Term
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Definition
| enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts |
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Term
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Definition
| when personality traits become *INFLEXIBLE* and *MALADAPTIVE* and cause significant *FUNCTIONAL IMPAIRMENT* or subjective *DISTRESS* |
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Term
| *prevalence of personality disorders* |
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Definition
**10% for ANY personality disorder (high!)
**1-3% for a specific personality disorder |
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Term
| comorbidities with personality disorders |
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Definition
-other personality disorders, usually in the same cluster
-related Axis I disorder
families tend to have same cluster personality disorders and related Axis I disorders |
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Term
| dimensions of personality |
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Definition
Hippocrates' "four humors"
Jung's psychological types |
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Term
| Hippocrates' "four humors" |
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Definition
entirely biologically based and closely parallel current personality categories
Blood: emotional lability
Black bile: depression
Yellow bile: anger
Phlegm: slow, stolid, cold |
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Term
| Carl Jung's psychological types |
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Definition
dimensions of personality; quite stable
Introvert/Extravert: how much attachment yo have to people around you; social connectedness
Thinking/Feeling: degree to which we are attached to cognitive vs. emotional processes
Sensing/Intuiting: seeing and hearing vs. "getting a feel for"
Judging/Perceiving: how one reached conclusions about things |
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Term
| personality assessment instruments |
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Definition
self report interviews
SCID
clinical interview
projective tests |
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Term
self-report inventories
(personality assessment instruments) |
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Definition
sit down and answer questions about yourself
MMPI: 500+ T/F questions that fall into 10 clinical scales; validity scale to detect "Faking"; special scales
Meyers=Briggs: scores plotted along Jung's 4 dimensions |
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Term
structured clinical interview for diagnosis
SCID
(personality assessment instrument) |
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Definition
-based on diagnostic criteria, not dimensions
-go through items on DSM like a checklist |
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Term
clinical interview
(personality assessment instrument) |
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Definition
sit down and talk to patient to get their story
ask questions that parallel SCID |
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Term
projective tests
(personality assessment instruments) |
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Definition
not diagnostic, but show patterns of thought, dynamics, defenses, disorders of thought, etc.
Rorchach
Thematic Apperception Test
Sentence-Completion Task
Draw-A-Person |
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Term
| Rorschach (ink-blot) test |
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Definition
projective test to assess personality
listening for what part or image the patient focuses on, if they see motion or not, etc. |
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Term
| genetic and biologic factors affecting personality |
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Definition
-concordance rates of personality traits for MZ > DZ twins 9even when raised apart)
-important NT and genetic components discovered by Larry Siever and Robert Cloninger |
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Term
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Definition
**looked at activities of NT systems and devised 4 "schemas" that correspond well to the clusters of personality disorders in DSM**
-cognitive disorganization (A)
-impulsivity (B)
-affective instability (B)
-anxiety/inhibition (C) |
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Term
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Definition
**found 3 trackable behavior qualities that could be traced genetically**
1. novelty seeking: seeking new info/stimuli-->seeking stability, settling down
2. harm avoidance: degree willing to suffer consequences-->avoid
3. reward dependence: motivation of some goal |
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Term
| environmental factors affecting personality |
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Definition
~50% parenting and family style
~50% psychosocial milieu (environment around us and how we interact with it)
both interact with each other in complex ways |
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Term
| psychodynamic factors affecting personality |
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Definition
internal drives and defenses
developmental tasks and stages -certain things need to happen as we grow up |
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Term
| cluster classification of personality disorders |
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Definition
Cluster A: odd or eccentric
Cluster B: dramatic, emotional or erratic
Cluster C: anxious or fearful |
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Term
| Cluster A personality disorders |
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Definition
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder
--odd or eccentric-- |
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Term
| paranoid personality disorder |
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Definition
-a pattern of distrust or suspiciousness such that others' motives are interpreted as malevolent
-psychotherapy tx of choice, but few come in
-need straightforward approach from doc, pt may come across as hostile/threatened |
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Term
| schizoid personality disorder |
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Definition
-a pattern of detachment from social relationships and a restricted range of emotional expression
-don't send/perceive signals to carry a convo, no facial expressions, flat tone, blandness
-lack of hobbies
-psychotherapy tx of choice, use straightforward approach
trait can be adaptive for certain ppl: truck driver, lighthouse keeper |
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Term
| schizotypal personality disorder |
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Definition
-pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and *eccentricities of behavior*
-AWKWARDNESS
