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PSYC 430
Exam 2 material
Physical, Medical, Mental and Problems.
- Diagnosed and coded as Mild, Moderate and Severe
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Healthy paranoia, paranoid personality disorder, paranoid disorder, paranoid
schizophrenia
Personality Disorders
- People with a personality disorder have very rigid personality traits and outward
behavior, they do not learn with experience
- They often experience psychological pain and social or occupational problems
- These disorders usually become apparent in adolescence or early adulthood. Rarely
develop in middle adults or senior adults
- Personality disorders can be assessed using the (PAI) Personality Assessment Inventory
CLUSTER A: Odd Personality Disorders.
- Paranoid Personality Disorder
- Schizoid personality disorder
- Schizotypal Personality Disorder
Paranoid Personality Disorder: A personality disorder marked by a pattern of distrust and
suspiciousness of others without just cause”
- Typical Behaviors
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Distrust others motives
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avoid close relationships
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Extreme trust in their own abilities
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Belittle or threaten other
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critical of others
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sensitive to criticism
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Refuses to recognize their own mistakes
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Suspicious nature, and suspicious of others without just cause, self-reinforcing cycle.
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Looking for “hidden” meanings
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Hold grudges
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Blame others for things that go wrong
- Statistics:
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Between 0.5 & 3 percent of adults are believed to experience this disorder
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Men are more likely to have this disorder
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If not extreme, good job would be detective
- Possible Cause: there is no specific determined cause; however possible factors may
contribute
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Early experiences with demanding parents
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Mistreatment as child
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Lack of love
Schizoid Personality Disorder: “A personality disorder characterized by persistent avoidance of
social relationships and little expression of emotion”
- detachment from social activity
- Restricted emotions
- Not interested in romance
- Unresponsive to family
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- Holds jobs that require aa little or no social contact
- Focus on self
- Unaffected by praise
- Statistics:
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This disorder is estimated to be present in fewer than 1 percent of the population.
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It is slightly more likely to occur in men than in women
- Possible causes:
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There is no specific determined cause; however possible factors may contribute
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Unaccepting, non-consistent or abusive parents
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“Victims suffer from deficiencies in their thinking and perceptual skills
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Unable to pick up emotional signals from others.
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May have been “picked on”
Schizotypal Personality Disorder: the eccentric personality: “ A personality disorder
characterized by odd forms if thinking perceiving, and behavioral eccentricities.”
- Typical behaviors
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Odd and eccentric in beliefs and actions
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Have strange religious, political, social ideas
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Have few close friends
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often dress or act in odd or eccentric ways
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Lonely, often drive others away
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Sometimes believe they have extrasensory abilities
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Some believe they have magical control over others
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Emotions- usually “inappropriate, flat or humorless”
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Difficulty focusing attention
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Choosing undemanding jobs
- Statistics
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2 to 4% of all people experience degrees of this disorder
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Slightly more males than females
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If intelligent and creative, they can become inventors, troubleshooters, ect; because
they think thoughts others do not
- What causes this?
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There is not specific cause; however possible factors may contribute
o Linked to family conflicts
o Psychological disorders in parents
o Defects in attention and short term memory
CLUSTER B:
Dramatic Personality Disorder
- Antisocial Personality Disorder
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The criminal personality” A personality disorder marked by general pattern of
disregard for and violation of other people’s rights”
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In extreme known as psychopath or sociopath
- typical behaviors
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Patterns of misbehavior before 15
o truancy
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o Running away
o Physical cruelty to people animals
o Destruction of property
o Fires
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Recklessness
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Self-centered
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Majority of prison populations have this personality disorder
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trouble w/relationships
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Impulsive
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Careless with money
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Irritable
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Aggressive
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Quick to fight
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Co-Morbidity
o Alcoholism
o Other substance related disorders
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Statistics
o 3.5 of people in the U.S meet the criteria for anti-social personality
disorder
o Four times more common among men than women
o Can be good in situations where aggression is more acceptable – war,
natural disasters, ect.
