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Lecture

PSYCH257 Lecture Notes - Attention Seeking, Psychopathy Checklist, Dialectical Behavior Therapy


Department
Psychology
Course Code
PSYCH257
Professor
Allison Kelly

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LECTURE 17
PERSONALITY DISORDERS PART 2 OF 2
CHAPTER 12 OF TEXTBOOK
RECAP: Last Class
The nature of personality disorders
o On axis two more stable and chronic. Disorders that are considered to
last a lifetime in most cases
Cluster A PDs
o Paranoid, schizoid, schizotypal
Cluster C PDs
o Avoidant, dependent, obsessive-compulsive
Today’s Outline
Cluster B personality disorders: Emotional, dramatic disorder
o Borderline
Notorious for the harm that people suffering can cause to
themselves (and others)
o Narcissistic
o Histrionic
o Antisocial
Pose a risk to society break the law
o Summary game name that PD
Borderline PD
Overview
Characteristics
Unstable emotions
o In the course of a day, and even an hour
Patterns of unstable moods, relationships, and impulsive behaviours
o Have intense relationships and then all of a sudden they hate that person
and wish them dead
o Act out in ways that are harmful to themselves (emotionally harmful to
others)

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Profound fear of abandonment
o Worry that they will be alone and that they are not loved
Emptiness and poor self-image
o Don’t have a strong sense of who they are or what they want
o Easily influenced by partner
Difficulties with emotion regulation and distress tolerance self-mutilation
o Difficulty to experience an emotion and cope with it
Not having a strong reaction
** VIDEO**:
Girl Interrupted Assessment Interview (YOUTUBE)
o Feel like they have no hope
DSM Symptoms
Frantic efforts to avoid abandonment
Pattern of unstable relationship characterized by extremes
Unstable self-image
Impulsivity that are self-damaging
Recurrent suicidal behaviour, gestures, or threats, or self-mutilation
Mood instability
Chronic feelings of emptiness
Inappropriate anger
Transient, stress-related paranoid ideation or severe dissociative symptoms
o Can include drinking a lot
Jeopardizing their safety
o Eating Disorders
o Hear voices
Know that they are coming from themselves
Understanding Self Mutilation in BPD video
o Way to punish yourself for the impulsivity
o Blood is cleansing?
o Release of strong feelings
o Blood and physical pain is way of validating what went wrong
o Cutting themselves, burning themselves, scratching and punching

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Prevalence & Comorbidity
Prevalence
General population
o 1-2%: Diagnosed more in females
Psychiatric settings
o In patient: 20%
o Out-Patient 10%
Females > males
Comorbidity
Other PDs
o Antisocial, schizotypal, histrionic
o Substance related disorders, PTSD, mood disorders
o History of abuse
Etiology
Biological factors
Tends to run in families
o Environmental or biological?
Genetics related to impulsivity or lower serotonin
Consensus: Biological doesn’t explain it all
Psychological factors
Born with Stronger attachment needs
Impulsivity
Emotional reactivity
Social factors
Invalidating environment
o Feeling sad as a child optimal validating thing is parent supporting and be
warm
Invalidating: “you’re not sad”, not giving them attention
Abuse, neglect, maltreatment
o High rates
61% have history of sexual abuse vs. 32% with other personality
disorders
90% with BPD have some form of abuse in history
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