibness/ superficial charm •Grandiose sense of self worth •Pathological lying •Conning/manipulative •Lack of remorse or guilt •Shallow affect •Callous/lack of empathy •Failure to accept responsibility for own actions •Promiscuity •Many short-term marital relationships Need for stimulation •Parasitic lifestyle •Lack of realistic long term goals •Impulsivity •Irresponsibility •Poor behavioral controls •Early behavioral problems •Juvenile delinquency •Revocation of conditional release •Criminal versatility

borderline personality disorder

Holly is a 30-year-old single Caucasian female who works as a nurse. She was sexually abused by one of her mother's boyfriends for two years, beginning at age 7. Since she was a teenager, she has had difficulty managing her emotions. She described going to extremes of feeling happy and sad, typically in response to things happening around her. Since adolescence, when overwhelmed by emotion she either cuts her legs with a razor or burns herself with cigarettes. She also has a history of attempting suicide by overdose three times in her life, the last time being four years ago. Her romantic relationships have been tumultuous, as she will become violently enraged at the slightest misstep made by one of her boyfriends or girlfriends. In contrast, she has been unfaithful to her romantic partners, especially when her relationships are going well. Despite this pattern, when one of her past lovers has tried to end their relationship, she typically responds in desperation by threatening to hurt herself or harm her partner. She drinks to the point of passing out four to five times per week. She has lost her job multiple times after starting heated arguments with her supervisors, coworkers, and patients. She has attempted to return to college multiple times, but always skips classes, falls behind and drops classes or fails, costing herself thousands of dollars. She describes difficulty trusting others, including people she would have once called friends, because she believes they have or will betray her.

borderline personality disorder clinical description

Instability in relationships •Fear of abandonment and efforts to avoid abandonment •Unstable sense of identity or sense of self •Impulsivity in self-damaging areas •Suicidal and self-injurious behaviors Emotional reactivity and episodes of rage •Feelings of emptiness •Stress-related paranoid ideation and transient dissociation •Splitting defense mechanism •75% of cases are women

four facet model of psychopathy

Interpersonal and Affective •Interpersonal •Affective •Social Deviance •Lifestyle •Antisocial

histrionic personality disorder

Jackie is a 35-year-old divorced female. Wherever she goes, she Jackie is a 35-year-old divorced female. Wherever she goes, she seems to become the center of attention. Indeed, since she was a teenager, people have described her as a "drama queen." When she is angry or sad, everyone around her knows. At parties, Jackie will be very charming and talk to complete strangers as if they were her best friends. She also dresses very seductively most of the time, wearing short skirts and low-cut blouses. She tends to be flirtatious in social gatherings and this style has led to many conflicts with romantic partners, including her ex-husband who became fed up with her antics and sought a divorce. When Jackie is describing the events of her life, she is usually very colorful and intense in her choice of words. People who know her, however, have realized things in her life are seldom as exciting as she makes them sound. Her coworkers and acquaintances have discovered she tends to have a "friend-of-the-month" and often will described people she has just met as if they were her closest confidant. Similarly, she tends to change her interpersonal style according to who is around, such that her acquaintances consider her to be disingenuous and generally avoid her once they discover how manipulative she can be.

obsessive compulsive personality disorder

Jeff would be happiest if his life never varied. He is a 52-year-old married statistician with three children. Every day for the past 15 years, he has risen at 5:30, exercised for 30 minutes while reading the paper, had two cups of coffee, a bowl of cereal and a piece of fruit, and caught the same train to work. He insisted that the household be run to his specifications. If the kids were asked to fold laundry, it had to be done right. If they did it wrong, he gave them one chance to fix it, and if they still did it wrong, he did it himself. His motto was, "If you want something done right, you have to do it yourself." Dinner was expected at 6:30. He played tennis on Tues. and Thurs. evenings. Other evenings he worked in his study. His office was a shrine of order and organization. Color-coded post-it notes contained lists of what he and his team had to accomplish for various projects. At times he would sit at his desk with three colored-coded lists and faced with scores of emails, but would get lost looking for the algorithm that could make him most efficient. As the lists became longer and the inbox more crowded, he could become paralyzed by anxiety. He had long stopped supervising grad students. Several had dropped out, unable to deal with his exceedingly high expectations and constant criticism.

