Class Notes (808,761)
Canada (493,382)
Psychology (2,034)
PSYCH 257 (141)

CHAPTER 12 Psych 257

6 Pages
Unlock Document

University of Waterloo
Uzma Rehman

CHAPTER 12: PERSONALITY DISORDERS  DSM IV AXES REVIEW o Axis I – acute (right now) psychological problems o Axis II – Personality Disorders (in axis II: the disorder is more chronic, the diagnosed people don’t know they have disorder, often something hard to characterize or talk about, things/characteristics with a long standing history, treatment is longer/ prognosis of treatment is difficult, egocentonic- usually a part of the person) o Axis III – physical health o Axis IV – psychosocial issues o Axis V – Global Assessment of Function  Personality Disorders o Axis II in the DSM- IV o Patients usually don’t seek help for personality disorders! o Personality Disorders are often diagnosed after long treatment effort is not effective and provider becomes discouraged  DSM IV General criteria for Personality Disorder A. Enduring pattern of inner experience and behavior that deviates markedly from cultural expectations. Manifested in two or more of the following areas: o Cognition o Affectivity o Interpersonal functioning o Impulse control B. Pattern is inflexible and pervasive across a broad range of personal and social situations C. Pattern leads to clinically significant impairment or distress D. Pattern is stable and of long duration and onset can be traced to adolescence or early childhood E. Pattern not better accounted for as a manifestation of another disorder F. Not due to substance or GMC (e.g., head trauma) * Person must meet the general criteria before a specific PD is diagnosed  Other Features o Lack insight into PD (seek treatment for Axis I problem or relationship problems) o PD symptoms are ego syntonic = feels like a normal part of oneself o Most have interpersonal problems o Can be difficult to diagnose in initial session o Intractable, difficult to treat; can affect treatment of other disorders  Controversies in the Diagnosis of PDs o Dimensional versus categorical? o Reliability and validity?  Heterogeneous categories; core features not clearly defined  Thresholds are not adequately justified  High degree of overlap between PDs  The most common PD diagnosis is not one of the ten described in the DSM – the most common PD is PD-NOS  Clinicians tend to be reliable in their assessment of whether a person has a PD, but not on the specific diagnosis o Gender bias?  Given the controversies surrounded, why are there still criteria for DSM IV? o PD influence course or outcome of other mental disorders o PD diagnoses allow for a rationale for longer-term treatment  Personality Disorder Clusters o Cluster A: Odd or eccentric cluster  Paranoid, Schizoid, and Schizotypal o Cluster B: Dramatic, emotional, or erratic cluster  Histrionic, Narcissistic, Antisocial, and Borderline o Cluster C: Fearful or anxious cluster  Avoidant, Dependent, and Obsessive-Compulsive  CLUSTER A: DISORDERS CHARACTERIZED BY ODD OR ECCENTRIC BEHAVIOURS 1. CLUSTER A: PARANOID PERSONALITY DISORDER • Overview and Clinical Features – Pervasive and unjustified mistrust and suspicion • Treatment Options – Few seek professional help on their own – Treatment focuses on development of trust – Cognitive therapy to counter negativistic thinking – Lack good outcome studies showing that treatment is efficacious 2. CLUSTER A: SCHIZOID PERSONALITY DISORDER • Overview and Clinical Features – Pervasive pattern of detachment from social relationships – Very limited range of emotions in interpersonal situations • The Causes – Etiology is unclear – Preference for social isolation in schizoid personality resembles autism • Treatment Options – Few seek professional help on their own – Focus on the value of interpersonal relationships, empathy, and social skills – Treatment prognosis is generally poor – Lack good outcome studies showing that treatment is efficacious 3. CLUSTER A: SCHIZOTYPAL PERSONALITY DISORDER • Overview and Clinical Features – Behaviour and dress is odd and unusual – Most are socially isolated and may be highly suspicious of others – Magical thinking, ideas of reference, and illusions are common – Risk for developing schizophrenia is high in this group – Many also meet criteria for major depression • The Causes – Schizoid personality – A phenotype of a schizophrenia genotype? – Left hemisphere and more generalized brain deficits • Treatment Options – Main focus is on developing social skills – Treatment also addresses comorbid depression – Medical treatment is similar to that used for schizophrenia – Treatment prognosis is generally poor CLUSTER C: Disorders characterized by anxious or fearful behaviors 1. CLUSTER C: AVOIDANT PERSONALITY DISORDER • Overview and Clinical Features – Extreme sensitivity to the opinions of others – Highly avoidant of most interpersonal relationships – Are interpersonally anxious and fearful of rejection • The Causes – Numerous factors have been proposed – Early development – a difficult temperament produces early rejection • Treatment Options – Several well-controlled treatment outcome studies exist – Treatment is similar to that used for social phobia – Treatment targets include social skills and anxiety 2. CLUSTER C: DEPENDENT PERSONALITY DISORDER • Overview and Clinical Features – Excessive reliance on others to make major and minor life decisions – Unreasonable fear of abandonment – Tendency to be clingy and submissive in interpersonal relationships • The Causes – Still largely unclear – Linked to early disruptions in learning independence • Treatment Options – Research on treatment efficacy is lacking – Therapy typically progresses gradually – Treatment targets include skills that foster independence 3. CLUSTER C: OBSESSIVE COMPULSIVE PERSONALITY DISORDER • Overview and Clinical Features – Excessive and rigid fixation on doing things the right way – Tend to be highly perfectionistic, orderly, and emotionally shallow – Obsessions and compulsions are rare • The Causes – Are largely unknown • T
More Less

Related notes for PSYCH 257

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.