psych exam #4 ch.16

Dramatic cluster

-Antisocial, borderline, narcissistic, and histrionic personality disorders -Behaviors are dramatic, emotional, or erratic --Makes it almost impossible for them to have satisfying relationships -More commonly diagnosed than the others -Causes not well understood -Treatments range from ineffective to moderately effective

Anxious cluster

-Avoidant, dependent, and obsessive-compulsive personality disorders -Display anxious and fearful behavior -No direct links to mood/anxiety disorders -Limited research, better treatments

Schizotypal personality disorder

-Characterized by a range of interpersonal problems -extreme discomfort in close relationships -odd (even bizarre) ways of thinking -behavioral eccentricities --ideas of reference and/or bodily illusions --Loose associations/digressive speech

paranoid personality disorder

-Characterized by deep distrust and suspicion of others -Not delusional -Cold and distant -Highly critical -Unable to recognize mistakes -Extremely sensitive to criticism -Blame others and hold grudges

treatments for borderline personality disorder

-Dialectical behavior therapy (DBT) --Marsha Linehan --CBT-based --Balance between acceptance and change --Hierarchy of treatment targets -Antidepressant, antibipolar, antianxiety, and antipsychotic drugs

narcissitic personality disorder

-Inflated sense of self-importance -Need for admiration -Extreme self-involvement -Lack of empathy -Confident -Arrogant -Manipulative

borderline personality disorder

-Instability --Major shifts in mood --Unstable self-image --Impulsivity --Unstable interpersonal relationships ---Fear of abandonment -Prone to anger, potentially aggressive and violent --May engage in self-injurious behavior --Suicidal ideation and attempts -Other behaviors include --Alcohol and substance abuse --Reckless behavior, including driving and unsafe sex

Distinguish between the components of personality and the components of personality disorder.

-One's personality is made up of specific traits that tend to be consistent and predictable throughout life. These traits tend to influence the person's behaviors, emotions, and thoughts and how he or she interacts with others. Those with personality disorders have personality traits that are extreme and dysfunctional that lead to problems with others and cause psychological pain for both themselves as well as others.

Odd cluster

-Paranoid, schizoid, and schizotypal personality disorders -Sxs similar to schizophrenia -Extreme suspiciousness -Social withdrawal -Peculiar ways of thinking and perceiving -Isolation -"Schizophrenia-spectrum?"

Schizoid personality disorder

-Persistent avoidance of social relationships and limited emotional expression -Reclusive/withdrawn -Prefer to be alone -Flat, cold, humorless, dull

A person who was overly indulged by his or her parents, received excessive, unconditional parental valuation, and was not required to follow rules or develop self-control is at risk for developing _____ personality disorder.

-narcissistic

The characteristic of perfectionism and a striving for control are associated with _____ personality disorder.

-obsessive compulsive

3 clusters

-odd, dramatic, anxious

People with _____ personality disorder distrust the motives of others.

-paranoid

obsessive compulsive personality disorder

-perfectionism, preoccupation with orderliness, pervasive need for mental and interpersonal control -stubbornness and rigidity -preoccupation with details, organization, schedules, lists, and rules -inflexibility in matters of ethics and morality -"workaholic" -miserly spending -hoarding

A pattern of inflexible and maladaptive personality traits that impair social or occupational functioning and cause intense distress are indicative of _____.

-personality disorders

Individuals who are detached and reclusive, with no interest in developing relationships, may experience _____ personality disorder.

-schizoid

John experiences ideas of reference and bodily illusions. MOST likely, John has _____ personality disorder.

-schizotypal

The persistent and consistent personality characteristics that lead us to react in fairly predictable ways are often called personality _____.

-traits

avoidant personality disorder

-very uncomfortable and inhibited in social situations -overwhelmed by feelings of inadequacy -extremely sensitive to negative evaluation -believe themselves unappealing or inferior and often have few close friends -Vs social phobia --Fear relationships vs situations

treatment for avoidant personality disorder

-A key task of the therapist is to gain the individual's trust --tend to treat the disorder as they treat social phobia and anxiety -Group CBT provides practice in social interactions -Antianxiety and antidepressant drugs

personality

-A unique and long-term pattern of inner experience and outward behavior -Characterized by: --Consistency --Traits --Flexibility

personality disorder

-An inflexible pattern of inner experience and outward behavior -Seen across interactions -Differs from what is expected of people -Continuous -Rigid traits -Social/occupational dysfunction

antisocial personality disorder

-Persistent disregard for and violation of others' rights -Prone to lying, recklessness, and impulsivity -Can be cruel, sadistic, aggressive, and violent -"Psychopathic" traits --Callous disregard for others --Lack of empathy, guilt, remorse -Linked to criminal behavior -Evidence of conduct problems prior to age 15, can't diagnose until 18

Dependent personality disorder

-Pervasive, excessive need to be taken care of -Clinging and obedient -Fear of separation from their loved ones -Reliance on others for decision making -Distressed, lonely, sad -Dislike themselves -At risk for depression, anxiety, EDs -Suicidal ideation is common

How Do Theorists Explain Obsessive-Compulsive Personality Disorder?