-highly correlated with creativity
-odd people that have a hard time being a part of social groups
-often do come in for tx, psychotherapy best form - straightforward approach, do not ridicule odd or over-valued ideas; avoid over rejection |
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Term
| Cluster B personality disorders |
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Definition
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder
--dramatic, emotional, erratic-- |
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Term
| antisocial personality disorder |
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Definition
-pattern of disregard for, and violation of, the rights of others
-criminals
-issues with violence, criminal behavior, suicide
-from an early age; chaotic home environment
trait may be adaptive in a professions of decisive leadership |
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Term
| *prevalence of antisocial personality disorders* |
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Definition
**3% of males
**1% of females
**M:F = 3:1 |
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Term
| *comorbidities of antisocial personality disorder* |
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Definition
*substance abuse
*ADD
*depression
*anxiety |
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Term
| *family disorders related to antisocial personality disorder* |
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Definition
*somatization disorder
*substance abuse
*other Cluster B disorders (esp. antisocial personality disorder) |
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Term
| *treatment of antisocial personality disorder* |
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Definition
*no psychiatric treatment addressed the core pathology
-psychotherapy generally not useful but may help alleviate depression and anxiety
-nothing other than containment really works (jailed criminals)
-firm limits by physician are essential; very difficult to deal with |
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Term
| borderline personality disorder |
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Definition
-pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts
-instability in every aspect of life
-mood swings over minutes to hours (often mis-diagnosed as bipolar)
-very needy
-suicide and self mutilation
-psychosis
-dissociation
-splitting
-childhood trauma (trait can be adaptive) |
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Term
| *prevalence of borderline personality disorder* |
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Definition
*3% of females
*1% of males
*F:M = 3:1 |
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Term
| *comorbidities of borderline personality disorder* |
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Definition
*depression
*substance abuse
*eating disorders
*brief reactive psychois |
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Term
| *family disorders related to borderline personality disorder* |
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Definition
*mood disorders
*substance abuse
*other Cluster B disorders, esp. antisocial |
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Term
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Definition
major clinical issue related to borderline personality disorder
-dividing the world into all good (idealization) or all had (devaluation) elements
-rapid switching between idealization and devaluation in relationships |
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Term
| treatment of borderline personality disorder |
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Definition
-dialectical.behavioral therapy is preferred
-idealization, devaluation, splitting toward therapist is common
-need to set firm limits and high tolerance for regressive behavior
-countertransference must be monitored carefully |
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Term
| histrionic personality disorder |
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Definition
-pattern of excessive emotionality and attention seeking ("Scarlet O'Hara type)
-comorbid/fam hx with somatization, depression, anxiety |
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Term
| treatment of histrionic personality disorder |
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Definition
-dynamic psychotherapy is treatment of choice
-overly dependent or seductive behavior is common
-dramatic presentation may obscure the differences between major and minor physical and psychiatric problems
-rapid fluctuation between overwhelmingly anxiety about a medical problem and total indifference is common |
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Term
| narcissistic personality disorder |
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Definition
-a pattern of grandiosity, need for admiration, and lack of empathy
-comorbid/fam with mood disorders, substance abuse, anorexia
-psychotherapy difficult bc the pts are difficult to be around, but method of choice
-IPT may be most effective |
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Term
| Cluster C personality disorders |
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Definition
Avoidant personality disorder
Dependent personality disorder
Obsessive compulsive personality disorder
--anxious or fearful-- |
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Term
| avoidant personality disorder |
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Definition
-pattern of social inhibition, feelings or inadequacy, and hypersensitivity to negative evaluation
-pathologically shy; all about intimacy
-comorbid/fam hx with social phobia, other anxiety disorders, depressive disorders
-treatment with CBT is ideal
-unconditional respect and concern are ideal, avoid implications of rejections
-even limited personal interactions may be very important to pt (and it's loss very distressing) |
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Term
| dependent personality disorder |
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Definition
-pattern of submissive and clinging behavior related to an excessive need to be taken care of
-difficulty making everyday decisions
-comorbid/fam hx of mood disorders, anxiety disorders, adjustment disorders
-dynamic, behavior, group, and family therapies are all helpful/successful
-physician should take an active role in treatment planning, with clear explanations and recommendations
-patients may need encouragement to make decisions about treatment plans
-family involvement often helpful |
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Term
| obsessive compulsive personality disorder |
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Definition
-pattern of preoccupation with orderliness, perfectionism, and control
-comorbid/fam hx with OCD, eating disorders, hypochondriasis
-psychoanalytic, behavioral, group therapies often useful
-SSRIs
-thorough explanations and specific, detailed information are valued |
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