-
Phases
- Prodromal (gradual deterioration)
- Active (symptoms erupt), Residual
-
Prognosis related to length of prodromal phrases
the shorter- the better is the prognosis, age of onset, and more
-
Positive Symptoms:
- Hallucination, delusions,
- etc- excesses
-
Negative Symptoms
Alogia (?) , avolition, flat affect, anhedonia
-
Dimensions
- Positive, Negative,
- Disorganized
-
Personality Disorders
Long-lasting, maladaptive, inflexible patterns of inner experience and behavior, manifested in 2 of 4 areas: - Cognition, affect interpersonal, impulse control. Comorbidity with alcohol and drug abuse.
-
Difficulties in Diagnosis
- Symptoms Overlap and Comorbidity (more than one Personality Disorder
- -As separate clinical category or variation over normal behavior
- -“PD Not Otherwise Specified” is the most common diagnosis
- -
-
3 Clusters
- -CLUSTER A – The Eccentric
- Ones
- -Paranoid Personality
- -Schizoid Personality
- - Schizotypal Personality
- -CLUSTER B – The Dramatic
- Ones
- -Antisocial personality disorder
- -Borderline Personality Disorder
- -Histrionic Personality Disorder
- -Narcissistic Personality Disorder
- -CLUSTER C – The Anxious
- Ones
- -Anxiety-related personality Disorders
- -Avoidant
- -Dependent
- -Obsessive-compulsive personality disorder
-
Psychopath personality type:
- - Lack of remorse for shameful and cruel acts
- -Poor Judgment
- - Egocentricity
- -Inability to learn from experience
- -Lack of emotional responsiveness to others
-
Anti social
(Cluster B)
- A personality disorder characterized by a lack
- of regard for society's moral or legal standards-
- - Childhood: Reflected in Conduct Disorder in children, expressed in cruelty to animals, vandalism, violence toward others.
- -Maturation Hypothesis: suggesting a reduction in antisocial behavior toward middle age.
-
Borderline
(Cluster B)
- -A personality disorder characterized by pervasive instability with a pattern of poor impulse control.
- -Instability is evident in mood, interpersonal
- relationships, and self-image.
- -Often sufferers are confused about their own identity or concept of who they are.
- - thought to be in between psychosis and neurosis.
- -Note “splitting”, parasuicide, chronic boredom, intense anger, fear of being abandoned, and
- stimulation-seeking.
-
Histrionic
(Cluster B)
- -A personality disorder characterized by exaggerated emotional reactions,
- approaching theatricality, in everyday behavior. Melodramatic.
-
Narcissistic
(Cluster B)
-Personality disorder characterized by an unrealistic, inflated sense of self-importance and lack of sensitivity to other people’s needs:
-
Psychological Perspective
-abnormal patterns of learning and attention; failing to show normal response of anxiety (note Lykken and the “fearlessness” hypothesis, may be related to cortical under-arousal (explains why they can pass the lie detector)
-
Response modulation hypothesis
proposing that psychopaths are not able to process any information that is not relevant to their primary goal.
-
Sociocultural factors
Note summary of Lykken of the relationship of the antisocial to childhood abuse-(p. 318). Lykken concludes that the parents of the antisocial are themselves psychopaths (that is- the environment reflects the genetic factor).
-
Theories about Causes of Borderline
(Cluster B)
- -The Biopsychosocial model—vulnerable
- temperament (genetic), early trauma, and current life event that elicits stress.
- -Biological correlates, such as neurotransmitter dysregulation.
- - Hypothesis: sexual abuse in childhood
- may make the sympathetic nervous system (the one that reacts to stress)
- pathways hypersensitive to stress. Note that abuse occurs within the context of
- dysfunctional family, making it difficult to tease apart the genetic vs. environmental factors (that is- the abusive parents themselves display psychopathology).
-
Histrionic: Excessive
emotionality and attention-seeking; shallow emotions
Narcissistic:
Self-love, egocentricity, grandiosity; sense of entitlement
Paranoid: extreme suspicion and
guardedness; bears grudges; reads malevolent meaning in innocent comments
-
Schizotypal
(Cluster A)
- -Schizotypal: Regarded as a dormant form
- of schizophrenia, along the
- spectrum”
- -Bizarre behavior; magical thinking, beliefs in telepathy, depersonalization
- -Note biological similarities to schizophrenia- enlarged ventricles;
- -First-degree relatives with
- schizophrenia
-
Schizoid
(Cluster A)
- -Schizophrenia-like qualities.
- -Regarded within the schizophrenia .
- spectrum.
- -Limited range of emotional experiences
- and expressions.
- -Indifference to social and sexual relationships.
- -Note clinical picture. Note risk factor of prenatal nutritional deficiency.
-
Avoidant (from cluster C)
- -desires closeness but is
- extremely sensitive to possible rejection. Seems to be a more severe form of
- social phobia. Differs from the schizoid who does not seek social connections.
-
Dependent (Cluster C)
- cannot make their own
- decisions, cling to others. Feel despondent and abandoned of not taken care
- of. Note symptoms. Good response
- to treatment.
-
Obsessive-compulsive personality disorder
(Cluster C)
- This condition is different
- from OCD- that we discussed within the anxiety disorders. This condition does
- not have specific obsessions or compulsive acts, but rather a rigid, inflexible
- style of relating to the world, accompanied by a tendency toward perfectionism
- and orderliness.
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