course of conduct problems of psychopathy

Life-Course Persistent •childhood onset •More aggression in childhood and adolescence •Show antisocial and criminal behavior into adulthood •worse outcome and prognosis Adolescent-Limited •delinquent behaviors limited to the period of adolescence •Association with deviant peer group •High levels of rebelliousness and authority conflict •some see this as more normal development

avoidant personality disorder

Lou was a 35-year-old mechanic who rarely came out from under a car. Ever since he can remember he was basically terrified of talking to other people. Even though his grades were acceptable throughout high school, he was afraid that people would think he was "simple" because he never knew what to say. He avoided all school social events and group projects, and would not attend graduation. He stayed in the garage all day working on cars. He quit work in one garage because he had to "cover" the front counter when the clerk went on breaks or lunch. He could not deal with the phones and the customers. He did excellent work and was offered several promotions that would require him to supervise others, but he refused because he did not know how to handle teams of people. To this day, Lou has never gone on a date. He eats alone in his house in front of the television every night and avoids all social contacts. When Lou's mother found out he had refused promotions, she decided she "had it" with his "ridiculous shyness" and brought him in for psychotherapy.

obsessive compulsive personality disorder treatment

Not much literature on this topic •Therapy addresses fears that underlie orderliness •Employ relaxation techniques

OCPS

OCD has obsessions and compulsions not _________

(grandiose) delusional disorder

Phil is a 47-year-old married male convenience store clerk. Over the past two years, he has exhibited a change in his behavior that has his wife and family very concerned. Phil believes he is the top advisor to President Obama and has been sending him emails and letters with recommendations for economic and foreign policy. Phil has travelled to Washington DC a few times over the past two years, stating he is required to meet with the President at a coffee house across from the Capital Building. His wife has discovered he has 30 binders full of "memos" he has written to various Cabinet members instructing them on a wide range of issues. Most recently, Phil's behavior has prompted an investigation by the Secret Service because his repeated letters and phone calls to the White House are become a concern.

obsessive personality disorder clinical description

Preoccupation with orderliness, perfectionism, and mental interpersonal control •Get angry in situations in which they are not in control •Unable to delegate work •Preoccupied with details, rules, and schedules Perfectionism to the point it interferes with task performance •Take a lot of time to make decisions •Excessively devoted to wok and productivity at the expense of leisure •Miserly and unable to discard worn out belongings Overly conscientious and inflexible about morality •Rigidity and stubbornness •The traits are ego-syntonic

degenerative

Schizophrenia as a ____________________ process •May account for functional deterioration and medication resistance •Explains finding that longer untreated initial episodes is associated with poorer long-term outcome •Widespread neuronal loss has not been observed •Subtle signs: decreased neuropil and synapse density may result from degenerative process

dependent personality disorder

See this a lot with people who stay in abusive relationships

dependent personality disorder causes

Some have thought that early loss of a parent or rejection by parent leads one to grow up with a fear of abandonment •If the infant-caregiver attachment is interrupted, then the person may be constantly anxious that others will leave them

narcissistic personality disorder

Stephan has always been outwardly confident in his small-town high school. He believed he transcended his Midwestern peers because he had travelled to Europe during childhood. His edgy, electronic music and interest in water polo and European soccer were not as popular in his high school as the upper crust Northeastern schools he read about in the New York Times. Stephan was generally aloof and condescending toward his fellow students, considering himself above their common and ordinary lives. His attitude led him to have few friends. The few relationships he managed to maintain were characterized by exploitation—he befriended schoolmates who could provide him some benefit. This approach persisted into college at the nearby state university, where he was often rude to professors, whom he believed are unqualified to teach him. He also complained about the university requirements, which he considered unnecessary. Stephan made little effort and was essentially an average student. During his senior year, he became enraged when none of his classmates would accept him as part of a group project for his Economics seminar. Upon graduation, Stephan applied for positions with several Fortune 500 companies based in Chicago and New York, but was uniformly rejected. He wound-up returning home and working at his family landscaping business.

