Psych 324 exam 3

DSM criteria for dissociative identity disorder

Part A. Disruption of identity characterized by two or more distinct personality states; marked discontinuity; alterations in affect, behavior, memory, or consciousness. May be reported by others or observed Part B: Recurrent gaps in the recall of daily events or traumatic events Part C: Significant distress Part D: Not considered culturally normal Part E: Symptoms not attributable to substances or other medical condition (seizures) 16

How is DID assessed ?

Structured Interview MSE Minnesota Multiphasic Personality Inventory (MMPI) 7 scales Look at "deception" scales (F and Fb)—detects deviancy in replies Dissociative Experience Scale

what are the 5 key symptoms of dissociative disorders

1. depersonalizaton 2. derealization 3. dissocoative identity disorders 4. identity confusion 5. identity alteration

what are the 3 limitations in the post traumatic model

1. links between self reported data & dissocation based on cross sectional design 2. fills out self reporting questionnaire about experiencing trauma 3. high dissociative individuals report more cognitive failures than low dissociative individuals

what is the DID prevalence rate in the US

1.5%

what % of the general population meet the criteria for personality disorder

10-15%

DSM criteria for schizophrenia

2+ of the following, present for significant portion of 1 month period. At least one must be: 1,2, or 3 Part A: 1. Delusions 2.Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms

what percent of those with schizophrenia attempt suicide?

20%

What percent of children adopted still develop symptoms of schizophrenia ?

28%

all personality traits can be organized into the what

5 factor model

what percent of those with schizophrenia die by suicide?

5-6%

what is the heritability rate of schizophrenia ?

60-90%

prevalence rate of schizophrenia

7%

what % of those with DID attempt suicide

70%

Which of the following is a term that suggests a lack of caring or pleasure, and a reduction in a person's motivation or ability to engage in actions necessary to obtain a positive outcome? a) anhedonia b) alogia c) aphasia d) apraxia

A

Individuals who experience dissociation only one time during their lives undergo which type of dissociation? a) state b) trait c) traumatic d) fantastical

A. state

A reduction in the drive or ability to take the steps or engage in actions necessary to obtain the potentially positive outcome.

Anhedonia/amotivation

agreeableness Vs______

Antagonism

Which area of the brain shows a marked decrease in functionality of patients with schizophrenia? a) Parietal lobes b) Frontal lobes c) Temporal lobes d) Occipital lobes

B

Brian feels disconnected from his body, like he is watching a movie of himself. What symptom of dissociation is Brian experiencing? a) derealization b) depersonalization c) identity alteration d) dissociative amnesia

B. depersonalization

Which trait contained in the Five-Factor Model can be roughly described as a person's level of emotional stability or instability? a) extraversion b) neuroticism c) openness d) conscientiousness

B. neuroticism

why is there little known about the specific etiology of personality disorders in the DSM

Because each personality disorder represents a constellation of personality traits, the etiology for the syndrome will involve a complex interaction of an array of different neurobiological vulnerabilities and dispositions with a variety of environmental, psychosocial events.

a chronic pattern of instability. This instability manifests itself in interpersonal relationships, mood, self-image, and behavior that can interfere with social functioning or work. It may also cause grave emotional distress.

Borderline Personality Disorder

Marietta is studying for a psychology test and is working with flashcards that she made. One of them says the following: "This is a person's characteristic manner of thinking, feeling, behaving, and relating to others." What word will she find when she flips the card over? a) attitude b) temperament c) personality d) attribution

C. personality

Behaviors that seem to reflect a reduction in responsiveness to the external environment. This can include holding unusual postures for long periods of time, failing to respond to verbal or motor prompts from another person, or excessive and seemingly purposeless motor activity.

Catatonia

what are the 4 types of dissociative defense states

DID, Depersonalization, dissasoiative amnesia, dissociative fugue

False beliefs that are often fixed, hard to change even in the presence of conflicting information, and often culturally influenced in their content.

Delusions

conscientiousness Vs______

Disinhinition

Behavior or dress that is outside the norm for almost all subcultures. This would include odd dress, odd makeup (e.g., lipstick outlining a mouth for 1 inch), or unusual rituals (e.g., repetitive hand gestures).

Disorganized behavior

Speech that is difficult to follow, either because answers do not clearly follow questions or because one sentence does not logically follow from another.

Disorganized speech

a disruption and or discontinuity in the normal integration of consciousness, memory, identity, emotion,perseption,body representation, motor control& behavior

Dissociation

extensive forgetting typically associated with highly adverse events, hypothetical disconnection of memories, they are still there just cannot be reached

Dissociative amnesia,

What is the most widely used self reported measures of dissaciation but only is a screening tool to give indication for further investigation

Dissociative experience scale

People who are largely comfortable with themselves, characteristic manner of behavior, feelings & relating to others

Ego-syntonic

The ability to learn and retrieve new information or episodes in one's life.