-Psychodynamic --"anal retentive" -Cognitive --E.g., black and white thinking

how do theorists explain antisocial personality disorder?

-Psychodynamic --Absence of parental love, leading to lack of basic trust -Behavioral --Learned through modeling or unintentional reinforcement -Cognitive --Hold attitudes that trivialize the importance of other people's needs -Biological --Low serotonin --Deficient frontal lobe functioning --Lower baseline arousal

treatments for dependent personality disorder

-Psychodynamic --Free association, etc -Cognitive-behavioral --Challenge/change assumptions of incompetence and helplessness --assertiveness training -Antidepressants for comorbid depression -Group therapy

Treatments for Obsessive-Compulsive Personality Disorder

-Psychodynamic --Increase insight -Cognitive --Target dichotomous thinking

how do theorists explain borderline personality disorder

-Psychodynamic --Lack of early acceptance --Abuse/neglect ---Link to early sexual abuse -Biological --overly reactive amygdala --underactive prefrontal cortex --lower brain serotonin activity --heritable

How Do Theorists Explain Dependent Personality Disorder?

-Psychodynamic --Rejecting OR overinvolved parenting -Behavioral—learning --Positive reinforcement of dependence; punishment of independence --Modeling effects -Cognitive--maladaptive attitudes --"I am inadequate and helpless to deal with the world" --"I must find a person to provide protection so I can cope"

how do theorists explain histrionic personality disorder

-Psychodynamic --Unhealthy relationship with cold parents --Left afraid of abandonment --Fear of loss causes dramatic behavior, which induces protection by others -Cognitive --Assumption of helplessness -Multicultural --Exaggerated femininity

how do theorists explain narcissistic personality disorder

-Psychodynamic --cold, rejecting parents -Cognitive-behavioral --treated too positively early in life -Cultural --"era of narcissism"

How Do Theorists Explain Avoidant Personality Disorder?

-Same causes as anxiety disorders, including: --Early trauma --Conditioned fears --Upsetting beliefs --Biochemical abnormalities -Psychodynamic --general sense of shame rooted in childhood experience -Cognitive --Assumption that their environment will always judge them negatively -Behavioral --Failure to develop social skills

treatments for antisocial personality disorder

-Typically ineffective, especially for those with psychopathic traits -Main obstacle is lack of conscience or desire to change -Cognitive --Teach empathy -Behavioral --Token economies -Biological --Atypical antipsychotics (e.g., Risperdal, Seroquel)

Lev has a lifelong history of misconduct, including vandalism, fighting, and a disregard for other people's rights. He fits the description of someone with _____ personality disorder.

-antisocial

Social phobias may be related to _____ personality disorder.

-avoidant

Impulsive behaviors and swinging in and out of depressed, anxious, and irritable states are characteristic of _____ personality disorder.

-borderline

If two disorders tend to occur together, we call the relationship _____.

-comorbidity or comorbid

A growing number of personality theorists believe that personality disorders differ more in _____ than in _____ of dysfunction.

-degree, type

Willa cannot do anything on her own and consults others, even on the smallest decision. She is constantly in need of praise to validate her work and is overly sensitive to any disagreement. She will do almost anything to please others. She may be experiencing _____ personality disorder.

-dependent

Many clinicians favor moving from a categorical to a(n) _____ approach for diagnosis; this could be a possible change in the next edition of DSM.

-dimensional

histrionic personality disorder

-extremely emotional -continually seek to be the center of attention -engage in attention-getting behaviors and are always "on stage" -Exaggerated, dramatic, theatrical -Need approval -Seductive, vivacious, flirtatious -Overestimate intimacy -vain, self-centered, and demanding -Shallow -Suggestible -Suicide attempts

Marcel has a pattern of excessive emotionality and attention seeking. He may be demonstrating _____ personality disorder.