etiology of ASPD and psychopathy: temporal lobe and limbic system

Temporal lobe •Typically, violence is inhibited in the face of distress cues •Leads to autonomic arousal •Dysfunction leads to problems with Limbic system •Structural changes in the amygdala associated with Hippocampus also involved in emotional learning and contextual fear conditioning

histrionic personality disorder treatment

Therapy focuses on problematic interpersonal relationships •Learn how short-term gains have long-term costs •More appropriate ways to negotiate their wants and need

histrionic personality disorder causes

There may be a relation between HPD and ASPD •Possible sex-typed manifestations of the same underlying vulnerability

obsessive compulsive personality disorder

These people don't get anything done because they are constantly fixing and perfecting projects

endophenotype research

This research looks for genes that are connected to symptoms or other phenomena associated with a disease •Smooth-pursuit eye movement (eye-tracking) •Tracking movement with head immobilized •Deficient in patients with schizophrenia •Abnormal in relatives of patients with schizophrenia

narcissistic personality disorder treatment

Vulnerable to depression in middle age •When addressing the narcissism, there is a focus on their grandiosity and hypersensitivity to criticism

narcissistic personality disorder causes

We all begin life narcissistic, but learn empathy and altruism through socialization •Failure by parents to model empathy, leaving the person fixated at the self-centered stage of development •Societal focus on short-term hedonism, individualism, and competitiveness

prevalence of personality disorders

Worldwide, 6-10 % of adults meet criteria for at least one personality disorder •Comorbidity is common •With personality disorders •With other psychological disorders •Sex differences may be due to diagnostic bias

schizoid personality disorder

Zack is a 24-year-old single male stable hand. He is most comfortable when alone with the horses and mucking stalls. He came in early in the morning, did his work, left late at night, and barely spoke to anyone. New people would try to engage him in conversation, but he just wasn't interested. People would sometimes interpret his lack of interest as arrogance and wonder what made him feels so special, but more often they would wonder how anyone could go so long without talking to anyone. A new young rider brought her horse to the stables and took a liking to Zack. Even though he seemed really distant, she thought he was attractive. She asked him out, but he just seemed to have absolutely no interest in her—or anyone else. Zack would visit his parents about once a month. His mother was a seamstress and his father delivered mail. When he went home, he sometimes helped his mother rip out seams of articles she was sewing, but they all basically sat there in silence or worked while the TV was on.

10

____ personality disorders in three categories - cluster A: odd/eccentric - cluster B: dramatic/ erratic - cluster C: anxious/ fearful

70

_______ percent of genetic factors contribute to schizophrenia (check the book for a different percentage)

genes

___________ are responsible for making some individuals vulnerable to schizophrenia. - This risk is the majority for schizophrenia

borderline

____________ is very common •avoidant is also common but because of anxiety type disorders that they also possess

dissociative

______________ amnesia is characterized by an inability to recall important personal information

depersonalization/ derealization

________________ disorder is characterized by experiences of unreality or detachment from one's mind, self, body and/or surroundings

Robert Hare

________________ quote is a good definition for antisocial behavior

dopamine

__________________ Hypothesis •Possibility that the dopamine system is too active •But it's more complicated than that •At least 3 specific neurochemical abnormalities •Drugs that effectively treat schizophrenia lower dopamine (DA) •DA antagonists •Decrease schizophrenia Sx •Increase Parkinson's Sx •DA agonists •Reduce Parkinson's Sx •Induce schizophrenia-like Sx (positive symptoms)

posttraumatic

__________________ model ◾Major factors in DID •Childhood sexual abse •Innate dissociative capacity (diathesis?) •Lack of social support after the abuse ◾Process •Child is sexually abused •Develops second personality to deal with abuse •Other personalities develop over time to deal with psychological conflicts •Requires high intelligence

prenatal

___________________ Exposure •Birth Complications •Patients with schizophrenia are more likely to have been born after pregnancy and birth complications •Many birth complication interfere with oxygen supply •Bleeding during pregnancy also related •Unclear whether which direction this relationship goes

delusional

___________________ disorder includes the presence of delusions in the absence of other symptoms of schizophrenia

schizoaffective

_____________________ disorder includes symptoms of schizophrenia and mood disorder occurring together schizophrenia type symptoms with mood disorders added

