PSYCH 333 1nd Edition Lecture 21 Outline of Last Lecture I What is Personality II Personality Disorder III Cluster A Odd Eccentric IV Cluster B Dramatic Emotional Outline of Current Lecture II Theories of ASAP cont III Treatment of Antisocial PD IV Borderline Personality Disorder V Narcissistic Personality Disorder VI Histrionic Personality Disorder Current 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 to exploit 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 o o o o 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 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 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 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 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 highstatus 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 of criticism 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 disorder