PAB: Chapter 14 Mind Tap Activities

What personality disorder matches Pablo Picasso's profile?

Narcissistic Personality Disorder

Which one of these personality disorders is included in Cluster B? - Narcissistic personality disorder - Obsessive compulsive personality disorder - Schizotypal personality disorder - Avoidant personality disorder

Narcissistic personality disorder

Which of the following personality disorders are included in Cluster C?

- Avoidant personality disorder - Dependent personality disorder - Obsessive compulsive personality disorder

Case Study: - Name: Margaret - Age: 58 - Sex: Female - Family: Single - Occupation: Self-employed, carpentry - Presenting problem: Sister's concern Margaret has lived a relatively isolated existence ever since she graduated from high school and moved out. prior to that time, she didn't seem to fit in with her family very well. Her brothers and sisters are all gregarious and outgoing, which Margaret prefers to be alone. These days, she barely bothers maintaining contact with her family. The only person she regularly talks with is her younger sister, Karen. Margaret reports that the only reason she sought out a clinician was because she promised Karen that she would. Her family is distraught and angry over Margaret's reaction to the news of their father's recent passing. When told about it, Margaret flatly responded, "Well, everyone dies at some point." Margaret reports that she doesn't hate, or even dislike, her family. At the same time, it's clear that she doesn't feel any particular affinity for them, either. If it weren't for her sister's continual efforts to keep in touch, Margaret would probably be completely estranged. This emotional coldness and distance extends to other parts of Margaret's life as well. She has a few friends but, overall, seems rather disinterested in maintaining relationships with others. When people try to engage her in conversation, she can come across as cold or aloof, even though she's never overtly rude. Margaret has a steady job as a carpenter. She works by herself, and most of her business is generated through recommendations from former customers. I looked up some online reviews, and most were very similar. Here's a typical one: "We needed some custom shelves built, and while Margaret did great, high-quality work, she wasn't very personable. She basically kept her nose to the grindstone and seemed kind of annoyed at my attempts to talk to her. On the plus side, she finished the job earlier than expected! Would definitely recommend if you want someone to just come in and get it done right." When asked about these reviews, she bluntly stated that it didn't matter to her one way or another. She said that she always delivers exactly what the contract states, and if her clients don't like it, it's their problem. Her work ethic is very strong, and she rarely takes any time off. When asked why, she claims that she likes to stay busy and doesn't have any interests outside of work. On the whole, Margaret is not very introspective, and her attitude is grounded in practicality and matter-of-factness. She shows no interest in pursuing romantic or sexual relationships. In fact, such things seem almost foreign to her. According to her sister, Margaret is "mostly cordial" toward her neighbors. She says that Margaret does her thing, and they do theirs. Nevertheless, her bluntness and general demeanor can rub some people the wrong way. Which of the following diagnostic criteria does Margaret meet? - Demonstrates paranoid or suspicious behavior - Maintains a solitary lifestyle, with few close interpersonal relationships - Avoids interactions with others, including extended family - Shows no interest in intimate or romantic relationships - Presents with restricted range of emotional expression

- Maintains a solitary lifestyle, with few close interpersonal relationships - Avoids interactions with others, including extended family - Shows no interest in intimate or romantic relationships - Presents with restricted range of emotional expression