depersonalization

_____________________ of dissociative disorders ◾Experiences of unreality ◾Detachment ◾Outside observer of one's mental processes or body •Thoughts •Feelings •Sensations •Body •Actions ◾Examples •Perceptual alterations •Distorted sense of time •Unreal or absent self •Emotional or physical numbing

derealization

_______________________ of dissociative disorders ◾Experiences of unreality or detachment from one's surroundings ◾Examples •Individual or objects are experienced as unreal •Dreamlike •Foggy •Lifeless •Visually distorted

sociocognitive

_______________________ theory(DID) ◾Highly suggestible person learns to adopt and enact the roles of multiple identities ◾Clinicians have inadvertently suggested and reinforced this pattern ◾Different personalities are geared toward the individual's goals ◾Occurs spontaneously •Not intentionally by the patient

schizophrenia

a disorder characterized by hallucinations, delusions, disorganized speech, disorganized behavior, and/or negative symptoms, lasting between one month and six months less than six months

empathy

a lot of people who don't have _________________ don't have social skills also

schizotypal

a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

schizoid

a pattern of detachment from social relationships and a restricted range of emotional expression

antisocial

a pattern of disregard for, and violation of, the rights of others

paranoid

a pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent

histrionic

a pattern of excessive emotionality and attention seeking

narcissistic

a pattern of grandiosity, need for admiration, and lack of empathy

borderline

a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity

obsessive-compulsive

a pattern of preoccupation with orderliness, perfectionism, and control

avoidant

a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

dependent

a pattern of submissive and clinging behavior related to an excessive need to be taken care of

personality disorder

a persistent pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and relationships.

obsessive-compulsive personality disorder

a pervasice pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency

dependent personality disorder

a pervasive and excessive need to be taken care of, which leads to submissive and clinging behavior and fears of separation

paranoid personality disorder

a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent

antisocial personality disorder

a pervasive pattern of disregard for and violation of the rights of others

histrionic personality disorder

a pervasive pattern of excessive emotion and attention seeking

narcissistic personality disorder

a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy

borderline personality disorder

a pervasive pattern of instability of interpersonal relationships, self-image, affects, and control over impulses

schizotypal personality disorder

a pervasive pattern of social and interpersonal deficits marked by acute discomfort with reduced capacity for close relationships, as well as by cognitive or perceptual distortions and eccentricities of behavior

avoidant personality disorder

a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

psychopathy

another name for antisocial personality disorder, it describes people with unusual emotional responses and impulsive rages but no deficits in reasoning ability

cluster B (dramatic, emotional, or erratic disorders)

antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder

cluster C

anxious/ fearful

instability

borderline personality disorder can be described in one word = _____________

mutilation

borderline personality disorder is often associated with _____________________

obsessive-compulsive disorder

characterized by hallucinations, delusions, disorganized speech, disorganized behavior, and/or negative symptoms, lasting at least six months

treatment for children with psychopathy symptoms

child born with probs - parents apply coercive parenting - coercion with peers, child associates with delinquent peers - problematic child •rarely identify themselves as needing treatment •can be manipulative with therapist •higher psychopathy - worse treatment outcomes •more success with prevention strategies in high risk kids •low apathy individuals don't get psychology sessions because it teaches them to lie better

experiences

common dissociative ________________ ◾Daydreaming ◾Losing track of surroundings ◾Driving hypnosis ◾Missing part of a conversation ◾Deja vu or jamais vu

comorbidity

describes the condition in which a person has multiple diseases

fugue

dissociative _____________ is a subtype of dissociative amnesia, characterized by a loss of memory regarding identity, and purposeful travel or bewildered wandering

amnesia

dissociative __________________ ◾Unable to recall important personal information, usually after stressful event ◾Memory loss is for personal information (episodic or autobiographical memories) ◾Memory loss can be generalized (less common) or localized or selective(more common) ◾Not due to a known medical disorder or physical cause, as in cognitive disorders ◾Prevalence = 1.8% (some estimates up to 7.3%) ◾More common in females: •Males = 1.0% •Females = 2.6% ◾Usually occurs in adulthood

identity

dissociative __________________ disorder is characterized by the personality states and recurrent episodes of amnesia

malingering

distinguishing among conversion reactions, real physical disorders, and outright ______________ (faking) is sometimes difficult