Episodic memory

A reduction in the display of emotions through facial expressions, gestures, and speech intonation.

Flat affect

The ability to engage in self-care (cook, clean, bathe), work, attend school, and/or engage in social relationships.

Functional capacity

Perceptual experiences that occur even when there is no stimulus in the outside world generating the experiences. They can be auditory, visual, olfactory (smell), gustatory (taste), or somatic (touch).

Hallucinations

what personality disorders have been considered to be taken out of the DSM because they have little empirical evidence with diagnosis ?

Histrionic, schizoid, paranoid, dependent

what 3 personality disorders are in cluster C ?

OCD, avoident and dependent

personality disorder that is largely a disorder of maladaptive conscientiousness, including such traits as workaholism, perfectionism, punctilious, ruminative, and dogged; schizoid is confined largely to traits of introversion

Obsessive compulsive

How is DID treated?

Psychodynamic therapy Focus on stabilization for patient Safety and awareness "Fusion" - Internal group therapy Focus on creating stable relationships Family Therapy SSRIs or anxiolytics can help reduce anxiety + co-occurring affective disorder

personality disorder strongly defined by traits of introversion

Schizoid

personality disorder includes traits from neuroticism , introversion, unconventionality and antagonism

Schizotypal

A sufficient lack of restorative sleep over a cumulative period so as to cause physical or psychiatric symptoms and affect routine performances of tasks.

Sleep deprivation

Sleep paralysis occurs when the normal paralysis during REM sleep manifests when falling asleep or awakening, often accompanied by hallucinations of danger or a malevolent presence in the room.

Sleep paralysis

causes of dissiciative disorders

Trauma (Controversial) Recreating memories and/or self-report Sleep Historically referred to a "dreamy state" Sleep paralysis rates associated with dissociative symptoms Abnormal sleep patterns Sleep loss associated with triggering dissociative symptoms

typical schizophrenia medication

a strong block of the D2 type dopamine receptor. Although these drugs can help reduce hallucinations, delusions, and disorganized speech, they do little to improve cognitive deficits or negative symptoms and can be associated with distressing motor side effects.

gullible, trusting, confiding, honest, giving,docile, meek, humble, soft

agreeableness

A reduction in the amount of speech and/or increased pausing before the initiation of speech.

alogia

"Emerging measures and models" Acknowledges continuum of personality, incorporates recent research 9

alternative hybrid dimensional categorical model

skeptical, cynical, suspicious, paranoid, cunning, manipulative, deceptive, stingy, selfish, aggressive

antagonism

What 4 personality disorders are in Cluster B?

anti social, boarder line personality disorder, histrionic and narcissistic

combination of traits from antagonism, and low conscientiousness

antisocial personality disorder

what are the 10 personality disorders included in the DSM

antisocial, avoidant, borderline, dependent, historic, narcissistic, obsessive compulsive, paranoid, schizoid, schizotypal

patterns of social inhibition, feeling of inadequacy, hypersensitivity to negative situations/evaluations.

avoidant

why are categories of PD difficult to distinguish from one another

because of their symptom over lap

what is DID commonly misdiagnosed with ?

bipolar 2 disorder

some genes related to schizophrenia are related to other mental health conditions such as ?

bipolar disorder, depression, autism

personality disorder is largely a disorder of neuroticism, including such traits as emotionally unstable, vulnerable, overwhelmed, rageful, depressive, and self-destructive

boarder line personality disorder

dissociative symptoms are not limited to dissociative disorders but also in

boarder line personality disorder, PTSD, and OCD

what personality disorder is the most common to seek treatment/ realize their problem because of how much pain and suffering it causes them?

borderline personality disorder

environmental factors that increase risk of schizophrenia

children born to older fathers, complications in pregnancy, canibis use

10 disorders in 3 clusters, clinically distinct symptoms

classical categorical model

what are the two classification systems of personality disorders?

classical categorical model & alternative hybrid dimensional categorical model (6 disorders)

openness Vs_____

closedness

practical, concrete, uninvolved, constricted, unaware, routine, stubborn, rigid

closedness

enduring pattern in personality disorder is manifested in two of what 4 areas ?

cognition, affectivity, interpersonal functioning, impluse control

everyday slips and lapses such as failing to notice road signs, forgetting appointments, and bumping into people

cognitive failures

ordered, organized, dependable

conscientiousness

personality disorder includes submissiveness, clinging behavior, and fears of separation, for the most part a

dependent

alteration in the perception of ones surroundings so scene of reality of the external world is lost like living in a movie or looking through a fog

derealization

lax, neglected, disorganized, careless, rash

dis inhibition

What other mental illness is schizophrenia commonly associated with but has no relation?