Case Study: - Name: Emmie - Age: 28 - Sex: Female - Family: Live-in boyfriend - Occupation: Unemployed - Presenting problem: Recent suicidal gestures Emmie was taken to a local crisis clinic by family members following recent suicidal gestures. Emmie was found in a local hotel room; she was intoxicated, had multiple superficial scratches on her forearms, and was threatening to jump out of the hotel's 5th-floor window. According to family members, Emmie has a history of abusive relationships and has been abusing alcohol since adolescence. Emmie's family initially became concerned about her self-destructive behavior during her sophomore year of high school when she shaved her head and threatened to kill herself after a romantic breakup. It was during this time that Emmie began openly smoking cigarettes and drinking alcohol. She once tried to boast about her sexual activity with several partners, even though her friends were more alarmed than impressed. During her junior year, Emmie became romantically involved with an older man, dropped out of school, and moved in with him. Following the breakup of that relationship, Emmie's family received a phone call reporting that she was at the local hospital following an attempted suicide. Shortly after being released, she ran away and has had on-and-off contact with her family since. Her family described this period as "going from one crisis to the next". According to them, Emmie would start dating someone and feel ecstatic in the beginning. Pretty soon, however, the arguing and fighting would begin. Then, she'd talk about committing suicide when they broke up. This appears to be the general pattern of her life over the past decade. After every breakup, emmie crumbled emotionally, constantly blamed herself, and despaired about ever finding someone who would love her. About a year ago, she moved in with her current boyfriend, and their relationship has been plagued with several alochol-related domestic disputes. When her parents tried to discuss this, Emmie first thought they were joking and tried to laugh it off. When she realized that they were serious, she immediately went ballistic. She angrily screamed about how they didn't understand her, and "he's the only person who's ever loved me, and you just want to drive him away!" According to Emmie's counseling and legal history (noted on the counseling and legal history tab), she has a history of alcohol dependence, suicidal gestures and attempts, and alcohol-related criminal offenses. Law enforcement noted that Emmie is generally argumentative and protective of her boyfriend and, one time, needed to be placed in handcuffs while being interviewed by police. While having an initial interview with a customer, Emmie's emotions vacillated between sadness and anger. She had moments of slight sadness when expressing that her boyfriend is the only one who loves and understands her, and she is afraid he will leave her "Because of all this." She reports that "without him, there isn't any reason to live." When informed that she would be required to complete an alcohol assessment, Emmie became volatile and screamed "You are all out to get me!" Which of the following symptoms does Emmie have? - Paranoid ideation during stressful confrontations or situations - Recurrent suspicions of infidelity of the intimate, sexual partner - Recurrent threats of suicide or other self-injurious behaviors - History of turbulent relationships marked by fear of abandonment - Belief that others are often envious of her

- Paranoid ideation during stressful confrontations or situations - Recurrent threats of suicide or other self-injurious behaviors - History of turbulent relationships marked by fear of abandonment

Which of the following personality disorders are included in Cluster A, characterized by odd or eccentric behaviors?

- Paranoid personality disorder - Schizoid personality disorder - Schizotypal personality disorder

Case Study: - Name: Margaret - Age: 58 - Sex: Female - Family: Single - Occupation: Self-employed, carpentry - Presenting problem: Sister's concern Margaret has lived a relatively isolated existence ever since she graduated from high school and moved out. prior to that time, she didn't seem to fit in with her family very well. Her brothers and sisters are all gregarious and outgoing, which Margaret prefers to be alone. These days, she barely bothers maintaining contact with her family. The only person she regularly talks with is her younger sister, Karen. Margaret reports that the only reason she sought out a clinician was because she promised Karen that she would. Her family is distraught and angry over Margaret's reaction to the news of their father's recent passing. When told about it, Margaret flatly responded, "Well, everyone dies at some point." Margaret reports that she doesn't hate, or even dislike, her family. At the same time, it's clear that she doesn't feel any particular affinity for them, either. If it weren't for her sister's continual efforts to keep in touch, Margaret would probably be completely estranged. This emotional coldness and distance extends to other parts of Margaret's life as well. She has a few friends but, overall, seems rather disinterested in maintaining relationships with others. When people try to engage her in conversation, she can come across as cold or aloof, even though she's never overtly rude. Margaret has a steady job as a carpenter. She works by herself, and most of her business is generated through recommendations from former customers. I looked up some online reviews, and most were very similar. Here's a typical one: "We needed some custom shelves built, and while Margaret did great, high-quality work, she wasn't very personable. She basically kept her nose to the grindstone and seemed kind of annoyed at my attempts to talk to her. On the plus side, she finished the job earlier than expected! Would definitely recommend if you want someone to just come in and get it done right." When asked about these reviews, she bluntly stated that it didn't matter to her one way or another. She said that she always delivers exactly what the contract states, and if her clients don't like it, it's their problem. Her work ethic is very strong, and she rarely takes any time off. When asked why, she claims that she likes to stay busy and doesn't have any interests outside of work. On the whole, Margaret is not very introspective, and her attitude is grounded in practicality and matter-of-factness. She shows no interest in pursuing romantic or sexual relationships. In fact, such things seem almost foreign to her. According to her sister, Margaret is "mostly cordial" toward her neighbors. She says that Margaret does her thing, and they do theirs. Nevertheless, her bluntness and general demeanor can rub some people the wrong way. Which of the following diagnostic criteria does Margaret meet? - Presents as indifferent to compliments or praise from others - Feel anxious in social settings regardless of familiarity - Has general distrust of others that interferes with social relationships - Has attitude and behavior that reflect arrogance or grandiosity - Appears emotionally detached with flattened affect