18

don't diagnose antisocial behavior before _____, have to have a conduct disorder history by 15

cluster B

dramatic/ erratic

schizophrenia

if someone's biological parents have ___________________ but they were raised in a different home they are still at risk but have some protection

advances

impact of ______________ •Reduction in need for hospitalization •Deinstitutionalization of the mentally ill •More outpatient treatment and need for outpatient resources •Increased burden on families •Reduction in the number of beds for psychiatric patients •Fewer state hospitals •Patients living in communities Criminalization because of insufficient resources

factitious disorders

more puzzling is a set of conditions called _______________________, which fall somewhere between malingering and conversion disorders. The symptoms are under voluntary control, as with malingering, but there is no obvious reason for voluntarily producing the symptoms except, possibly, to assume the sick role and receive increased attention

avoidant personality disorder

nothing done for them seems to help when it comes to soothing them

antisocial personality disorder clinical description

pattern of disregard and violation of others' rights •Criminal behavior, deceitfulness, and conning for own gain •Impulsive and reckless disregard for others •Irritable and repeated aggression •Substance abuse present in 83% of cases •Consistent irresponsibility •Lack of remorse History of conduct disorder •Aggression to people and animals •Destruction of property •Deceitfulness or theft •Serious violations of rules •Likelihood of ASPD is higher for CD and ADHD •Early onset of conduct problems results in higher risk for ASPD •Girls with later onset more associated with antisocial behaviors

dissociative

people with ______________ disorders experience •Detachment ◾Detached from self (e.g., out-of-body experience) ◾Triggered by immediate overwhelming emotion •Compartmentalization ◾Compartmentalizing normally integrated functions (e.g., multiple personalities) ◾Product of traumatic development ◾Alters structure of personality

ideas of reference

people with paranoid and schizotypal personality disorders often have _____________________, mistaken beliefs that meaningless events relate just to them

schizoid personality disorder description

pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings

bulimia

recurrent episodes of binge eating and compensatory behaviors in order to prevent weight gain

binge-eating

recurrent episodes of binge eating without compensatory behaviors

anorexia

restriction of energy intake relative to requirements, leading to a significantly low body weight, as well as an intense fear of gaining weight or of becoming fat

prefrontal

schizophrenia ______________ cortex •Poor performance on cognitive tasks requiring this cortex •E.g., working memory •Low metabolism (imaging studies) when performing tasks involving this cortex •Especially patients with prominent negative Sx •Brain dysfunction seems to occur before the onset of schizophrenia •May develop progressively, years before the first symptoms

exposure

schizophrenia is thought to be causes by prefrontal _______________ •Viral Infection •Disproportionate number of people with Schizophrenia born between February and May •Replicated in southern hemisphere August-December •Data suggest prenatal exposure to influenza may be related •Risk seems greatest in first trimester (7x) •First half of pregnancy (3x) •Other diseases also implicated in schizophrenia (e.g., Rubella)

family therapy

schizophrenia patients shouldn't have __________ as a treatment by itself •Education about illness and treatment •Reduction of expressed emotion reduces relapse and medication utilization •Communication and problem-solving within the family

individual therapy

schizophrenia patients shouldn't have __________ as a treatment by itself •Social Skills training •Managing arousal (e.g., anxiety) •Increasing activity •Monitoring compliance with treatment

alters

shorthand term for the different identities or personalities in DID

neurosis

suggests a specific cause for certain disorders

large

the majority of people with schizophrenia show abnormally ___________ lateral and third ventricles

psychological factors affecting medical condition

the presence of a diagnosed medical condition such as asthma, diabetes, or severe pain clearly caused by a known medical condition such as cancer that is adversely affected by one or more psychological or behavioral factors

defining line

there is not really a _______________________ that says when an individual has a personality disorder which is a flaw for the DSM

the culture of narcissism

this personality disorder is increasing in prevalence in most Western societies, primarily as a consequence of large-scale social changes, including greater emphasis on short-term hedonism, individualism, competitiveness and success

endophenotype

underlying aspects of a disorder that might be more directly influenced by genes

illness anxiety disorder

was formerly known as hypochondriasis which is still the term widely used among the public

ego-syntonic

when someone has feelings that they feel like they are apart of "how I always behave so this behavior is okay'

crime

when you see or meet someone who doesn't seem like their personality fits the ________ they did = may be psychopathy (no guilt)

expressed emotion (EE)

