PSYCH 333 1nd Edition Lecture 22 Outline of Last Lecture I Theories of ASAP cont II Treatment of Antisocial PD III Borderline Personality Disorder IV Narcissistic Personality Disorder V Histrionic Personality Disorder Outline of Current Lecture II Theories of Histrionic PD III Cluster C Anxious Fearful Personality Disorder IV General Approach to Treatment V Neurodevelopmental Disorders VI ADHD Current Lecture Theories of Histrionic PD o Psychoanalytic theories Parental seductiveness o Being center of attention to cope with low self esteem Needs attention from others to feel valued Cluster C Anxious Fearful Personality Disorder o Avoidant personality disorder Pattern of social inhibition feelings of inadequacy and hypersensitivity to negative evaluation Avoids occupational activities that involve interpersonal contact for fear of criticism Unwilling to get involved with people unless certain of being liked Shows restraint within intimate relationships for fear of being shamed ridiculed Preoccupied with being criticized or rejected in social situations Inhibited in new interpersonal situation due to feelings of inadequacy Views self as socially inept of inferior Unusually reluctant to try new activities for fear of embarrassing self 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 Associated features Overly vigilant hypersensitive to others reactions especially nonverbal cues Fearful of anxious response blushing crying Desire relationships may fantasize about ideal relationships Theories Genetics o Heritability between 27 35 o Overlap with genetic vulnerability for social anxiety Little is known because individual with this disorder are reluctant to be interviewed o Dependent personality disorder Pervasive and excessive need to be taken care of that leads to submissive clinging behaviors and fears of separation Difficulty making everyday decisions without advice and reassurance from others Needs others to assume responsibility for most major areas of life Difficulty expressing disagreement for fear of loss of support or approval Difficulty initiating or doing things on own due to lack of selfconfidence Goesto excessive lengths to obtain nurturance and support from others Feels uncomfortable helpless when alone due to fears of being unable to care for self Urgently seeks out a new relationship when one source of support ends Unrealistically preoccupied with being left alone to care for self Associated features Pessimistic self doubt and low self esteem Often belittle their abilities use self deprecating humor Perceive criticism or disapproval as proof of their worthlessness Theories Parenting styles o Overprotective authoritarian o Insecure attachment anxious Genetics o Seems to have some genetic contribution but exact heritability us unknown o Obsessive Compulsive personality disorder Pattern of preoccupation with orderliness perfectionism and mental and interpersonal control at the expense of flexibility openness and efficiency Preoccupied with details rules lists organization to the extent that the point of the activity is lost Perfectionism that interferes with task completion Excessive devotion to work Inflexible about moral ethics and values Difficulty discarding worthless items Reluctance to delegate to others due to concerns that others will not meet their standards Miserliness Rigidity and stubbornness Associated features When rules cannot dictate correct answer decision making is time consuming Show anger get upset if they cannot control a situation Show affection in an overly controlled or stylized manner Overly preoccupied with logic and intellect Uncomfortable around emotionally expressive people Theories of OCPD Little is known regarding etiology of OCPD Genetics o Conflicting evidence for genetic vulnerability associated with OCD Cognitive o View defects flaws and or disorder as intolerable General Approach to Treatment o Understand how early childhood experiences may have shaped personality o Cognitive therapy focusing on areas of rigidity E g suspicious thoughts in paranoid PD o Behavioral interventions Exposure for more fearful responses Social skills training Behavioral experiences Neurodevelopmental Disorders Neurodevelopmental Disorders o Deficits early in developmental period o Wide range cognitive social academic occupational o Vary from very specific to general o DSM 5 Neurodevelopmental disorders Attention Deficit Hypersensitivity Disorder ADHD Autism Spectrum Disorder Intellectual Disability Specific Learning Disorder ADHD o Persistent pattern of inattention and or hyperactivity impulsivity o 6 symptoms of inattention AND OR o 6 symptoms of hyperactivity impulsivity o Symptoms present prior to age 12 o Symptoms present in multiple settings o Specify which symptoms are predominant inattention hyperactivity impulsivity or both o Inattention Careless mistakes errors lack of attention to detail Difficulty sustaining attention in tasks play activities Does not seem to listen when spoken to Does not follow through on instructions fails to finish activities projects Difficulty organizing tasks activities Avoids dislikes is reluctant to engage in tasks that require sustained attention Loses important things Easily distracted be extraneous stimuli Forgetful in daily activities o Hyperactivity impulsivity Fidgets squirms in seat Often gets out of seat when being seated in expected Runs about climbs on things during inappropriate times Unable to play quietly Always on the go acts as if driven by a motor Talks excessively Blurts out answer before questions are completed Difficulty waiting their turn Interrupts intrudes on others o Associated features More commonly diagnosed in boys Girls are more likely to have the predominantly inattentive type Low frustration tolerance Novelty seeking Irritability mood lability Difficulty with peer relationships Poor academic performance despite adequate intelligence Comorbid with depression anxiety conduct disorder substance use Symptoms tend to get better overtime especially hyperactive impulsive symptoms o Biological theories Genetics Runs in families higher concordance rates in MZ twins than DZ twins Dopamine genes have been implicated Neurobiological Lower frontal lobe activation Irregularities in the basal ganglia Treatment Stimulant medications o Amphetamines and amphetamine derivatives E g Ritalin Adderall concerta