- Presents as indifferent to compliments or praise from others - Appears emotionally detached with flattened affect

Case Study: - Name: Emmie - Age: 28 - Sex: Female - Family: Live-in boyfriend - Occupation: Unemployed - Presenting problem: Recent suicidal gestures Emmie was taken to a local crisis clinic by family members following recent suicidal gestures. Emmie was found in a local hotel room; she was intoxicated, had multiple superficial scratches on her forearms, and was threatening to jump out of the hotel's 5th-floor window. According to family members, Emmie has a history of abusive relationships and has been abusing alcohol since adolescence. Emmie's family initially became concerned about her self-destructive behavior during her sophomore year of high school when she shaved her head and threatened to kill herself after a romantic breakup. It was during this time that Emmie began openly smoking cigarettes and drinking alcohol. She once tried to boast about her sexual activity with several partners, even though her friends were more alarmed than impressed. During her junior year, Emmie became romantically involved with an older man, dropped out of school, and moved in with him. Following the breakup of that relationship, Emmie's family received a phone call reporting that she was at the local hospital following an attempted suicide. Shortly after being released, she ran away and has had on-and-off contact with her family since. Her family described this period as "going from one crisis to the next". According to them, Emmie would start dating someone and feel ecstatic in the beginning. Pretty soon, however, the arguing and fighting would begin. Then, she'd talk about committing suicide when they broke up. This appears to be the general pattern of her life over the past decade. After every breakup, emmie crumbled emotionally, constantly blamed herself, and despaired about ever finding someone who would love her. About a year ago, she moved in with her current boyfriend, and their relationship has been plagued with several alochol-related domestic disputes. When her parents tried to discuss this, Emmie first thought they were joking and tried to laugh it off. When she realized that they were serious, she immediately went ballistic. She angrily screamed about how they didn't understand her, and "he's the only person who's ever loved me, and you just want to drive him away!" According to Emmie's counseling and legal history (noted on the counseling and legal history tab), she has a history of alcohol dependence, suicidal gestures and attempts, and alcohol-related criminal offenses. Law enforcement noted that Emmie is generally argumentative and protective of her boyfriend and, one time, needed to be placed in handcuffs while being interviewed by police. While having an initial interview with a customer, Emmie's emotions vacillated between sadness and anger. She had moments of slight sadness when expressing that her boyfriend is the only one who loves and understands her, and she is afraid he will leave her "Because of all this." She reports that "without him, there isn't any reason to live." When informed that she would be required to complete an alcohol assessment, Emmie became volatile and screamed "You are all out to get me!" Which of the following symptoms apply to Emmie? - Recurrent suicidal or other self-injurious gestures or behavior - Pattern of turbulent relationships, marked by abuse and violence - Persistent fear of abandonment - Intense negative emotions, such as anger control problems - Persistent demands of admiration of exaggerated, grandiose self-image

- Recurrent suicidal or other self-injurious gestures or behaviors - Pattern of turbulent relationships, marked by abuse and violence - Persistent fear of abandonment - Intense negative emotions, such as anger control problems

From a cognitive perspective, what might describe the cognitions associated with APD?

A predatory strategy

From a sociocultural perspective, what role might gender play in the development of APD?

Aggression in boys is more acceptable

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause lower functioning in the ___________.

Amygdala

Cognitive approaches target inappropriate behaviors by enforcing consequences for rule violations and teaching participants to _____________.

Anticipate consequences of behaviors and practice new ways of interacting with others

What personality disorder matches Aileen Wuornos' profile?

