-Schizophreia spectrum

-twin studies(heritability of 0.50)

-cognitive

    -underlying belief that people are evil and deceitful combined with lack of confidence in ability to defend self

    -beliefs endorsed more than in other PDs

-Retrospective research

    -early abuse or trauma

-Cultural factors may interact with cognitive beliefs

    -difficulty with language/customs

-Typically seek treatment for depression or anxiety

-Challenge of paranoid minsenterpreted

    -cannot be directly confronted; need to build trust

-Cognitive therapy

    -increase self-efficacy; decrease fear and hostility toward others

-Twin studies suggest some personality traits may be inherited

     -low sociability and low warmth

-Childhood shyness possible precursor

-Possible childhood abuse/neglect

-Loner

-Possible biological dysfunction similar to autism

Psychosocial Treatment- rather than meds

-point out the value of social relationships

-social skills training-modeling and role-playing

-group therapy

-awareness of his or her feelings

-Genetic support

    -twin study heritability 0.81

    -family and adoption studies-1st degree relatives

-Nongenetic biological factors

    -difficulty in sustaining attention in cognitive tasks

    -memory deficits-less tempoal gray matter

    -dysregulation of dopamine

    -enlarged ventricles

-Treated with the same meds as Schizophrenia

    -haloperidol, olanzapine and antidepressants

-Psychotherapy

    -therapist establishes relationship

    -help client increase social contacts and learn social skill

    -teach to identify and disregard bizarre thoughts

    -combo of meds, community treatment and social skills may postpone or reduce schizophrenia symptoms

Biological Factors

-twin studies higher concordance in MZvsDZ(.5-.96%)

-adoption studies

    -criminal records of sons

    -gene-environment interaction

    -adopted children of felons

        -deficits in high-quality contact

-endophenotyping-looking for the genes involved in the characteristic behaviors of APD such as lack of remorse

-low levels of 5-HT linked to aggression and impulsivity

-structural and functional differences in frontal and temporal lobes

     -deficits in executive brain function and verbal skills

-low levels of arousability

     -low resting HR, low skin concuctance, excessive slow-wave EEG

-intelligence

     -higher itelligence more rewards and more influenced by societal norms

-Emotion and psychopathy

     -lack of fear or anxiety

     -low baseline levels of skin conductance

          -also less reactive

-dont learn from experience

-also lack of empathy

-Reward/punishment processing

    -computer card-playing task

-family environment

    -lack of warmth and negativity

    -poverty

    -inconsistent discipline and harsh parenting

    -marital problems and substance abuse

    -particularly influential when genetic risk is also present

-submit to therapy when forced

     -blame others and do not accept responsibility

-psychotherapy

     -gain control over anger and impulsivity by recognizing triggerand develop alternative coping strategies

-Lithium and atypical antipsychotics,SSRIS

-identify at risk children

-parent training

     -success depends on level of family dysfunction, ses, high family stress, parents' history of antisocial behavior and CD of the child

-behavioral genetics-60% heritability

     -May play a role in impulsivity(frontal lobe) and emothional dysregulation(amygdala)

     -decreased sensitivity to 5-HT

-overlap wdiathesis for mood disorders increased activation of amygdala

-fronal lobe dysfunction

-memory bias

     -remembered more word related to bpd en when instructed to forget

-experience more shame

Etiology of BPD:

Social Environmental Factors

-Object-Relations Theory

     -introjection

     -object-representation

          -BPD involves disturbed object representations, possible due to inconsistent parenting

     -conflict between introjected values and current needs

     -splitting-defense mechanism-terms of black and white

-possible childhood trauma such as sexual abuse

-neurological impairments from drug exposure combined with parental styles

-Medications

     -Antidepressandts

     -Antipsychotics

     -anticonvulsants

-object relations therapy

-dialectical behavioral therapy

     -supported by brain imaging

Etiology of Histrionic Personality Disorder

Psychodynamic theory

-emotional displays and seductiveness result from parental seductiveness

     -fathers sexual attention towards daughter

-conflicting family attitudes towards sexuality

     -negative attitudes towards sex while simultaneously acknowledging titillation

-Must be taught that short-term gains from their histrionic behavior is not worth the cost

-operant conditioning

-interpersonal therapy

-Kohuts Self Psychology Model

     -characteristics mask low self esteem

     -parents fail to model empathy

     -in childhood narcissist valued as a means to increase parents own self esteem

          -not valued for his or her own competency and self worth

Social cognitive model

-narcissist has low self esteem

-interpersonal relationships are a way to bolster sagging self esteem

-self esteem tied to external feedback

-CBT and relaxation

     -focus on grandiosity and hypersensitivity to evaluation

-teach empathy skills

-may treat depression

-Not much available reserch

-Avoidant PD

     -parents model fear; over protective

     -chronic parental criticism or rejection

-Obsessive-Compulsive PD

     -fixation at anal stage of development

     -cope with fears of losing control by overcompensation

-Dependent PD

     -disruption of early childhood attachment by death, neglect,rejection, or overprotectiveness and authoritarian parenting

-CBT and relaxation for OCPD

- Little research on effective treatment for dependent

-similar to social phobia

-behavioral intervention techniques(CT and interpersonal therapy)

-social skills

-therapeutic alliace imp predicator for success