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Possible Causes
o Absence of parental love during infancy and childhood; one or both
parents may have been criminals
o Lack of basic trust
o Antisocial symptoms may be learned through modeling as they often come
from families or neighborhoods where there is criminal activity
- Histrionic Personality Disorder
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center stage “personality disorder characterized by a pattern of excessive emotionally
and attention seeking
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Also known as Hysterical personality disorder
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Often makes good actors or other occupation in public life
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Typical Behaviors
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Emotional
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Seek to be the center of attention
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Exaggerated
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Rapid mood change
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Complicates life
- Borderline Personality Disorder: “An unstable sense of self “personality disorder
characterized by repeated instability in interpersonal relationships, self-image, and mood
and by impulsive behaviors”
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Very depressive
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Anxious
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Irritable
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Their emotions conflict with the world around them
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Bouts of anger
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Aggressive and violent
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Self-destructive
o Alcoholic and substance
o Unsafe sex
o Reckless driving
o Self-Mutilating behaviors
o Suicide threats
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- Narcissistic Personality Disorder: Personality marked by a broad pattern of grandiosity,
need for admiration, and lack of empathy.
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Typical behaviors
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Expect constant attention and admiration
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Aware of their own success, power, and beauty
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Truly think more highly of themselves than they should
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They have a sense of entitlement
Cluster C: Anxious Personality Disorder
Avoidant Personality disorder
- Uncomfortable and retrained in social settings
- overwhelmed by feelings on inadequacy
- Cannot take negative criticism
- Fearful of being rejected so they do not give anyone the chance to reject them
- few or no close friends
- Loyal, Responsible and hard working
Dependent Personality Disorder
- Relentless & disproportionate need to be taken care of that leads to submissive and
clinging behavior and an extreme fear of separation
- Having major difficulties making even small choices
- Will remain in an abusive relationship as long as it means that they have a relationship
Obsessive – Compulsive Personality Disorder
- Focused on order, perfection, and control
- They lose all flexibility in an attempt to do everything just right
- They set unreasonably high standards for themselves and others
- Tend to be rigid and stubborn
OCPD is ego-syntonic; agreeable to the ego
OCD is ego-dystonic; disagreeable to the ego
Impulse control disorders
- Pyromania: Impulsive setting of fires
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- kleptomania: Impulsive steaking or shoplifting, even when having money to pay for
items
- Intermittent Explosive Disorder: Impulsively aggressive with little provocation
- Trichotillomania: Impulsive pulling or plucking of one’s hairs
- NSSI: Non-social self-injury
- Self-Mutilation: cutting or may stick things under the skin
- Pathological Gambling
- Excoriation: skin picking disorder
Other personality types not in the current DSM:
- Passive-Aggressive personality
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Concept developed by the Military to describe the soldier who would not directly
disobey an older, but would not follow through with following or obeying it
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Often complain about anything or everything
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Hard time expressing direct disagreements or stating their needs
- Self-defeating personality
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Insecure, often sabotage themselves
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Own worst enemy
- Sadistic personality
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This person enjoys causing friction, division, in groups such as families and churches.
- Depressive personality (dysthymia, a mood disorder)
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To describe the person who is usually negative and always sees the glass half empty
What are anxiety disorders?
- The term anxiety disorder is a blanket term that covers several forms of abnormal
anxiety, fear, phobia and nervous conditions, some come suddenly and all interfere with
normal life.
Anxiety
- Psychodynamic Perspective
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Realistic Anxiety – Facing actual danger
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Neurotic Anxiety – repeatedly prevented
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Moral Anxiety – Punished or threatened when expressing ID
- Freudian Therapies:
1. free association
2. Transference interpretation
3. Resistance interpretation
4. Dream interpretation
- Explanations:
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High levels of anxiety as a child
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Over-protective parents prevent children from developing effective coping
- Object relational therapy
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Helps patients identify and resolve childhood relationship problems.
Humanistic Perspective
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- Anxiety disorders develop as a result of not looking at one’s self honestly and acceptingly
- This occurs when children fail to receive unconditional positive regard
- Child then develops conditions of worth
- Therapy: client centered therapy
Types of Anxiety Disorders
- Panic Disorder
- Agoraphobia
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Social phobia
- Specific or simple phobia
- Generalized anxiety disorder
- Obsessive compulsive disorder (OCD)
Anxiety- Fear
- Anxiety: an anxious state of being is anxiety normal, ever helpful.
- fear: fear or anxiety response to certain stimuli or certain situations
- Trait Anxiety: Relatively fixed state of anxiety
- State Anxiety: Anxiety response at certain times and or in response at certain times and or
in response to certain situations.
