Term
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Definition
Personality refers to individual differences in characteristic patterns of thinking, feeling and behaving.
“characteristic patterns”
- How you act and feel over time: TRAITS
- How you act and feel under certain circumstances: STATES |
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Term
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Definition
| openness (imagination, feelings, actions, ideas). conscientiousness (competence, self-discipline, thoughtfullness, goal-driven), extroversion (sociability, asserviteness, emotional expression), agreeableness (cooperative, trustworthy, good-natured), neuroticism (tendency toward unstable emotions) |
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Term
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Definition
• traits are not extreme
• able to work
• coherent stable sense of self
• able to make and keep relationships
• able to consider others’ perspectives
• resilient under stress |
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Term
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Definition
• traits may be extreme
• difficulty working
• trouble making and/or keeping relationships
• trouble imaging others’ perspectives
• impulsive attempts to manage overwhelming emotions in the face of stress |
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Term
| How can you assess personality? |
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Definition
• Self-reports
What kind of person are you?
What makes you unique, different from other people? [ ask same about other loved ones]
• Collateral reports What kind of person is X?
How have things been going at her job, with people she knows? Ask direct care staff (e.g. nurses in the hospital).
• Observation
How does X act? How do you feel interacting with X? |
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Term
| What is a personality disorder? |
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Definition
A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or
problems functioning, and lasts over time • Trait model / DSM Alternative Model
• Diagnostic and Statistical Manual (official psychiatric diagnosis list) • Personality Organization model |
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Term
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Definition
| step 1: assess impairment in personality functioning, self: identity, self-direction. interpersonal: empathy, intimacy -> step 2 assess pathological personality traits (negative affectivity, detabchment, antagonism, disinhibition, psychotism) -> step 3a: apply criteria A and B for specific personality disorders- antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, schizotypal -> step 3b: apply criteria A and B for personality disorder-trait specified- moderate or greater impairment in personality functioning. one or more pathological personality traits (domains or facets) -> Step 4: apply other inclusion and exclusion criteria. inflexibility and pervasiveness: stability and early onset- other mental disorder, sustance and medical exclusions, agea nd cultural exclusions |
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Term
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Definition
ODD-ECCENTRIC
Paranoid Schizoid Schizotypal |
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Term
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Definition
DRAMATIC-ERRATIC
Borderline Narcissistic Histrionic Antisocial |
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Definition
ANXIOUS-FEARFUL
Avoidant
Dependent Obsessive-compulsive |
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Definition
| a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent. |
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Definition
| lack of interest and detachment from social relationships, apathy, and restricted emotional expression. |
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Definition
| extreme discomfort interacting socially, and distorted cognitions and perceptions. |
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Term
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Definition
pervasive pattern of abrupt mood swings, instability in relationships, self-
image, identity, behavior and affect, often leading to self-harm and impulsivity. |
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Term
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Definition
| pervasive pattern of grandiosity, need for admiration, and a perceived or real lack of empathy. |
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Term
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Definition
| pervasive pattern of attention-seeking behavior and excessive emotions. |
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Definition
| pervasive pattern of disregard for and violation of the rights of others, lack of empathy, bloated self-image, manipulative and impulsive behavior. |
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Definition
| pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation. |
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Definition
| pervasive psychological need to be cared for by other people. |
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Term
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Definition
| characterized by rigid conformity to rules, perfectionism, and control to the point of satisfaction and exclusion of leisurely activities and friendships |
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Term
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Definition
• Traits: how extreme?
• Work? What kind? How does it go?
• Sense of self (stable?)
• Ability to make and keep relationships
• Ability to consider others’ perspectives
• Emotions and behaviors under stress |
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Term
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Definition
• Prevalence:
• Heritability 55-68% (SCZ 85%, MDD 45%).
Rates of remission and recovery after inpatient admission
1-5% in the general population 10-20% in psychiatric settings
• 50X more suicide attempts
• 5-10% complete suicide
• Remission (no longer meeting criteria) is common
• Recovery is less common:
• Remission and
• 1+ emotionally sustaining relationship
• Full time work or school |
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Term
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Definition
• Changeable mood from minute to minute, hour to hour
• Depressed, anxious mood
• Emptiness |
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Term
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Definition
• Aggression • Driving
• Sex
• Alcohol/Drugs
• Financial • Self-harm |
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Term
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Definition
• Odd ideas
• Magical ideas
• Paranoia
• Hearing voices |
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Term
| interpersonal BPD symptoms |
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Definition
• Difficult relationships with lots of ups and downs
• Strongly conflicted relationships
• Other symptoms come and go with
interpersonal problems |
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Term
| People with BPD feel ___ how to test |
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Definition
| ostracized, Cyberball: a social ball tossing game |
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Term
| People with BPD see most faces as |
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Definition
angry
People with BPD:
• Quickly notice and pay more attention to angry faces
• Judge ambiguous (only partly angry) faces to be angry
• Have more trouble
distinguishing more detail about negative faces |
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Term
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Definition
hyperactive
The amygdala is more active
in people with BPD than in people without BPD
• All the time
• When seeing faces
Also, pre-frontal cortex (PFC)- amygdala connectivity is decreased in BPD. |
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Term
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Definition
| amygdala doesn't signal effectively, in game doesn't increase money to get partner to keep playing |
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Term
| Possible levels of awareness of partner irritability in BPD |
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Definition
Social behavior is impaired:
ignorant optimistic realistic pessimistic fatalistic |
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Term
| Psychopharmacology for BPD: |
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Definition
• Data is recent, inconclusive, practice guidelines still recommend no meds • Polypharmacy is common, and inversely related to improvement
• Meds may work for the expected symptom clusters:
affect regulation- mood stabilizer, anti-depressant, anti-psychotic, placebo
impulsivity- mood stabilizer, anti-psychotic
psychotic-like symptoms- anti psychotic |
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| Considerations in Psychopharmacology: for BPD |
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Definition
Treating symptoms
• Symptoms can be debilitating
• Symptoms fluctuate as part of the disease
Maintaining safety
• Impulsivity–many medications are risky in overdose
• Suicidality and self-harm
• Co-morbidities: PTSD, panic disorder, substance use disorders...
Meaning of medications
• Adding and decreasing medications can trigger strong feelings of being
judged to be sick, having help withdrawn etc... |
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Term
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Definition
• Good Psychiatric Management (JohnGunderson,PaulLinks,LoisChoi-Kain)
• Dialectical Behavioral Therapy (MarshaLinehan)
• Transference-focused Psychotherapy (OttoKernbergandCornellgroup)
• Mentalization Based Treatment (PeterFonagyandAnthonyBateman) |
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Term
| Practical approaches: for BPD |
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Definition
• Consider your own personality: https://sapa-project.org/survey/report.php
• What is your patient’s personality?
• Managing patients with personality disorders
-- acknowledge patient strengths
-- acknowledge your limitations, set clear expectations
-- describe problems in factual, non-judgmental terms
-- refer to appropriate treatment (esp. case management)
-- referrals for caregivers and loved ones |
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