Chapter 9 Personality Disorders Diagnosis 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 Borderline Personality Disorder Pervasive pattern in instability in mood and interpersonal relationships Histrionic Personality Disorder Pervasive pattern of emotionality and attention seeking behavior Narcissistic Personality Disorder Pervasive pattern of grandiosity need for admiration and inability to empathize with others 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 Prevalence in Community and Clinical Samples The overall lifetime prevalence for having at least one personality disorder is Frequency approximately 10 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 Schizotypical Personality Disorder Treatment Ego syntonics patients don t see their problems as problems nature of personality disorders Ego dystonic patient is distressed by his own symptoms Otto Kernberg 1967 1975 BPD refers to a set of personality features or de ciencies that can be found in individuals with various disorders Genetic Parental loss neglect and mistreatment during childhood Fonagy Bateman Causes Treatment BPD conditions are the most dif cult to treat 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 Measuring Intelligence 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 Approximately two standard deviations below average meaning 2 of populations would wall below this 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 Early Efforts The creation of IQ tests helped to prove intellectual disabilities Early efforts included dividing mental age by chronological age to compute IQ 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 Fragile X syndrome Abnormality of the X chromosome Most common genetic cause of intellectual disability Genetic Disorders PKU 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 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 Externalizing disorders Few children or adolescence identify themselves as having an externalizing disorder Identi ed by engaging in serious misconduct Exernalizing problems that begin before adolescence are most likely to persist into adult like Many of these are characterized by violations of age appropriate social rules Most notable in classrooms Relational Aggression Girls are more likely to engage in this actions designed to hurt others in subtle ways such as put downs gossip social exclusion Frequency of Externalizing Disorders 9 5 had a lifetime diagnosis of ADHD 6 family predictors Callousesness can be a predictor of ASD low income overcrowding in home maternal depression paternal antisocial behavior con ict between parents removal of the child from home Dif cult temperament during infancy toddlerhood predicts later development of externalizing disorders Shaping children s behaviors and attitudes to conform with societal Children with serious conduct problems often have neglectful parents Occurs when positively reinforcing a child s misbehavior by giving in to Temperament Social Factors expectations Parenting styles Coercion child s demands Negative Attention Inconsistency The idea that a punishment sometimes may actually reinforce misbehavior Involves frequent changes in the style and standards of one or more parents Inconsistent rules and expectations from them Low Self Esteem Children with ED tend to overestimate their competence Delay of grati cation Children with ED tend to opt for immediate roles Are Psychostimulants Overused Every year 2 7 million children in the US almost 4 8 of the school age population are treated for ADHD with psychostimulants Behavioral Family Therapy for ODD Treatment teaches parents to be very clear and speci c about their expectations Internalizing disorders Affect child s internal world Separation Anxiety Disorder and School Refusal Troubled Peer Relationships Anxiety and Depressive Disorder Frequency Anxiety disorders may occur among in as many adolescents as 31 9 of all young people A child with excessive anxiety may be diagnosed with internalizing disorder Suicide Third leading cause of death among teenagers Cluster suicide can also occur
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