disosiative identity disorder or split personality disorder

short lived reversible amnesia for personal identity, involving unplanned travel or bewildered wondering

dissociative fugue

Neuroticism Vs ______

emotional stability

relaxed, unconcerned, cool, even tempered, optimistic, clear thinking, restrained

emotional stability

dopamine hypothesis of schizophrenia

excessive amounts of dopamine activity in the brain cause psychotic symptoms

cordial, affectionate, attached, social, outgoing, dominate, force full, vigorous, energetic, & reckless

extroversion

engaging in extensive and vivid fantasizing, increasing exaggerating

fantasy proneness

depersonalization

feeling of detachment or estrangement from ones self, imagine being outside your body looking at yourself from a distance as if you were looking at someone else

antisocial personality disorder is considered to be the result of what interactions?

genetic disposition for low anxiousness, aggressiveness, impulsivity, with a tough urban environment, inconsistent parenting, poor potential role model/peer support

cluster C in the classical categorical model

group of disorders classified by anxious or fearful behaviors

cluster B in the classical categorical model

group of disorders classified by dramatic, emotional or erratic behavior

cluster A in the classical categorical model

group of disorders classified by odd or eccentric behaviors

What is the difference between hallucinations and delusions?

hallucinations are like a dream that is happening in real life, delusions are beliefs that are unlikely to be true

what is the problem with those who have disassociative symptoms and self reporting ?

have high fantasy proneness

what evidence is there for the dopamine hypothesis

high intake of amphetamines it goes up, antiphyschotics it goes down

personality disorder is largely a disorder of maladaptive extraversion, including such traits as attention-seeking, seductiveness, melodramatic emotionality, and strong attachment needs

histrionic

schizophrenia is in 1/3 of what population?

homeless

thoughts and feelings of uncertainty and conflict a person has related to their identity

identity confusion

What is malingering ?

intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives

cold, aloof, indifferent, withdrawn, isolated, unassuming, quiet, resigned, passive, lethargic, dull

introversion

extroversion Vs _________

introversion

avoidant personality disorder is a combination of what two personality traits

introversion and neuroticsism

the more identical genetic DNA a person shares what happens to the chance they also develop schizophrenia ?

it goes up

Any dream in which one is aware that one is dreaming.

lucid dreams

schizophrenia treatment

medication (typical & atypical)

signs of malingering

medicolegal context of presentation; (2) marked discrepancy between the person's claimed stress or disability and the objective findings; (3) lack of cooperation during the diagnostic evaluation and in complying with the prescribed treatment regimen; and (4) the presence in the patient of antisocial personality disorder

A typical schizophrenia medication

mixed mechanisms of action in terms of the receptor types that they influence, though most of them also influence D2 receptors. These newer antipsychotics are not necessarily more helpful for schizophrenia but have fewer motor side effects serotonin & dopamine .

personality disorder includes traits from neuroticism , extraversion antagonism and conscientiousness

narcissistic

fearful, apprehensive, angry, bitter, pessimistic, glum, timid, embarrassed, tempted, urgency, helpless, fragile

neuroticism (emotionally unstable)

dependent personality disorder is a combination of what personality traits

neuroticism and maladaptive agreeableness

personality disorders are extreme or maladaptive vairents of what?

normal personality traits

dreamer, unrealistic, imaginative, aesthetic, self aware, strange, odd, creative, permissive

openness

what other two personality disorders are considered sub categories according to the DSM

other specified personality disorder, & unspecified personality disorder

what 3 personality disorders are in cluster A of the classical categorical model ?

paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder

characteristic manner of thinking, feeling, behaving, and relating to others

personality

an enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individuals culture

personality disorders

what symptoms respond better to schizophrenia medication

positive symptoms

positive vs negative symptoms in schizophrenia

positive symptoms are things such as hallucinations or delusions, negative are absences of cognitive behaviors

what does the classical categorical model assume ?

problematic traits are either present or absent, ignores the continuous nature of personality traits PD is either displayed or not

what is the most impairing disorders in psychopathology ?

schizophrenia

absorption, derealization, and depersonalization all orginate from what?

sleep

viewed as a transient symptom, which lasts a few minutes or hours

state dissociation

when are OSPD & UPD utilized in diagnosing a personality disorder

the clinition believes the patient has a personality disorder but their traits are not well covered by the 10 existing diagnosis

How is DID related to sleep disturbances?

the more sleep disturbances the more symptoms of DID

What are important diagnostic criteria for personality disorders? How are they different than other disorders (e.g., how is OCPD different than OCD)?

the symptoms of each individual can vary from person to person, and each specific disorder that falls under the general term personality disorder may be different

why is there no complete treatment of personality disorders?

they involve well established behaviors that can be integral to a clients self image

an integral aspect of personality

trait dissociation

Schizophrenia is a heterogeneous disorder, meaning what ?

two people could have very different symptoms making it hard to identify specific genes associated

psychoanalytic theory of dissociative disorders

type of defense mechanism (dissociative states)