•Characteristics •Emotional over involvement •Criticism •Hostility •Associated with increase (3.7X) relapse risk •Especially for chronically ill patients •When EE is lowered, risk for relapse decreases •People with schizophrenia more sensitive to stress

pharmacotherapy

•Definitely the first line of treatment •Primarily dopamine antagonists - these lower/ block dopamine activity •Antipsychotics/neuroleptics •Noncompliance is common •Longer without treatment → more severe illness •First Generation •Older drugs used to treat schizophrenia •Work best on positive Sx •Examples •Thorazine •Haldol •Prolixin •Problem with side effects •Extrapyramidal Sx •Tardive dyskenisia - lip smacking, tongue out of mouth - permanent •Second Generation •Newer drugs •Better side effect profile •Drowsiness •Weight gain •Examples •Clozaril •Geodon •Abilify •Effectiveness is largely the same

biology of eating disorders

•Genetic: Familial aggregation and high concordance between MZ twins (reared together) •Inherited tendency of being highly responsive to stress and eating implsively •Tendency toward perfectionism •Hypothalamus abnormalities (serotonin), but unclear if cause or result •Release of endogenous opioids may be reinforcing starvation

labeling theory

•Labeling with schizophrenia leads one to act in a manner consistent with diagnosis •Society treats people labeled with schizophrenia differently •But...symptoms are too bizarre to be accounted for by just labeling and adopting a social role

the other way around

•Most people who have ocd have ocpd but not _______________________________

dissociative fugue

•Purposeful travel or bewildered wandering •Loss of memory for identity or other autobiographical information •Usually follows trauma •Often find themselves in a new place, with no memory of how they got there Comes from Latin fuga, which means flight

bulimia nervosa

•Recurrent episodes of binge-eating •Large amount of food in two-hour period (more than normal) •Sense of loss of control over episode •Recurrent compensatory behavior to prevent weight gain •Vomiting (purging), laxatives, enemas, excessive exercise •Binging and purging occur, on average, at least once a week for three months •Self-evaluation is unduly influenced by body shape and weight •Recognize behavior is odd and make efforts to hide actions •Normal body weight (or overweight) •Subtypes - (No longer used) •Purge type •Non-purge type •Severity based on frequency of compensatory behaviors •Dental decay •Enlarged salivary glands •Loss of electrolytes •Needed for neurons to fire properly •Cardiac arrhythmia & renal failure •Ulcers in throat and other gastrointestinal problems •Damage to fingers —calluses and damage from acid •Strong association with mood disorders •Elevated suicide risk •Anxiety disorders •Personality disorders, especially borderline personality •Substance abuse •Particularly effective •Education •Address body image distortion and terminations of binge-purge behavior pattern •Prescribe regular food intake •More beneficial role than anorexia •Antidepressants may be helpful given comorbidity with depression •Prozac approved by FDA for eating disorders since 1996

binge eating disorder

•Repeated bingeing without compensatory behavior •Binge eating associated with •Rapid eating •Uncomfortably full •Large amounts of food when not hungry •Eating alone out of embarrassment •Disgust, depression, or guilt after binge •Once per week for three months •Marked distress about binge eating •Attempt to conceal eating problems •Severity gauged on frequency of binges •Comorbidity similar to bulimia and anorexia

