Understanding Diagnostic Criteria for Personality Disorders and Impulse Control Disorders, Study notes of Abnormal Psychology

Download Understanding Diagnostic Criteria for Personality Disorders and Impulse Control Disorders and more Study notes Abnormal Psychology in PDF only on Docsity! Personality Disorders (Chapter 8) 1. Personality Defined a. Personality: The unique pattern of relatively enduring traits and behaviors that characterize the individual b. traits are relatively persistent over time and situations c. Healthy personality is associated with Successful adjustment: flexibly adapting to changing demands, opportunities, and limitations associated with different stages of life. 2. Personality Disorder : General Criteria a. A long-standing pattern of inner experience and behavior that significantly deviates from the individual’s culture. The pattern is manifested in two or more of the following areas: b. cognition, affectivity, interpersonal functioning, impulse control. c. Pattern is inflexible and pervasive across a broad range of situations d. Pattern is stable and long lasting (onset in adolescence or early adulthood) e. Significant distress or impairment f. Classification of PD’s i. There are ten personality disorders, which are categorized in 3 clusters ii. Cluster A: Odd, eccentric 1. Paranoid 2. Schizoid 3. Schizotypal iii. Cluster B: Dramatic, emotional, erratic 1. Borderline 2. Histrionic 3. Narcissistic 4. Antisocial iv. Cluster C: Anxious, fearful 1. Avoidant 2. Dependent 3. Obsessive-Compulsive personality disorder. 3. Cluster A: Odd or Eccentric a. Paranoid, Schizoid & Schizotypal Personality Disorders b. Paranoid PD Diagnostic Criteria i. Paranoid PD is characterized by pervasive distrust and suspiciousness ii. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him 1. Preoccupied with doubts about the loyalty/trustworthiness of friends and associates 2. Reluctant to confide in others for fear of the information being used against him/her 3. Reads threatening meanings into benign remarks 4. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights. 5. Perceives character attacks not apparent to others and is quick to react angrily 6. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner iii. Basic Belief: People are potential adversaries 1. Strategy: Weariness 2. I cannot trust other people. 3. Other people have hidden motives. 4. I have to be on guard at all times. iv. SUSPECT 1. S - spouse is cheating suspected 2. U - unforgiving - bears grudges 3. S - suspicious (of others) 4. P - perceives attacks (and reacts quickly) 5. E - enemy in everyone - suspects associates, friends 6. C - confiding in others feared 7. T - threats seen in benign events c. Schizoid PD Diagnostic Criteria i. Schizoid PD is characterized by detachment from social relationships and the restricted expression of emotions 1. Neither desire nor enjoy close relationships, including being part of a family 2. Almost always choose solitary activities 3. Little if any desire to have sexual experiences with another person 4. Takes pleasure in few, if any activities 5. Lacks close friends or confidants other than relatives 6. Indifferent to the praise and criticism of others 7. Shows emotional coldness, detachment or flat affect ii. Basic Belief: I need plenty of space 1. Strategy: Isolation 2. It doesn't matter what other people think of me. 3. I enjoy doing things more by myself than with other people. 4. I am not influenced by others in what I decide to do. 5. Intimate relations with other people are not important to me iii. SOLITARY. 1. S – shows emotional coldness 2. O – omits close relationships 3. L – lacks close friends or confidants 4. I – involves in solitary activities 5. T – takes pleasure in few activities 6. A – appears indifferent to praise or criticism 7. R – restricted interest in sexual experiences 8. Y – yanks himself or herself from social relationships d. Schizotypal PD Diagnostic Criteria i. Schizotypal PD is marked by interpersonal problems and odd patterns of thinking, perceiving, and behaving . i. Pervasive pattern of instability of interpersonal relationships, self image, and affects. Marked impulsivity. 1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships marked alternating between extremes of idealization and devaluation 3. Identity disturbance: markedly & persistently unstable self-image. 4. Impulsiveness in at least 2 potentially self-damaging areas (e.g., spending, sex, substance abuse, reckless driving). 5. Inappropriate, intense anger or difficulty controlling anger (frequently loses temper or engages in physical fights) 6. Affective instability: Drastic, unpredictable mood shifts, chronic feelings of emptiness. 7. Recurrent attempts to self-mutilate or suicide. 