Lecture 10

advertisement
• personality disorder: enduring patterns of perceiving, relating to
and thinking about the environment and oneself. . . . that are
inflexible and maladaptive - cause functional impairment or
subjective distress
•
•
•
•
chronic
originate in childhood – continue as an adult
may or may not distress the person with the disorder
listed on Axis II of the DSM-IV
• Cluster A: odd or eccentric beliefs
• Paranoid p.d.
• Schizoid p.d.
• Schizotypal p.d.
• Cluster B: dramatic, emotional, erratic
• Antisocial p.d.
• Borderline p.d.
• Narcissistic p.d.
• Histrionic p.d.
• Cluster C: fearful disorders
• Obsessive-Compulsive p.d.
• Avoidant p.d.
• Dependent p.d.
• failure to conform to social norms
• deceitfulness
• impulsivity
• aggressiveness – repeated fights or assaults
• disregard safety of self and others
• irresponsibility
• lack of remorse
• psychopathy: focuses on personality traits
– some psychopaths do not have legal or
severe interpersonal problems
•
•
•
•
•
•
Glibness/superficial charm
Grandiose sense of self-worth
Prone to boredom/need stimulation
Pathological lying
Conning/manipulative
Lack of remorse
• Crowe
• “adopted away” children of felons had significantly higher criminality
• Eysenck & Eysenck
criminality concordance rate
- Monozygotic – 55%
- Dyzygotic – 13%
•
under-arousal hypothesis: abnormally low level of
cortical arousal
•
fearlessness hypothesis: higher threshold for
experiencing fear than others
•
differences in autonomic arousal
•
galvanic skin response (GSR): measure of sweating and autonomic
arousal
• coercive family process – parents give into children to avoid
problems
• trauma
• SES disadvantage
• after age 40 – the psychopath begins to “burn out”
•
frantic efforts to avoid real or imagined abandonment
•
unstable and intense interpersonal relationships
•
unstable self-image or sense of self
•
impulsivity in ways that are harmful
•
recurrent suicidal behavior or self-mutilating
•
affective instability
•
chronic feelings of emptiness
•
inappropriate anger
•
transient paranoid ideation – severe dissociation
• Based on a bio-social theory of BPD.
Problems w/
Emotionally
Vulnerable
Person
An
invalidating
Environment
1. Ability to
Understand &
label feelings.
2. Coping skills.
3. Emotion
modulation.
• medications:
• tricyclic antidepressants and lithium
• dialectical behavior therapy (DBT) – Linehan
• help cope with stressors that trigger suicidal behaviors – learn to identify
and regulate emotions
• histrionic personality disorder:
express emotions in an overly
dramatic fashion – often seductive
in appearance - speech is vague,
impressionistic
• Lilienfeld and colleagues
• Histrionic overlaps with antisocial p.d. –
females histrionic – while males antisocial
• narcissisic personality disorder: pervasive pattern of grandiosity,
need for admiration, and lack of empathy
• Kohut – caused by a lack of empathic “mirroring” by parents
early in development – child is fixated on self-centered
grandiose stage of development
• paranoid personality disorder: excessively mistrustful and
suspicious of others without justification
• schizoid personality disorder: pattern of detachment from social
relationships combined with a limited range of emotions in
interpersonal situations
• schizotypal personality disorder: social isolation combined with
odd or eccentric beliefs
• preoccupied with details, rules, lists, order, or
schedules – point of activity becomes lost
• excessively devoted to work and productivity to
exclusion of friends and leisure
• inflexible about matters of morality
• can’t discard worn out items
• can’t delegate tasks to others
• miserly spending
• rigidity and stubborn
• avoidant personality disorder: pattern of social
inhibition, feelings of inadequacy, and hypersensitivity
to negative evaluation
• behavioral intervention techniques for anxiety and social skills
problems
• systematic desensitization
• behavioral rehearsal
• dependent personality disorder: excessive need to be taken care
of that leads to submissive and clinging behavior and fears of
separation
• agree with others even when they disagree to avoid rejection –
cling to relationships
Download