Textbook Notes (362,902)
Canada (158,096)
Psychology (1,851)
PSY346H5 (21)
Dior (8)
Chapter 11

chapter 11 notes

10 Pages
Unlock Document

University of Toronto Mississauga

PERSONALITY DISORDERS - 1 I. Statistics and Development A. 0.5% to 2.5% of the general population, higher rates in inpatient and outpatient settings. B. originate in childhood and continue into the adult years; relatively little is known about the developmental course. C. Significant comorbidity about half of those diagnosed with a personality disorder also meet criteria for another personality disorder. D. Gender biases borderline personality disorder is diagnosed much more frequently in females, who make up 75% of the identified cases. Knowledge of whether the client is male or female can influence whether a client receives one personality disorder diagnosis over another. For example, antisocial personality disorder is assigned more often when the patient is male, whereas a similar description of antisocial personality features with a fictitious female client is more likely to be labeled histrionic personality disorder. Many features of histrionic personality disorder are characteristic of the stereotypical Western female. 1. criterion gender bias 2. assessment gender bias). PERSONALITY DISORDERS - 2 II. Cluster A (odd, eccentric) Personality Disorders A. Paranoid personality disorder (PPD) 1. Evidence for a biological contribution to PPD is limited, and evidence for a psychological contribution is unclear. The most salient psychological feature is a pervasive negative view of the world and the motives of others; a view that may originate in early childhood. 2. Treatment for PPD is difficult few persons with this disorder seek professional help on their own, difficulty in developing trusting relationships a. Treatment focuses on development of trust and may include cognitive therapy to counter the person’s mistaken assumptions about others. b. There are no good studies showing that treatment is effective for PPD. B. Schizoid personality disorder (SZPD) Unlike the DSM-IV, the DSM-IV-TR recognizes that at least some people with SZPD are sensitive to the opinions of others but are unwilling or unable to express this emotion. For this group, social isolation may be painful. Homelessness is quite prevalent in persons with SZPD. 1. The etiology of SZPD is unclear. 2. Treatment for SZPD focuses on the value of social relationships, including learning empathy skills, social skills training. Role playing is also used to help the person learn to establish and maintain social relationships. Treatment prognosis is poor for people with SZPD, persons with this diagnosis rarely seek treatment, except in response to a crisis. PERSONALITY DISORDERS - 3 C. Schizotypal personality disorder (STPD) Some increased risk that many may go on to develop more severe characteristics of schizophrenia. 1. Some consider STPD a phenotype of a schizophrenia genotype and genetic research seems to support such a relationship. Family, twin, and adoption studies have shown an increased prevalence of STPD among relatives of people with schizophrenia who do not have schizophrenia themselves. Exposure to influenza during pregnancy may increase risk of STPD in the unborn fetus. 2. Cognitive factors include mild-to-moderate deficits in memory and learning, suggesting damage to the left hemisphere of the brain, whereas MRI studies suggest more generalized brain abnormalities in STPD individuals. 3. Few controlled treatment studies exist for STPD. The main treatment focus tends to be on developing social skills. Given that as many as 30% to 50% of persons with STPD who seek treatment meet criteria for major depressive disorder, therapy also tends to focus on alleviating depressed mood. Medical treatment tends to follow that for people with schizophrenia. Prognosis is poor for persons with STPD. PERSONALITY DISORDERS - 4 III. Cluster B (dramatic) Personality Disorders A. Antisocial personality disorder (ASPD) Substance abuse occurs in about 83% of persons with antisocial personality disorder. Long-term outcome of persons with ASPD is poor, regardless of gender. 1. Dyssocial psychopathy (i.e., antisocial behavior that is thought to originate in a person’s allegiance to a culturally deviant group, such as a gang) may be included with ASPD, but not psychopathy. Dyssocial psychopaths are presumed to have the capacity for guilt and loyalty. 2. Psychopathy and ASPD are not synonymous with legal problems. Those that get into legal problems seem to have lower IQs. 3. The diagnosis of conduct disorder is reserved for children who engage in behaviors that violate cultural norms. Many with this disorder become juvenile offenders and tend to become involved with drugs. Lack of remorse is not part of the DSM-IV-TR criteria for conduct disorder, but is present for ASPD. 4. Family, twin, and adoption studies all suggest a genetic influence on ASPD and criminality. A gene-environment interaction appears involved, suggesting that genetic vulnerability interacts with environmental factors a. The average concordance rate for criminality among monozygotic twins is 55%, whereas with dizygotic twins the rate drops to about 13%. 5. Neurobiological research suggests that general brain damage does not explain why people become psychopaths or criminals. Two theories have attracted a great deal of attention. a. According to the underarousal hypothesis, psychopaths have abnormally low levels or cortical arousal. Low cortical arousal is used to explain antisocial risk taking behavior. Future criminal behavior is predicted by low skin conductance activity, lower heart rate during rest, and slow brain wave activity. PERSONALITY DISORDERS - 5 b. The cortical immaturity hypothesis suggests that the cerebral cortex of psychopaths is at a primitive stage of development and may explain why the behavior of psychopaths is often childlike and impulsive. c. According to the fearlessness hypothesis, psychopaths show higher thresholds for experiencing fear than most persons. Research suggests that psychopaths have difficulty associating cues with impending punishment or danger. 6. Psychological and social dimensions of psychopathy and ASPD include the following: a. Family and social factors may also contribute to psychopathy and ASPD, particularly inconsistent parental discipline, trust and solidarity in the family and community neighborhood. 7. An integrative model of ASPD includes genetic vulnerability, perhaps resulting from underarousal or fearlessness, Family stress and family interaction styles may activate the biological vulnerability, and the resulting antisocial behavior, including problems at school, may further alienate the individual from other children that may serve as good role models. 8. Treatment for ASPD is complicated by the fact the few persons with such problems see any need for treatment. Antisocial behavior is generally predictive of po
More Less

Related notes for PSY346H5

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.