Antisocial Personality Disorder

From a sociocultural perspective, what role does culture play in the etiology of APD?

Antisocial behavior occurs less often in collectivist cultures

Which of the following describe behavior cluster C from the DSM-5?

Characterized by anxious or fearful behaviors

What personality disorder matches Michael Jackson's profile?

Avoidant Personality Disorder

Which of the following describe behavior cluster B from the DSM-5?

Characterized by dramatic, emotional, or erratic behaviors

Which of the following describe behavior cluster A from the DSM-5?

Characterized by odd or eccentric behaviors

What personality disorder matches Allysha's profile?

Borderline Personality Disorder

Case Study: - Name: Emmie - Age: 28 - Sex: Female - Family: Live-in boyfriend - Occupation: Unemployed - Presenting problem: Recent suicidal gestures Emmie was taken to a local crisis clinic by family members following recent suicidal gestures. Emmie was found in a local hotel room; she was intoxicated, had multiple superficial scratches on her forearms, and was threatening to jump out of the hotel's 5th-floor window. According to family members, Emmie has a history of abusive relationships and has been abusing alcohol since adolescence. Emmie's family initially became concerned about her self-destructive behavior during her sophomore year of high school when she shaved her head and threatened to kill herself after a romantic breakup. It was during this time that Emmie began openly smoking cigarettes and drinking alcohol. She once tried to boast about her sexual activity with several partners, even though her friends were more alarmed than impressed. During her junior year, Emmie became romantically involved with an older man, dropped out of school, and moved in with him. Following the breakup of that relationship, Emmie's family received a phone call reporting that she was at the local hospital following an attempted suicide. Shortly after being released, she ran away and has had on-and-off contact with her family since. Her family described this period as "going from one crisis to the next". According to them, Emmie would start dating someone and feel ecstatic in the beginning. Pretty soon, however, the arguing and fighting would begin. Then, she'd talk about committing suicide when they broke up. This appears to be the general pattern of her life over the past decade. After every breakup, emmie crumbled emotionally, constantly blamed herself, and despaired about ever finding someone who would love her. About a year ago, she moved in with her current boyfriend, and their relationship has been plagued with several alochol-related domestic disputes. When her parents tried to discuss this, Emmie first thought they were joking and tried to laugh it off. When she realized that they were serious, she immediately went ballistic. She angrily screamed about how they didn't understand her, and "he's the only person who's ever loved me, and you just want to drive him away!" According to Emmie's counseling and legal history (noted on the counseling and legal history tab), she has a history of alcohol dependence, suicidal gestures and attempts, and alcohol-related criminal offenses. Law enforcement noted that Emmie is generally argumentative and protective of her boyfriend and, one time, needed to be placed in handcuffs while being interviewed by police. While having an initial interview with a customer, Emmie's emotions vacillated between sadness and anger. She had moments of slight sadness when expressing that her boyfriend is the only one who loves and understands her, and she is afraid he will leave her "Because of all this." She reports that "without him, there isn't any reason to live." When informed that she would be required to complete an alcohol assessment, Emmie became volatile and screamed "You are all out to get me!" Based on the full diagnostic criteria listed by the DSM-5 for personality disorders (not just the symptoms), Emmie appears to meet the criteria for a diagnosis of ____________.

Borderline personality disorder

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause lower functioning in the amygdala. A person grows up unable to recognize ____________.

Cues that signal threat

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause neurological differences in the limbic amygdala circuitry. Youth exhibit ____________ reactivity in these areas.

Diminished

True or False: Comorbidity, poor inter-rater reliability, and a reluctance to diagnose individuals with personality disorders are the major challenges presented by the categorical diagnosis model.

False

True or False: Personality disorders are EASILY treated.

False

True or False: The high level of comorbidity - the overlap of personality disorders with other disorders - actually improves clinicians' ability to properly diagnose personality disorders.

False

The most useful behavior modification programs focus on decreasing deviant activities combined with learning appropriate behaviors and social skills. Without support from ______________, young people with APD are likely to revert to antisocial activity once they leave the treatment program.

Families and peers

From a psychodynamic perspective, what might lead to APD?

