Abnormal Psych Chapter 14

psychopathy

A cluster of traits that form the core of the antisocial personality, developed by Hervey Cleckley

histrionic personality disorder

A personality disorder - exaggerated emotional reactions, theatrical in everyday behavior. Wants to be loved and be the center of attention. Flirtatious. Easily influenced. Wants instant gratification.

obsessive-compulsive personality disorder (OCPD)

A personality disorder - extreme perfectionism and inflexibility manifested in worrying, indecisiveness, and behavioral rigidity. Define their sense of self and self-worth in term of their work productivity.

schizoid personality disorder

A personality disorder - indifference to social and sexual relationships, a very limited range of emotional experience and expression, prefers to be alone, withdrawn, zero empathy, no desire to love or be loved

antisocial personality disorder

A personality disorder - lack of regard for society's moral or legal standards, impulsive and risky lifestyle. Synonymous with "psychopath" or "sociopath"

schizotypal personality disorder

A personality disorder - odd beliefs, behavior, appearance. No clear sense of direction or motivation, inability to form accurate perceptions about the world. Maladaptive end of psychoticism.

borderline personality disorder (BPD)

A personality disorder - pervasive pattern of impulsivity, instability of mood and relationships, and lack of sense of self

avoidant personality disorder

A personality disorder - the individual desires, but is fearful of, social interaction and is terrified of being rejected or embarrassed. Define themselves as lacking in social skills. Feelings of shame and inadequacy. VERY low self esteem.

paranoid personality disorder

A personality disorder - the individual is unduly suspicious of others and is always on guard against potential danger or harm. Can't really trust anybody.

narcissistic personality disorder

A personality disorder - unrealistic, inflated sense of self-importance, lack of sensitivity to the needs of other people. Base their self-esteem excessively on the view of others. Strong sense of entitlement. Constant attempt to gain approval. Unable to empathize.

dependent personality disorder

A personlity disorder - extremely passive and tends to cling to other people, unable to make any decisions on their own or take independent action. Clingy. Convinced of their own inadequacy.

Metacognitive interpersonal therapy

A procedure that causes clients to "think about their thinking". Clinicians help clients identify problematic ruminative thinking patterns, while building a supportive therapeutic environment

core mindfulness

A process used in DBT where clinicians teach their clients to balance their emotions, reason, and intuition as they approach life's problems

Psychological perspective on antisocial personality disorder

APD reflects neurological deficits caused by abnormal patterns of learning and attention

"borderline" in BPD refers to

Alludes to the condition being "on the border" between neurotic and psychotic; on the edge of schizophrenia

personality trait

An enduring pattern of perceiving, relating to, and thinking about the environment and others. Characterizes the majority of a person's interactions and experiences.

transference-focused psychotherapy

An evidence-based treatment for BPD, uses client-clinician relationships as the framework to help clients achieve greater understanding of their unconscious feelings and emotions. Based in psychoanalytic theory

Cluster C

Anxious or fearful behaviors. May seem highly restrictive. Avoidant, obsessive-compulsive, and dependent personality disorder

experiential avoidance

Avoidance of emotionally uncomfortable situations and feelings

criminal behaviors

Based in the legal system, has no psychological meaning

Alernative diagnostic criteria in Section 3 of the DSM-5

Based on the Five-Factor Model. Evaluate clients on a set of 5 pathological personality traits.

semantic dementia

Cleckley's description of the psychopath's inability to react appropriately to expressions of emotionality

Pathological personality trait of OCPD

Compulsivity/rigid perfectionism (the opposite of disinhibition). Also experience a great deal of negative affect in the form of being obsessive over their work.

Effective treatment for APD focuses on...

Convincing clients that they are responsible for their own behavior, and developing more prosocial ways to satisfy their needs.

splitting

Describes the way people with BPD relate to others. View people as "all good" or "all bad". Basically their love and affection can turn into hate and rage very quickly.

Psychopathy Checklist - Revised (PCR)

Developed by Robert Hare, an assessment instrument that includes the core psychopathic personality traits

antisocial behaviors

Distinct from antisocial personality disorder. Behaviors like stealing, lying, cheating.

Cluster B

Dramatic, emotional, or erratic behaviors. Antisocial, borderline, histrionic, or narcissistic personality disorders

Psychodynamic theory for avoidant personality disorder

Emphasizes the individual's fear of attachment in relationships

Basic principles of effective treatment for BPD center around...

Establishing clear boundaries, expectations, structure, and support.

Cognitive-behavioral treatment for OCPD

Focus on examining the client's thought processes, behavioral techniques such as thought stopping, eliminating ruminative worry.

Cognitive-behavioral treatment of NPD

Focus on the maladaptive ideas that people with NPD hold, these beliefs hamper their ability to perceive their experiences realistically. Their grandiose ideas of themselves clash with their inevitable experiences of failure.

Psychodynamic theory of OCPD

Freud believed that people with an obsessive-compulsive style are fixated at the anal stage of psychosexual development.

Cognitive-behavioral therapy for avoidant personality disorder

Goal is to break the client's negative cycle of avoidance. Clients must learn to confront and correct the automatic thoughts and dysfunctional attitudes. Gradual exposure to social situations

Biological perspective on BPD

High heritability. Abnormalities in the amygdala and prefrontal cortex as well as in neurotransmitters and hormones that regulate emotional responses.

Biological theory for antisocial personality disorder

High levels of serotonin and dopamine are linked to impulsivity.

