FSU CLP 4143 - Chapter 9: Personality Disorders

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ABP Test 4 Chapter 9 Personality Disorders Diagnosis Wednesday April 8 2015 Cluster A Paranoid Schizoid and Schizotypical Personality Schizotypical Personality Disorder Centers around peculiar behaviors Cluster B Antisocial Borderline Histrionic and Narcissistic Personality Disorders Antisocial Personality Disorder Persistent pattern of irresponsible and antisocial behavior that begins during childhood or adolescence Impulsive and reckless Lack conscience Borderline Personality Disorder Pervasive pattern in instability in mood and interpersonal relationships Find it very dif cult to be alone Rapid mood shifts Anger identity disturbances Histrionic Personality Disorder Pervasive pattern of emotionality and attention seeking behavior Emotionally shallow Tendency of inappropriate exaggeration Manipulative Narcissistic Personality Disorder Pervasive pattern of grandiosity need for admiration and inability to empathize with others 1 Wednesday April 8 2015 Greatly exaggerated send of self importance A Dimensional Perspective on Personality Disorders DSM 5 follows a dimensional model for diagnosis a two part process Clinician to make judgement based on identity and self direction empathy Using rating of pathological personality traits Frequency Prevalence in Community and Clinical Samples The overall lifetime prevalence for having at least one personality disorder is Highest prevalence rates for OCPD ASP and avoidant personality disorder is Low rates less than 1 for narcissistic personality disorder may suggest that those suffering do not recognize the nature of their own problems approximately 10 3 4 Gender Differences and women The overall prevalence of personality disorders is approximately equal in men Antisocial personality disorder 5 reported for men 2 for women Paranoid and obsessive compulsive personality disorder may be more common among men than women Stability of Personality Disorders over Time People with these diagnoses are likely to remain socially isolated and occupationally impaired Schizotypical Personality Disorder Treatment Ego syntonics patients don t see their problems as problems nature of personality disorders Do not tend to seek treatment Prematurely terminate from treatment 2 Ego dystonic patient is distressed by his own symptoms Borderline Personality Disorder One of the most perplexing most disabling and most frequently treated forms of Wednesday April 8 2015 personality disorder Otto Kernberg 1967 1975 BPD refers to a set of personality features or de ciencies that can be found in individuals with various disorders Features Splitting Causes Treatment Alternately seeing people as entirely good or entirely bad Paranoid schizoid cyclothymic and impulse control Genetic Parental loss neglect and mistreatment during childhood Fonagy Bateman BPD conditions are the most dif cult to treat Between 1 2 2 3 of all patients with BPD discontinue treatment prematurely Psychopaths burn out when they reach 40 or 45 years of age Older psychopaths nd new outlets for aggression impulsive behavior and They don t want structure Antisocial Personality Disorder Terrie Mof tt disregard for others Causes Biological factors Adoption studies 3 Highest rates of antisocial behavior determined by an interaction between genetic factors and adverse environment Wednesday April 8 2015 Psychological factors Investigations have attempted to explain several characteristic features of psychopathology such as lack of anxiety impulsivity and failure to learn from experience Chapter 15 Intellectual Disabilities and Autism Spectrum Disorders Autism is a more familiar term than ASD DSM 5 uses ASD to refer to a range of conditions Includes autism and Asperger s disorder Intellectual Disabilities and Autism are both initially a shock to parents Symptoms of Intellectual Disabilities DSM 5 dropped the term mental retardation in favor of intellectual disability so did the law Three criteria for de ning intellectual disability De cits in intellectual functions De cits in adaptive behavior Onset before age 18 Measuring Intelligence Commonly used intelligence tests Wechsler Intelligence Scale for Children fourth edition WISC IV Wechsler Adult Intelligence Scare fourth edition WAIS IV ID is de ned differently in more industrialized countries than in less industrialized countries IQ score of 70 or below is cutoff for an intellectual disability 100 is average SD is 15 4 Approximately two standard deviations below average meaning 2 of populations would wall below this Wednesday April 8 2015 Controversies of IT backgrounds Culture fair tests contain material equally familiar to people from diverse Intelligence is more than just a score How well intelligence is measure among people with intellectual disabilities Diagnosis Early Efforts The creation of IQ tests helped to prove intellectual disabilities Early efforts included dividing mental age by chronological age to compute IQ There has always been some controversy about the IQ cutoff score Cutoff changed to 1 SD in 1959 than back Contemporary Diagnosis DSM 5 divides intellectual disabilities into four levels based on IQ scores Mild Moderate Severe need close supervision for community living over a long period 20 25 to 35 40 Profound Below 20 25 Biological Factors almost 50 of ID s can be attributed to this Chromosomal Disorders Most commonly known cause of MR is the chromosomal disorder Down Syndrome Trisomy 21 Children with Down Syndrome have 47 chromosome rather than the normal 47 Fragile X syndrome 5 Wednesday April 8 2015 Abnormality of the X chromosome Most common genetic cause of intellectual disability Genetic Disorders PKU Infectious Diseases Syphilis Genital Herpes can cause intellectual disability in children when it is transmitted from the mother to the child during delivery Encephalitis results from infection of the brain Meningitis Toxins Alcohol Mercury poisoning Lead poisoning Other Biological Abnormalities Fetal alcohol syndrome FAS mild intellectual disability and learning disabilities associated with FAS Chapter 16 Psychological Disorders of Children Developmental psychology approach essential to disorders of childhood Children change rapidly during the rst 18 years of life Provides norms that can be used to determine whether behavior is abnormal Two long established and widely recognized dimensions of psychological problems in children Externalizing disorders Create dif culties in child s external world 6 Wednesday April 8 2015 Few children or


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FSU CLP 4143 - Chapter 9: Personality Disorders

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