-histrionic

"Personality Disorder—Trait Specified":A Dimensional Approach

-moderate impairment in personality functioning (2 or more): --Identity --Self-direction --Empathy --Intimacy -One or more pathological traits in these domains: --Negative affectivity (vs Emotional stability) --Detachment (vs Extraversion) --Antagonism (vs Agreeableness) --Disinhibition (vs Conscientiousness) --Psychoticism (vs Lucidity)

A person constantly strives to be the center of attention, yet the ideas the person so eloquently expresses are usually shallow and changeable. If this person were diagnosed with a personality disorder, it MOST likely would be: A) histrionic. B) borderline. C) antisocial. D) obsessive-compulsive.

A

An individual with a diagnosed personality disorder is emotionally unstable, impulsive, and reckless. This person's diagnosis is likely to be which personality disorder? A) borderline B) schizotypal C) obsessive-compulsive D) avoidant

A

How do personality disorders differ from the personality characteristics of typical people? A) They lead to more maladaptive, distressful, and inflexible behaviors. B) They include personality traits not experienced by typical people. C) They are generally treated successfully with antipsychotic medication. D) They are caused by epigenetic processes.

A

If you believe that personality disorders are BEST understood as a matter of degree in difference from typical personality rather than as a specific diagnosis, you agree with: A) the dimensional approach. B) the categorical approach. C) the symptomatic approach. D) the cluster approach.

A

One of the most common and certainly most troubling of the personality disorders is antisocial personality disorder. Define antisocial personality disorder. Then outline other behavior patterns with which this disorder is associated. Finally, suggest a course of treatment for someone suffering from this disorder.

Antisocial personality disorder is one of the main disorders linked to adult criminal behavior. Those with this disorder, who are often termed psychopaths or sociopaths, lie repeatedly, are careless with their finances, and are impulsive, irritable, aggressive, and reckless. They tend to have little regard for their safety and for the safety of others. They are also self-centered and often lack a moral conscience. Treatment for the disorder is generally ineffective. The personality of those with the disorder (lack of conscience, lack of a desire to change, and lack of respect for therapy) hinders their progress through treatment. However, cognitive therapy, which attempts to guide the client to think about moral issues and the ability to empathize with others seems to be somewhat useful for those with this disorder. The use of psychotropic medications may help reduce some of the characteristics of the disorder. It may be that the best treatment is a combination of cognitive therapy and psychotropic medications

"I am the greatest!" a famous boxer declared loudly and often. Had he in fact acted throughout his adult life as though he were the greatest, the most appropriate diagnosis would be: A) histrionic personality disorder. B) narcissistic personality disorder. C) antisocial personality disorder. D) impulse-control personality disorder.

B

18. DSM-5, like its predecessor, DSM-IV-TR, identifies 10 personality disorders utilizing a: A) systematical approach. B) categorical approach. C) dimensional approach. D) phrenological approach.

B

A person who is LEAST likely to be affected by criticism or praise from other people is one suffering from: A) avoidant personality disorder. B) schizoid personality disorder. C) paranoid personality disorder. D) obsessive-compulsive personality disorder.

B

Which statement is true regarding the relationship between obsessive-compulsive disorder (an anxiety disorder) and obsessive-compulsive personality disorder? A) You cannot suffer from both of them at the same time. B) Some people with obsessive-compulsive personality disorder also experience obsessive- compulsive disorder. C) The most likely disorder comorbid with obsessive-compulsive personality disorder is obsessive-compulsive disorder. D) The two obsessive-compulsive disorders are comorbid over half the time.

B

If parents excessively reinforce clinging and punish attempts at independence, the result might be the development of: A) paranoid personality disorder. B) borderline personality disorder. C) dependent personality disorder. D) narcissistic personality disorder.

C

19. Which is NOT the name used for a cluster of personality disorders? A) odd B) dramatic C) anxious D) schizophrenic

D

A friend asks your advice about the MOST effective therapy to use for treating borderline personality disorder. Your BEST answer is: A) "There is no effective therapy for borderline personality disorder. B) "If you're going to use a psychodynamic approach, avoid relational therapy. C) "Using drugs is a safe, effective way to treat the disorder." D) "Research suggests that dialectical behavior therapy is the most effective."

D

Digressive and vague language with loose associations accompanied by attention and concentration problems are characteristic of: A) schizoid personality disorder. B) avoidant personality disorder. C) paranoid personality disorder. D) schizotypal personality disorder.

D

The absence of parental love results in emotional detachment and the use of power to form relationships. This is most likely _____ personality disorder. A) cognitive B) biological C) behavioral D) psychodynamic

D

The category of "odd" personality disorders includes the traits of: A) anxiety and fearfulness. B) being highly dramatic, emotional, or erratic. C) inflexibility and total loss of contact with reality. D) extreme suspiciousness, social withdrawal, and cognitive and perceptual peculiarities.