8. Transient, stress related paranoid ideation or severe dissociative symptoms ii. Basic Belief: Other people must satisfy my needs. 1. Strategy: Relationship change. 2. I can't cope on my own. I need someone to rely on. 3. I must subjugate my wants to the desires of others or they'll abandon me or attack me. It isn't possible for me to control myself or discipline myself. 4. PRAISE : a. P - paranoid ideas b. R - relationship instability c. A - angry outbursts, affective instability, abandonment fears d. I - impulsive behavior, identity disturbance e. S - suicidal behavior f. E - emptiness e. Antisocial PD Diagnostic Criteria i. Pervasive pattern of disregard, and violation of the rights of others 1. Failure to conform to social norms of lawful behaviors 2. Deceitfulness - repeated lying, use of aliases, or conning others for personal profit or pleasure. 3. Impulsivity or failure to plan ahead 4. Irritability and aggressiveness -repeated physical fights/assaults. 5. Reckless disregard for safety of self or others 6. Consistent irresponsibility - repeated failure to sustain consistent work behavior or honor financial obligations. 7. Lack of remorse – indifference to having hurt, mistreated another. 8. CORRUPT a. C - cannot follow law b. O - obligations ignored c. R - remorselessness d. R - recklessness e. U - underhandedness f. P - planning deficit g. T - temper 9. Etiology of ASPD a. The Fearlessness theory: People vary in their level of fearlessness. i. Lack of fear would predispose to antisocial and violent behavior because such behavior (e.g., fights and assaults) requires a degree of fearlessness to execute. b. Lykken’s classic research: He reported that psychopaths exhibited less aversion to frightening social and physical situations c. Low autonomic reactivity & Sensation seeking i. ASPD’s have lower levels of ANS activity and are underaroused. ii. Low levels of arousal are uncomfortable and leads to sensation seeking to achieve an optimal level of arousal. d. Neurological factors: Violent offenders have reduced functioning of the prefrontal cortex (Raine, 1993; Volkow et. al., 1995). i. Familial Factors: Authoritarian, chaotic and punitive parenting & physical abuse of children ii. Social & Cultural Factors: Dangerous or Violent Neighborhoods and SES iii. Although treatments have failed to produce positive results, there is a tendency for some ASPD clients to “burn out” as they age 5. Cluster C Anxious or Fearful a. Avoidant, Dependent, & Obsessive Compulsive Personality Disorders b. Avoidant PD Diagnostic Criteria i. A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation 1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, or rejection. 2. Unwilling to get involved with people unless certain of being liked. 3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. 4. Views self as socially inept, personally unappealing, or inferior to others. 5. Preoccupied with being criticized or rejected in social situations 6. Avoids risks and engagement in new activities for fear of embarrassment 7. Basic Belief: I may get hurt. a. Strategy: Avoidance b. I am socially inept and socially undesirable in work or social situations. c. Other people are potentially critical, indifferent, demeaning, or rejecting. d. If people get close to me, they will discover the "real" me and reject me. e. AVOIDER i. A – avoids occupational activities ii. V – views self as socially inept iii. O – occupied with being criticized or rejected iv. I – inhibited in new interpersonal situations v. D – denies to get involved with people vi. E – embarrassed by engaging in new activities vii. R – restrains from intimate relationships c. Dependent PD Diagnostic Criteria i. A pervasive, excessive need to be taken care of that leads to clinging behavior and fears of separation 1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others 2. Needs others to assume responsibility for most major areas of life 3. Has difficulty expressing disagreement with others because of fear of loss of support or approval 4. Has difficulty initiating projects or doing things on his or her own because of a lack of self confidence 5. Feels uncomfortable when alone 6. goes to excessive lengths to obtain nurturance & support from others, to the point of volunteering to do things that are unpleasant 7. urgently seeks another relationship as a source of care and support when a close relationship ends 8. is unrealistically preoccupied with fears of being left to take care of himself or herself ii. Basic Belief: I am helpless. 1. Strategy: Attachment 2. I am helpless when I am left on my own. 3. The worst possible thing would be to be abandoned. 4. I must do nothing to offend my supporter or helper. 5. DEPENDENT