Cognitive-behavioral perspective of avoidant personality disorder

Hypersensitivity to rejection in childhood, extreme parental criticism, core belief of them being unworthy of people's regard, avoid getting close to people as a result of their expected rejection from others, distorted perceptions of their experiences

Psychodynamic treatment of NPD

Importance of the use of EMPATHY to support the client's search for recognition and admiration. Clinicians try to guide the client into realizing that no one is perfect.

passive avoidance

Individual learns to omit a response if it was previously punished. People with APD don't do this, and that is why they can't learn from their negative experiences.

Diagnostic criteria for antisocial personality disorder in DSM-5

Individual must show 3 out of 7 possible behaviors

grandiose narcissism

Individuals with NPD that have a truly inflated and grandiose sense of self.

vulnerable narcissism

Individuals with NPD who rely excessively on other people to confirm their worth, their narcissism reflect an underlying vulnerability in their sense of self. Sensitive to rejection and often feel sense of shame.

emotional dysregulation

Lack of awareness, understanding or acceptance of emotions, inability to regulate emotions, cannot control the intensity of duration of emotions, unwilling to experience emotional distress in order to achieve goals. Key characteristic of BPD

Treatment for schizotypal personality disorder

Medication that acts on dopamine, as well as other interventions commonly used to treat schizophrenia

Psychological perspective of BPD

More prominent perspective, emphasizes the disturbances in emotional functioning in people with BPD.

Goldwater Rule

Named after Barry Goldwater, APA says that you can't diagnose people that you haven't personally evaluated (such as celebrities and public figures)

Freud's theory of narcissistic personality disorder

Narcissism is the individual's failure to progress beyond the early, self-focused psychosexual stages

Five personality domains in DSM-5 Section 3

Negative Affectivity (emotional dysregulation) Detachment Disinhibition Antagonism Psychoticism

Early childhood experiences that play a role in BPD

Neglect, trauma, marital problems in the home, parent with a psych problem, insecure attachment styles

Difference between OCD and OCPD

OCPD is a disorder of personality, not a disturbance involving anxiety or out-of-control behaviors. People with OCPD do not experience obsessions and compulsions.

Cognitive-behavioral theory of OCPD

OCPD is based on a problematic way of viewing the self. People with the disorder have unrealistic standards of perfection and expectations of themselves, setting themselves up to fail. When they fail, they exhibit rumination tendencies.

Cluster A

Odd and eccentric behaviors. Paranoid, schizoid, and schizotypal personality disorders.

What trait from the Five Factor model did not fit into the alternative framework?

Openness to experience. Replaced with "psychosis" to be associated with schizotypal personality disorder

Hippocampus

Part of the brain that functions abnormally in people with psychopathy

response modulation hypothesis

People high in psychopathy are unable to pay attention to secondary cues in order to switch their attention when necessary. Exhibit behaviors where they pursue their own gains and don't care about punishment

Two areas of functioning in Section 3 criteria

Personality Functioning and Interpersonal Functioning. A person must have significant impairment in both areas of personality functioning to receive a diagnosis.

Most effective approach to treatment of NPD

Providing reassurance and developing a more realistic view of themselves and others.

Dialectical

Refers to the back-and-forth process where the clinician accepts the client as they are, but confronts them about problematic behavior and pushes them to change

Object relations framework of NPD

Says that the narcissistic individual has failed to form a cohesive, integrated sense of self. Their sense of self-importance is inflated as they try to make up for early parental support that they did not receive. An adult's expression of childhood insecurities and need for attention.

Schizotypal personality disorder is thought to be a latent form of...

Schizophrenia. Due to social isolation, peculiar communication, poor social adaptation, and eccentricity.

maturation hypothesis

Suggests that people with antisocial personality disorder and other Cluster B disorders become better able to manage their behaviors as they age. Aging brings a reduction of acting out and impulsive, high-risk behaviors.

People with NPD are difficult to treat because...

Tend not to have insight into their disorder, become critical and demeaning of their therapists, extreme perfectionism can obstruct treatment, hard for them to confront their inner insecurities.

dialectical behavior therapy

Treatment for BPD with the greatest demonstrated effectiveness, integrates supportive and cognitive-behavioral treatments to reduce the frequency of self-destructive acts and improve the client's ability to handle emotional distress.

personality disorder

an ingrained pattern of relating to other people, situation, and events with a RIGID and maladaptive pattern of behavior and inner experiences

antagonism

behaviors that put the person at odds with other people

Behavior patterns of a personality disorder must manifest themselves into 1 of 4 areas

cognition affectivity interpersonal functioning impulse control

Pathological personality trait that defines antisocial personality disorder

disinhibition (impulsivity)

Personality disorders are high comorbid with...

drug dependence/substance use disorder

disinhibition

engaging in behaviors on impulse, without reflecting on future consequences. Compulsivity is the opposite pole of this domain.

negative affectivity

experiencing negative emotions frequently and intensely

Antisocial lifestyle trait revolves around...

impulsivity

BPD's central feature is that of...

instability

psychoticism

involves unusual and bizarre experiences

Problems with treating an individual with antisocial personality disorder

lack of motivation to change, tendency for deceitfulness and manipulation, lack of emotion

distress tolerance

limitations in the ability to withstand distress, especially emotional distress.

Women with BPD are more likely to have comorbid...

mood and anxiety disorders, eating disorders, and PTSD

Pathological personality traits that define avoidant personality disorder

negative affectivity and detachment. Their negative affectivity takes the form of extreme anxiety

Two personality disorders that were almost removed from the DSM 5

paranoid and schizoid

Pathological personality trait that define schizotypal personality disorder

psychoticism and detachment (withdrawal). They also express negative affectivity as extreme suspiciousness.

Men with BPD are more likely to have comorbid...

substance use disorder and antisocial personality characteristics

detachment

withdrawal from other people and social interactions