D

The two childhood disorders that have been related to later antisocial personality disorder are: A) depression and withdrawal. B) schizophrenia and bipolar disorder. C) mental retardation. D) conduct disorder and attention-deficit/hyperactivity disorder.

D

Which does dialectical behavior therapy NOT emphasize? A) social skills training B) mindfulness meditation (a Zen technique involving observing one's emotions) C) the client-therapist relationship D) the use of antipsychotic medications in an outpatient setting

D

Which statement regarding the treatment of paranoid personality disorder is accurate? A) Drug therapy generally works best. B) Psychodynamic therapy involving hypnotic regression is often effective. C) Behavioral therapy usually works well, and in relatively few sessions. D) Most therapies are of limited effectiveness and progress slowly.

D

Take the perspective of both a psychodynamic psychologist and a cognitive psychologist. How would each explain the causes of histrionic and narcissistic personality disorder?

Psychodynamic psychologists view both histrionic and narcissistic personality disorders as stemming from the same source: people with these disorders had cold and controlling parents who left them feeling unloved and afraid of abandonment. Cognitive psychologists believe that histrionic personality disorder results from a person having a lack of substance and suggestibility. According to this view, those with this disorder are not interested in learning about the world because they are self-focused and emotional. In addition, those with this disorder hold a general assumption that they are helpless and need others. Narcissistic personality disorder, however, stems from people being treated either too positively or too negatively early in life.

What are some problems with using the DSM-5 to diagnose personality disorders? Explain two alternatives to DSM-5 diagnoses that are receiving research attention today.

Therapists using the DSM-5 to diagnose personality disorders regularly misdiagnose those disorders. This may indicate a problem with the validity and reliability of the categories used in the DSM-5. Many researchers believe that personality disorders should be classified using a dimensional approach, rather than a categorical approach. Presently, one dimensional approach is the "Big Five" model. The second dimensional approach is the personality disorder-trait specified model.

Outline the similarities and differences between antisocial and borderline personality disorder. In addition, discuss treatment options for both. Finally, discuss the reasons why these disorders are resistant to psychotherapy.

Those with borderline personality disorder exhibit instability in mood (depression, anxiety, and irritability) as well as their self-image. They are also impulsive and prone to outward displays of anger, which may lead to violence toward others or themselves. Those with this disorder are likely to attempt suicide. Treatment for antisocial personality disorder is generally ineffective. The personality of those with the disorder (lack of conscience, lack of a desire to change, and lack of respect for therapy) hinders their progress through treatment. However, cognitive therapy, which attempts to guide the client to think about moral issues and the ability to empathize with others, seems to be somewhat useful for those with this disorder. The use of psychotropic medications may help reduce some of the characteristics of the disorder. It may be that the best treatment is a combination of cognitive therapy and psychotropic medications. Treatment for borderline personality disorder generally involves dialectical behavior therapy (DBT). While psychotherapy is thought to be beneficial to people with this disorder, it is often difficult for a therapist to balance empathizing with a client and also challenging the client's way of thinking. Those with this disorder may cross the line in the client-therapist relationship.

Compare and contrast the "odd/eccentric" and the "dramatic" personality disorders.

Those with odd personality disorders have odd or eccentric behaviors that tend to be similar to those with schizophrenia. These include suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving things. As a result of these behaviors, the person is often isolated from others. People with these disorders rarely seek treatment. Those with dramatic personality disorders are dramatic, emotional, and erratic. They tend to have problems forming and maintaining close social relationships because of their behavior. These are the most commonly diagnosed personality disorders and treatment is generally ineffective.

Why is psychotherapy so often ineffective in treating the odd personality disorders?

Those with odd personality disorders rarely seek help on their own. They often do not view their behavior as problematic. Those who do make it into treatment tend to view the role of the patient as inferior and, as a result, tend to distrust their therapists and may even rebel against them. They may also be emotionally distant from therapists, hindering the effectiveness of treatment.

Which category of personality disorder contains the disorders MOST commonly diagnosed? A) "odd" B) "dramatic" C) "anxious" D) "strange"

b

The MOST important similarity among the personality disorders listed in the text is that: A) disorders of thought, perception, and attention are present. B) the personality traits are limited to discrete periods of illness. C) they are inflexible, maladaptive, and related to impaired functioning or distress. D) they are social in that they involve an inability to form lasting relationships with other people.

c