PS280 Study Guide - Final Guide: Egosyntonic And Egodystonic, Mental Disorder, Impulsivity

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14 Aug 2019
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CHAPTER 12: PERSONALITY DISORDERS
-enduring pattern of inner experience and behavior that deviates markedly from the expectations of the
individual’s culture; pervasive and inflexible; onset in adolescence/early adulthood + stable over time
-behaviour not modified by context; personality is rigid and inflexible / lead to impairment/distress
-likely to be characterized by a single dominant, dysfunctional trait
Criterion A: pattern of behaviour must be manifested in at least two of the following areas: cognition,
emotions, interpersonal functioning, or impulse control
-overall, about 6-9% of entire population will have one or more PDs during their life
-complicate treatment of other disorders (bad therapist-client alliance, be mistaken for other disorder)
-factors associated w having PD: Native or Black; young adult; low SES; divorced, separated,
widowed, never married
-egosyntonic: patient does not view symptoms as problematic
-egodystonic: cause distress/viewed as problematic by individual
-show fair test-retest reliability (except narcisistic and paranoid) but not as enduring as once thought
-lots of overlap (similar symptoms) in different PDs thus require significant inference by clinician
-WHO estimated 51% of those diagnosed w PDs meet criteria for at least one other mental disorder
Paranoid (Cluster A; odd and eccentric)
-distrust / suspiciousness such that others motives interpreted as malevolent
-tendency to interpret what others say and do as personally meaningful in a negative way
-humourless and eccentric + seen by others as hostile, jealous, preoccupied w power/control
-often become isolated, leading others to reject them, which worsens isolation and paranoia
-beliefs are non-bizarre and pertain to general suspiciousness (less severe than schizophrenia)
Schizotypal disorder (Cluster A; odd and eccentric)
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-eccentricity of thought and behaviour (extremely superstitious, odd beliefs)
-not considered so eccentric to meet criteria for delusional / hallucinatory psychotic experiences
-higher rates in African-Americans + high comorbidity w borderline and narcissistic PD
-modest effects w antipsychotic thiothixene and antidepressants
Schizoid: (Cluster A; odd and eccentric)
-detachment from social relationships + restricted range of emotional expression
-alone often and come across as being detached, aloof, cold, indifferent, or self-absorbed
-lack skills for effective social interaction, but also appear uninterested in acquiring such skills
-Cohen suggested schizoid PD may be more related to asocial disorders such as Autism SD
Histrionic (Cluster B; dramatic, emotional, erratic)
-excessive emotionality and attention seeking + often inappropriate sexual behaviour
-excessive need to be centre of attention, get jealous when someone else is (“life of the party”)
-tend to be very demanding and inconsiderate + shallow and unable to develop intimacy
-often comorbid w borderline
Borderline personality disorder (Cluster B; dramatic, emotional, erratic)
-fluctuations in/difficulty regulating emotions, unstable identity and relationships, impulsivity
-more emotionally reactive to stressors and have difficulty regulating emotions
-relationships: short, argumentative/volatile, alternate b/w idealation and devaluation
-can't tolerate being alone/become desperate about relationships + blame problems on others
-some experience psychotic-like symptoms or dissociation during times of stress
-may engage in non-suicical self-injury (up to 70%); 8-10% complete suicide
-higher rates in Hispanics + high comorbidity w ASPD, histrionic, and mood disorders
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