Abnormal Final Study GuideChapter 9: Personality Disorders- DSM Axis II: more stable than axis I, more resistant to treatmento Ego-Dystonic-different (they are aware of something odd) o Ego-Syntonic-same (does not bother the person)- Personality: enduring traits that are fairly stable over time, make a person who he/she is- Personality Disorders: Enduring patterns of perceiving, relating to and thinking about theenvironment and oneself…o That are inflexible and pervasive across a broad range of personal and social situationso That cause significant distress or impairment in social, occupational, or other important areas of functioning- Onset: traced back to adolescence or early adulthood- Categorical Model Advantages: used by majorly of clinician so it is familiar and convenient (yes/no format)- Categorical Model Disadvantages: very high comorbid and overlap, it is not based on theoretical model, arbitrary boundary between normal and abnormal personality - Five Factor Model:o Openness to new experienceso Conscientiousness- persistent in pursuit of goals, organization, dependability o Extraversion- interest in interacting with other people, positive emotionso Agreeableness- willingness to corporate and empathize with others o Neuroticism- expression of negative emotions, emotional stability - Dimensional Model Advantages: retention of information, avoids arbitrary cut offs, addresses problems with comorbidity. - Dimensional Model Disadvantages: less familiar, lacks clinical application, may be too complex, disagreement exists between preferences of which dimensional model to use. - Culture plays a large role in determining what is abnormal 1. Cluster A- includes people who often appear odd/eccentric - Paranoid: distrust and suspiciousness of others o Treatment: Establish a trusting atmosphere Challenge irrational thoughts Clinician should try to be optimistic- Schizoid: detachment from social relationships, and restricted range of expression o Treatment: Focus on social skills- Schizotypal: discomforts with close relationships, congenic and perceptual distortso Treatment: Antipsychotic medications (at lower doses) Similar to schizophrenia, use CBT, social skills training, family therapy- Etiology:o Neurological Factors: Risk factors are similar to those in schizophrenia (e.g., genetics and prenatal environment)o Psychological Factors: Cognitive deficits, such as impaired theory of mind in schizotypal PD: difficulty recognizing emotions in otherso Social Factors: Childhood abuse/neglect, which leads to insecure attachment styles2. Cluster B- includes people who often appear dramatic- Antisocial: disregard for and frequent violation of other rightso Antisocial vs. Psychopathic Psychopathic-focuses more on personality traits and behaviors- Personality traits: interpersonal (superficial charm) affective (lack of remorse) - Social deviance: Lifestyle (need for stimulation) antisocial (early behavioral problems)  Antisocial- focuses more on observable behavior o Etiology: Hypothesis 1: Emotional deficits- They lack fear & anxiety, so they can ignore the effects of punishment  Hypothesis 2: Impulsivity- They have trouble shifting their attention toconsider the negative consequences of their behavior- Borderline: instability of interpersonal relationship and self-image and emotionso 75% women o Dialectics: Refers to synthesizing opposing elements. For example, accepting your current situation while at the same time recognizing that in order to feelbetter, change must occur- Histrionic: excessive emotionality and attention seeking- Narcissistic: need for admiration, lack of empathy o Grandiose Narcissism- Characterized by inflated self-esteem, exhibitionismo Vulnerable Narcissism- Characterized by feelings of insecurity, Associated with, depression and reactive aggression, More likely to show up for treatment voluntarily3. Cluster C- includes people who appear anxious or fearful- Avoidant: social inhibition, hypersensitive to negative evaluation, patients avoid social situations- Dependent: excessive need to be taken care of, submissive or clingy, patients avoid making decisions/having responsibilities- Obsessive-Compulsive: preoccupied with orderliness and perfectionism at the expense of flexibility, patients avoid making mistakes/ experiencing strong emotions- Neurological factors- The anxiety that characterizes the 3 disorders indicates that theamygdala might be involved (but this is just speculation)- Psychological factors- Temperament: high in harm avoidanceChapter 13: SchizophreniaSymptoms:- Positive symptoms:o Delusions- rigidly held beliefs that are inaccurate or inconsistent with realityo Hallucination-most common is auditory and they strike the patient as being real- Negative symptoms:o Anhedonia- inability to experience pleasure o Blunted/flat affect- fail to exhibit signs of emotions/feelingso Alogia- impoverished thinking (speechless)o Avolition- lack of will - Disorganized:o Disorganized speech- tangential speech, very difficult to follow o Disorganized behavior- child-like silliness or unpredictable agitation o Catatonic posturing- unnatural postures, facial expressions, or body movementCriteria for Schizophrenia: duration of entire disorder must be at least 6 months. - Prodromal phase- marked by obvious deterioration in the role of functioning as a student, employee, or homemaker. Change in personality.o Outburst of anger, increased tension, restlessness o Social withdrawal, indecisiveness, lack of will power o Negative symptoms become more stable - Active Phase- At least 1 month. Hallucinations, delusions, and disorganized speech are symptoms- Residual Phase- signs and symptoms that are similar in many respects to those seen in prodromal. Most dramatic symptoms of psychosis have improved. Only negative symptomsSchizophrenia Subtypes:- Paranoid- one or more delusions or frequent hallucinations- Disorganized- disorganized speech and behavior, flat/inappropriate affect - Catatonic- Undifferentiated- does not fit any other subtypes- Residual- reduced symptoms in criterion a or presence of negative symptoms Different types: - Mood Disorder with Psychotic symptoms- which symptoms are strongero Schizophrenia with mood symptoms Duration of mood symptoms are brief in relation to the duration of active and residual schizophrenia symptomso Mood disorder with psychotic