Faulty superego development

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause lower functioning in the amygdala. A person grows up unable to recognize cues that signal threat. A person eventually becomes _____________.

Fearless

Based on previous research findings conducted on learning and fear conditioning, __________ most likely represents participants diagnosed with APD, providing clinicians with further evidence that people with this disorder experience ___________ when faced with possible punishment, leading to an increased tendency to engage in high-risk behaviors.

Group A; Decreased anxiety

Based on the theory behind the underarousal hypothesis, __________ most likely represents participants diagnosed with antisocial personality disorder, providing clinicians with further evidence that people with this disorder require ___________ stimulation in order to reach a point at which one is most likely to feel relatively content.

Group A; More

Based on the theory behind the fearlessness hypothesis, ___________ most likely represents participants diagnosed with antisocial personality disorder, providing clinicians with further evidence that people with this disorder are ____________ likely to experience anxiety and fear in seemingly tense situations.

Group B; Less

Case Study: - Name: Margaret - Age: 58 - Sex: Female - Family: Single - Occupation: Self-employed, carpentry - Presenting problem: Sister's concern Margaret has lived a relatively isolated existence ever since she graduated from high school and moved out. prior to that time, she didn't seem to fit in with her family very well. Her brothers and sisters are all gregarious and outgoing, which Margaret prefers to be alone. These days, she barely bothers maintaining contact with her family. The only person she regularly talks with is her younger sister, Karen. Margaret reports that the only reason she sought out a clinician was because she promised Karen that she would. Her family is distraught and angry over Margaret's reaction to the news of their father's recent passing. When told about it, Margaret flatly responded, "Well, everyone dies at some point." Margaret reports that she doesn't hate, or even dislike, her family. At the same time, it's clear that she doesn't feel any particular affinity for them, either. If it weren't for her sister's continual efforts to keep in touch, Margaret would probably be completely estranged. This emotional coldness and distance extends to other parts of Margaret's life as well. She has a few friends but, overall, seems rather disinterested in maintaining relationships with others. When people try to engage her in conversation, she can come across as cold or aloof, even though she's never overtly rude. Margaret has a steady job as a carpenter. She works by herself, and most of her business is generated through recommendations from former customers. I looked up some online reviews, and most were very similar. Here's a typical one: "We needed some custom shelves built, and while Margaret did great, high-quality work, she wasn't very personable. She basically kept her nose to the grindstone and seemed kind of annoyed at my attempts to talk to her. On the plus side, she finished the job earlier than expected! Would definitely recommend if you want someone to just come in and get it done right." When asked about these reviews, she bluntly stated that it didn't matter to her one way or another. She said that she always delivers exactly what the contract states, and if her clients don't like it, it's their problem. Her work ethic is very strong, and she rarely takes any time off. When asked why, she claims that she likes to stay busy and doesn't have any interests outside of work. On the whole, Margaret is not very introspective, and her attitude is grounded in practicality and matter-of-factness. She shows no interest in pursuing romantic or sexual relationships. In fact, such things seem almost foreign to her. According to her sister, Margaret is "mostly cordial" toward her neighbors. She says that Margaret does her thing, and they do theirs. Nevertheless, her bluntness and general demeanor can rub some people the wrong way. Personality disorders often affect a patient's behavior, interpersonal relations, thoughts and emotions. Which of the following best describes Margaret's emotional state?

Her emotions are flat and border on being nonexistent.

Traditional treatment approaches are often ______________ for those with APD.

Ineffectual

The most useful behavior modification programs focus on decreasing deviant activities combined with ______________.

Learning appropriate behaviors and social skills

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause neurological differences in the _______________.

Limbic amygdala circuitry

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetics influence a child's arousal levels, leading to chronically ____________ levels of arousal.

Low

From a sociocultural perspective, what role does gender play in the display of antisocial characteristics?

Men exhibit more symptoms

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetics influence a child's arousal levels, leading to chronically low levels of arousal. A child seeks out stimulation to counteract arousal levels. A child requires a ___________ intense stimulus to elicit a reaction compared to other children.

More

Traditional treatment approaches are often ineffectual for those with APD. Treatment is __________ likely to be effective in structured settings.

