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WSU PSYCH 333 - Personality Disorder (cont)
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PSYCH 333 1nd Edition Lecture 21 Outline of Last Lecture I. What is PersonalityII. Personality DisorderIII. Cluster A: Odd EccentricIV. Cluster B: Dramatic EmotionalOutline of Current Lecture II. Theories of ASAP (cont)III. Treatment of Antisocial PDIV. Borderline Personality DisorderV. Narcissistic Personality DisorderVI. Histrionic Personality DisorderCurrent Lecture- Theories of ASPD (cont):o Impulsivity. Lack of response to threats when pursuing rewards. Card study and effects of “waiting period.” Lower PFC activation.o Deficits in empathy. Lack of ability to understand other’s victimization may lead to tendency toexploit/harm others. Deficits in identifying emotions in others faces. Ventromedial prefrontal cortex – moral violation.- Treatment of Antisocial PD:o Some evidence of efficacy of intensive psychodynamic therapy. No control group. Unclear whether improvements were real or feigned.o Some evidence that therapy makes them worse.o Group therapy not indicated.- Borderline Personality Disorder:o Pattern of instability of interpersonal relationships, self-image, and affect; marked impulsivity. Frantic efforts to avoid real or imagined abandonment. Pattern of unstable and intense relationships (splitting).These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute. Identity disturbance. Impulsivity in at least two areas that are potentially self-damaging. Recurrent suicidal behavior. Emotional lability. Chronic feelings of emptiness. Inappropriate/intense anger; difficulty controlling anger. Transient, stress-related paranoid ideation/dissociation.o Associated features. More commonly diagnosed in women. High comorbidity with other diagnoses. High utilizers of mental health care services. Pattern of undermining goals/achievements. Transient psychotic symptoms. May feel more secure with transitional objects (pets, inanimate possession) than people. Symptoms tend to ameliorate with time.o Theories of BPD. Genetics - 60% heritable. Emotional dysregulation.- Low levels of serotonin.- Increased activation of the amygdala. Impulsivity.- Low level of activity in the PFC.- Structural differences in PFC.o Environmental factors. Childhood abuse.- Physical, sexual, emotional.- Relationship to DID. Parenting style.- Inconsistent, inappropriate, and harsh parenting. Diathesis stress model.- Biological predisposition.- Emotional invalidation, abuse.- Cycle between suppression and explosions of emotion.o Treatment. Dialectical behavior therapy.- Designed to treat BPD.- Distress tolerance.- Reducing self-harm/suicidal behaviors.- Mindfulness and cognitive interventions.- Validation and acceptance.- Group and individual therapy.- Treatment team.- Narcissistic Personality Disorder:o Pattern of grandiosity, need for admiration, and lack of empathy. Grandiose sense of self-importance. Preoccupied with fantasies of success, brilliance, beauty, etc. Believes he/she is special and can only be understood by other high-status people. Requires excessive admiration. Has a sense of entitlement. Is interpersonally exploitative. Lacks empathy. Envious of others OR believes other are envious of them. Arrogant behaviors/attitudes.o Associated features. More commonly diagnosed in men. Highly sensitive to “injury” from criticism/defeat; may react vengefully. May function well in societies/industries that require self-confidence and assertiveness. Functioning may be impaired by unwillingness to take risks due to fears ofcriticism/defeat.o Theories. Self-psychology.- Narcissism masks fragile self-esteem.- Parenting styles – coldness and overemphasis on achievement. Social-cognitive.- Fragile self-esteem; ideas of being “special” help them cope.- Rely on others for sense of self – constantly seek admiration/praise.- Histrionic Personality Disorder:o Pattern of excessive emotionality and attention-seeking. Uncomfortable in situation where they are not the center of attention. Inappropriately sexual or provocative. Rapidly shifting and shallow emotions. Uses physical appearance to draw attention to self. Speech is excessively impressionistic/lacking detail. Self-dramatization, theatrically, exaggerated emotional expressions. Overly suggestible. Considers relationships to be more intimate than they are.o Associated features. More commonly diagnosed in women. Unconsciously act our roles. May be controlling or dependent to manipulate other. Need for novelty, stimulation. Comorbid with depression and somatic symptom


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WSU PSYCH 333 - Personality Disorder (cont)

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