anorexia nervosa

•Restriction of energy intake leading to significantly low body weight •Less than minimally normal (or less than expected) •Intense fear of gaining weight or becoming fat, despite being underweight •Disturbance in the way one's body weight is experienced, undue influence of body weight on self-evaluation, denial of the seriousness of low body weight •Two Subtypes •Anorexia Nervosa, Restricting Type •Anorexia Nervosa, Binge-Purge Type •Severity •Based on BMI •Mild, Moderate, Severe, Extreme •Amenorrhea- cessation of menstruation •Dry skin, brittle hair/nails •Sensitivity to and intolerance for cold temperatures •Lanugo- soft, downy hair on limbs and cheeks •Cardiovascular problems (e.g., low blood pressure and heart rate) •Vomiting in anorexia results in similar medical problems as bulimia. •Depression •Elevated suicide risk (≈12/100K) •Anorexia also related to OCD and anxiety disorders •More psychopathology with binge-purge type - About 20 percent of people who have this die from either suicide or medical issues associated with it •May begin with hospitalization to address health crisis and restoration to healthy weight •Pharmacological •Not strong positive results, in general •May have a role in treating comorbid psychiatric problems once health and body weight are stabilized •Education •Cognitive-behavioral interventions addressing dysfunctional attitudes toward body shape •Address anxiety over becoming obese or losing control over eating •Family therapy for adolescents •Negative and critical communications •Attitudes about body shape and image distortions

neurodevelopment

•Risk genes affect ____________________________ in schizophrenia •Prefrontal cortex neurons have fewer dendrites •Slight decrease in brain volume & increase in ventricle size •Decreased size of hypothalamus, superior temporal lobe, PFC, and thalamus •Abnormal connectivity between brain regions

social class

•Schizophrenia is found more among lower SES Social causation versus social drift

families

•Schizophrenia is observed to run in ____________ •Risk increased with genetic relatedness •Twin, adoption, family studies suggest genetic factors account for 60% of disease risk •The genetic lesions associated with schizophrenia remain obscure •Evidence suggests schizophrenia may genetically heterogeneous

avoidant personality disorder clinical description

•Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation •Avoid situation that involve significant social contact for fear of disapproval or negative evaluation •Reluctant to make friends, unless it is their immediate family •Show restraint in intimate relationships because they fear being ridiculed Views self as socially inept and inferior to others and others see them as shy, timid and isolated •Discomfort may elicit ridicule from those around them (confirms self-doubts) •Vigilant and appraise the actions of others •Fail to develop social support networks to help during times of crisis

socio-cultural aspect of eating disorders

•Societal pressure for thinness and social judgments •Iconic images of beauty trending toward thinness over the years •Women rate their current appearance as heavier than what they expect men would find attractive, which is heavier than what they rate as ideal •Might be changing?

psychodynamic of eating disorders

•Starvation provides a sense of control during adolescence when other body urges are becoming intense •Older formulation is that food represents sexual gratification (oral stage) and starvation comes from fear of oral impregnation •Dysfunctional family •Parents are overinvolved and very controlling •Child starves her/himself in an effort to exert control •Anorexia is a method to avoid adulthood (no breasts or menstruation) and remain protected by parents

the Genain quadruplets

•all had schizophrenia and were tested on their whole lives •two did well with schizophrenia •the youngest who was premature was worse off than the rest •the two taller ones were treated better by the parents and the two shorter ones were treated as if they were dumb

psychopathy

•subgroup of individuals with ASPD •Focus more on personality traits •Antisocial PD is not same as psychopathy •ASPD criteria are mostly behavioral in nature •Criminals with ASPD & high in psychopathy most likely to recidivate

dissociative disorders

◾Disruption of and/or discontinuity in normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior ◾Positive Dissociative Symptoms •Unbidden intrusions into awareness and behavior •Deficits in continuity of subjective experience •Identity fragmentation, depersonalization, derealization ◾Negative Dissociation Symptoms •Inability to access information or to control mental functions •Amnesia, aphonia, paralysis ◾Partial or complete loss of mind's ability to integrate higher mental functions ◾Change in sense of identity, memory, and/or consciousness ◾Some aspect of cognition or experience becomes inaccessible •"Splitting off" typically familiar information from conscious awareness •"Elsewhere disorders"

DID

◾The disorder formerly known as Multiple Personality Disorder ◾DID terms: •Host ◾Identity that seeks treatment •Alters ◾Different identities ◾Average number- 15 •Switch ◾Transition from one personality to another