Most

From a learning perspective, what might lead to APD?

Neurobiological characteristics impede learning prosocial behavior

Yes or No: Tamayo has recently moved to the US from Japan. His friends notice that he is particularly quiet and submissive to others. Does Tamayo's extreme personality pattern suggest a personality disorder?

No

What personality disorder matches Steve Jobs' profile?

Obsessive Compulsive Personality Disorder

What personality disorder matches Richard Nixon's profile?

Paranoid Personality Disorder

From a social perspective, which of the following might lead children to devalue relationships with others?

Parental absence

Which of the following social factors is associated with antisocial behavior?

Parents with antisocial behavior

Which of the following social factors is associated with antisocial behavior?

Poor parental supervision

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetic influences cause neurological differences in the limbic amygdala circuitry. Youth exhibit diminished reactivity in these areas. Youth demonstrate ___________ compassion toward the plight of others.

Reduced

Case Study: - Name: Margaret - Age: 58 - Sex: Female - Family: Single - Occupation: Self-employed, carpentry - Presenting problem: Sister's concern Margaret has lived a relatively isolated existence ever since she graduated from high school and moved out. prior to that time, she didn't seem to fit in with her family very well. Her brothers and sisters are all gregarious and outgoing, which Margaret prefers to be alone. These days, she barely bothers maintaining contact with her family. The only person she regularly talks with is her younger sister, Karen. Margaret reports that the only reason she sought out a clinician was because she promised Karen that she would. Her family is distraught and angry over Margaret's reaction to the news of their father's recent passing. When told about it, Margaret flatly responded, "Well, everyone dies at some point." Margaret reports that she doesn't hate, or even dislike, her family. At the same time, it's clear that she doesn't feel any particular affinity for them, either. If it weren't for her sister's continual efforts to keep in touch, Margaret would probably be completely estranged. This emotional coldness and distance extends to other parts of Margaret's life as well. She has a few friends but, overall, seems rather disinterested in maintaining relationships with others. When people try to engage her in conversation, she can come across as cold or aloof, even though she's never overtly rude. Margaret has a steady job as a carpenter. She works by herself, and most of her business is generated through recommendations from former customers. I looked up some online reviews, and most were very similar. Here's a typical one: "We needed some custom shelves built, and while Margaret did great, high-quality work, she wasn't very personable. She basically kept her nose to the grindstone and seemed kind of annoyed at my attempts to talk to her. On the plus side, she finished the job earlier than expected! Would definitely recommend if you want someone to just come in and get it done right." When asked about these reviews, she bluntly stated that it didn't matter to her one way or another. She said that she always delivers exactly what the contract states, and if her clients don't like it, it's their problem. Her work ethic is very strong, and she rarely takes any time off. When asked why, she claims that she likes to stay busy and doesn't have any interests outside of work. On the whole, Margaret is not very introspective, and her attitude is grounded in practicality and matter-of-factness. She shows no interest in pursuing romantic or sexual relationships. In fact, such things seem almost foreign to her. According to her sister, Margaret is "mostly cordial" toward her neighbors. She says that Margaret does her thing, and they do theirs. Nevertheless, her bluntness and general demeanor can rub some people the wrong way. Based on the full diagnostic criteria listed by the DSM-5 for personality disorders (not just the symptoms), Margaret appears to meet the criteria for a diagnosis of:

Schizoid personality disorder

Case Study: - Name: Emmie - Age: 28 - Sex: Female - Family: Live-in boyfriend - Occupation: Unemployed - Presenting problem: Recent suicidal gestures Emmie was taken to a local crisis clinic by family members following recent suicidal gestures. Emmie was found in a local hotel room; she was intoxicated, had multiple superficial scratches on her forearms, and was threatening to jump out of the hotel's 5th-floor window. According to family members, Emmie has a history of abusive relationships and has been abusing alcohol since adolescence. Emmie's family initially became concerned about her self-destructive behavior during her sophomore year of high school when she shaved her head and threatened to kill herself after a romantic breakup. It was during this time that Emmie began openly smoking cigarettes and drinking alcohol. She once tried to boast about her sexual activity with several partners, even though her friends were more alarmed than impressed. During her junior year, Emmie became romantically involved with an older man, dropped out of school, and moved in with him. Following the breakup of that relationship, Emmie's family received a phone call reporting that she was at the local hospital following an attempted suicide. Shortly after being released, she ran away and has had on-and-off contact with her family since. Her family described this period as "going from one crisis to the next". According to them, Emmie would start dating someone and feel ecstatic in the beginning. Pretty soon, however, the arguing and fighting would begin. Then, she'd talk about committing suicide when they broke up. This appears to be the general pattern of her life over the past decade. After every breakup, emmie crumbled emotionally, constantly blamed herself, and despaired about ever finding someone who would love her. About a year ago, she moved in with her current boyfriend, and their relationship has been plagued with several alochol-related domestic disputes. When her parents tried to discuss this, Emmie first thought they were joking and tried to laugh it off. When she realized that they were serious, she immediately went ballistic. She angrily screamed about how they didn't understand her, and "he's the only person who's ever loved me, and you just want to drive him away!" According to Emmie's counseling and legal history (noted on the counseling and legal history tab), she has a history of alcohol dependence, suicidal gestures and attempts, and alcohol-related criminal offenses. Law enforcement noted that Emmie is generally argumentative and protective of her boyfriend and, one time, needed to be placed in handcuffs while being interviewed by police. While having an initial interview with a customer, Emmie's emotions vacillated between sadness and anger. She had moments of slight sadness when expressing that her boyfriend is the only one who loves and understands her, and she is afraid he will leave her "Because of all this." She reports that "without him, there isn't any reason to live." When informed that she would be required to complete an alcohol assessment, Emmie became volatile and screamed "You are all out to get me!" Personality disorders are viewed as global disorders, in that they often affect a patient's behaviors, thoughts, and emotions. Emmie, in particular, has a history of highly maladaptive behaviors. Which of the following best describes how her condition affects her behavior?

She is highly impulsive and rarely considers the consequences of her actions.

Case Study: - Name: Margaret - Age: 58 - Sex: Female - Family: Single - Occupation: Self-employed, carpentry - Presenting problem: Sister's concern Margaret has lived a relatively isolated existence ever since she graduated from high school and moved out. prior to that time, she didn't seem to fit in with her family very well. Her brothers and sisters are all gregarious and outgoing, which Margaret prefers to be alone. These days, she barely bothers maintaining contact with her family. The only person she regularly talks with is her younger sister, Karen. Margaret reports that the only reason she sought out a clinician was because she promised Karen that she would. Her family is distraught and angry over Margaret's reaction to the news of their father's recent passing. When told about it, Margaret flatly responded, "Well, everyone dies at some point." Margaret reports that she doesn't hate, or even dislike, her family. At the same time, it's clear that she doesn't feel any particular affinity for them, either. If it weren't for her sister's continual efforts to keep in touch, Margaret would probably be completely estranged. This emotional coldness and distance extends to other parts of Margaret's life as well. She has a few friends but, overall, seems rather disinterested in maintaining relationships with others. When people try to engage her in conversation, she can come across as cold or aloof, even though she's never overtly rude. Margaret has a steady job as a carpenter. She works by herself, and most of her business is generated through recommendations from former customers. I looked up some online reviews, and most were very similar. Here's a typical one: "We needed some custom shelves built, and while Margaret did great, high-quality work, she wasn't very personable. She basically kept her nose to the grindstone and seemed kind of annoyed at my attempts to talk to her. On the plus side, she finished the job earlier than expected! Would definitely recommend if you want someone to just come in and get it done right." When asked about these reviews, she bluntly stated that it didn't matter to her one way or another. She said that she always delivers exactly what the contract states, and if her clients don't like it, it's their problem. Her work ethic is very strong, and she rarely takes any time off. When asked why, she claims that she likes to stay busy and doesn't have any interests outside of work. On the whole, Margaret is not very introspective, and her attitude is grounded in practicality and matter-of-factness. She shows no interest in pursuing romantic or sexual relationships. In fact, such things seem almost foreign to her. According to her sister, Margaret is "mostly cordial" toward her neighbors. She says that Margaret does her thing, and they do theirs. Nevertheless, her bluntness and general demeanor can rub some people the wrong way. Which of the following best describes how Margaret interacts with others on an emotional level?

She lacks empathy and has difficulty understanding how her actions make others feel.

Case Study: - Name: Emmie - Age: 28 - Sex: Female - Family: Live-in boyfriend - Occupation: Unemployed - Presenting problem: Recent suicidal gestures Emmie was taken to a local crisis clinic by family members following recent suicidal gestures. Emmie was found in a local hotel room; she was intoxicated, had multiple superficial scratches on her forearms, and was threatening to jump out of the hotel's 5th-floor window. According to family members, Emmie has a history of abusive relationships and has been abusing alcohol since adolescence. Emmie's family initially became concerned about her self-destructive behavior during her sophomore year of high school when she shaved her head and threatened to kill herself after a romantic breakup. It was during this time that Emmie began openly smoking cigarettes and drinking alcohol. She once tried to boast about her sexual activity with several partners, even though her friends were more alarmed than impressed. During her junior year, Emmie became romantically involved with an older man, dropped out of school, and moved in with him. Following the breakup of that relationship, Emmie's family received a phone call reporting that she was at the local hospital following an attempted suicide. Shortly after being released, she ran away and has had on-and-off contact with her family since. Her family described this period as "going from one crisis to the next". According to them, Emmie would start dating someone and feel ecstatic in the beginning. Pretty soon, however, the arguing and fighting would begin. Then, she'd talk about committing suicide when they broke up. This appears to be the general pattern of her life over the past decade. After every breakup, emmie crumbled emotionally, constantly blamed herself, and despaired about ever finding someone who would love her. About a year ago, she moved in with her current boyfriend, and their relationship has been plagued with several alochol-related domestic disputes. When her parents tried to discuss this, Emmie first thought they were joking and tried to laugh it off. When she realized that they were serious, she immediately went ballistic. She angrily screamed about how they didn't understand her, and "he's the only person who's ever loved me, and you just want to drive him away!" According to Emmie's counseling and legal history (noted on the counseling and legal history tab), she has a history of alcohol dependence, suicidal gestures and attempts, and alcohol-related criminal offenses. Law enforcement noted that Emmie is generally argumentative and protective of her boyfriend and, one time, needed to be placed in handcuffs while being interviewed by police. While having an initial interview with a customer, Emmie's emotions vacillated between sadness and anger. She had moments of slight sadness when expressing that her boyfriend is the only one who loves and understands her, and she is afraid he will leave her "Because of all this." She reports that "without him, there isn't any reason to live." When informed that she would be required to complete an alcohol assessment, Emmie became volatile and screamed "You are all out to get me!" Personality disorders are viewed as global disorders, in that they often affect a patient's behaviors, thoughts, and emotions. One thing often impacted is how patients view themselves. Based on the case study, which of the following best characterizes Emmie's view of herself?

She views herself negatively and has a low sense of self-worth

The development of APD appears to involve interactions between biological vulnerabilities and environmental adversity. Considerable research has been devoted to trying to uncover the biological basis of behaviors associated with APD. Complete the following diagram to illustrate one integrated pathway for developing antisocial personality traits and behavior. Genetics influence a child's arousal levels, leading to chronically low levels of arousal. A child seeks out ____________ to counteract arousal levels.

Stimulation

True or False: A very low inter-rater reliability exists in personality disorder diagnoses. In other words, one clinician may not diagnose a person with the same personality disorder as another clinician.

True

True or False: People with personality disorders can function well in society.

True

True or False: People with personality disorders often have other mental disorders.

True

True or False: Someone's personality can be pathological, or affected by mental illness.

True

True or False: The categorical approach to diagnosis is problematic, because it is based on arbitrary diagnostic thresholds.

True

Yes or No: For as long as he can remember, Larry has felt that he is surrounded by inferior people and that his intelligence is unmatched. Even when his supervisor at work tells him he needs to be a better team player, and when his wife encourages him to be more accepting of his son, Larry maintains this view. If Larry's behavior is extreme, divergent from cultural expectations, and causes him to be distressed, might a diagnosis of a personality disorder be appropriate for Larry?

Yes