- Chronic Anxiety: When trait anxiety is high and maladaptive
- Acute Anxiety: when state anxiety is high and maladaptive
Anxiety Disorder Statistics
- Most common total category of mental disorder
- Yearly 5-10% of the population
- Lifetime prevalence 20-25%
- W to M ratio is 2/1
- Many people have more than one disorder
- In an anxiety disorder there are usually psychological symptoms
Differential Diagnosis:
- Distinguishing between different – similar types of symptoms
Generalized Anxiety Disorder
- Anxiety which is excessive, chronic, and typically interferes with a person’s ability to
function in their normal daily activities
- Free Floating Anxiety:
o associated with irregular levels of neurotransmitters in the brain
o Environmental stressors
o Childhood experiences
o Sleep inconsistency/deprivation
- Symptoms: nervousness, restlessness, hyper-vigilance, worry, irritability, lack of focus,
trouble sleeping, fatigue
- Treatment:
o Therapy: CBT, Interpersonal therapy, psychodynamic, relaxation, biofeedback,
spiritual, exercise, meditations, anti-anxiety drugs, muscle relaxers, sleep meds.
Phobias: Persistent and unreasonable fear of a particular object, activity and situation.
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- Many being in childhood
- Insects, animals, germs, illness, heights, flying, closed spaces.
Social Anxiety Disorder also called social phobia
- Most common: public speaking
- fear of opposite sex, fear of authority figures
- fear of being seen in public
Agoraphobia: The fear of these attacks can cause the person to avoid places and situations where
an attack has occurred or where they believe an attack may occur.
- Persistent fear of having a panic attack or future panic attacks
- Can happen with or without panic disorders
OCD:
- Obsessions: refers to intense worries, thoughts, worries, or images that are experienced as
intrusive and unwanted.
- Compulsions: behaviors that are done in an attempt to decrease the anxiety caused by
obsessive thoughts.
- Why?
1. Prevent something bad from happening
2. Undo the thought or feelings associated with an obsession;
3. Minimize or eliminate the anxiety caused by an obsessive thought
- Symptoms: Severe anxiety, unusual thinking patterns and depression
- Affects:
o These symptoms can affect any range of things. It becomes a disorder when such
symptoms start to affect a person’s daily activities. It can affect the person’s work
life, relationships, and even recreation activities If spiritual
o If spiritual in nature, can cause different affects that revolve around one’s religion or
spirituality
o People with OCD blame themselves for normal (although repetitive and intrusive)
thoughts and expect that terrible things will happen as a result
Stress, Coping and the Anxiety Response
- Stressor: events that creates demands/stress
- When we view a stressor as threatening, the natural reaction is arousal and fear
- Stress reaction, and the fear they produce, are often at play in psychological disorder
Stress and Psychological disorders
- Acute stress disorder
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Symptoms begin within the four weeks of event and last for less than one month
- PSTD
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Symptoms being either shortly after the event or months or years after and last a much
longer time.
- Fears are set in motion by the hypothalamus
Autonomic Nervous System
- Sympathetic: Produces initial fear/arousal responses by stimulating the organs directly
- Parasympathetic: brings the sympathetic nerve responses under control
Trauma reactions:
- During and immediately after trauma, we may temp experience levels of arousal, anxiety,
and depression.
- The precipitation event usually involves actual or threatened serious injury to self or
others
PSTD checklist:
1. Person is exposed to a traumatic event- death or threatened death, severe injury, or sexual
assault
2. Person experiences at least one of the following intrusive symptoms:
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Repeated, uncontrolled and distressing memories
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repeated and upsetting trauma linked dreams
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Dissociative experiences such as flashbacks
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Significantly upset when exposed to trauma-linked cues
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Pronounced physical reactions when reminded of event
3. Person continually avoids trauma linked stimuli
4. Person experiences negative changes in trauma-linked cognitions and moods, such as
being unable to remember key features of the events or experiencing repeated negative
emotions.
5. Person displays conscious changes in arousal and reactivity, such as excessive alertness,
extreme alert responses or sleep disturbances.
6. Person experiences significant distress or impairment, with symptoms lasting more than a
month
What triggers acute and posttraumatic stress disorders
- Combat and stress disorder
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Called “sell shock” or combat fatigue
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Post-Vietnam war clinicians discovered that soldiers also experience psychological
distress after combat
- As many as 29% of Vietnam combat veterans suffered acute PTSD
- Similar pattern is currently unfolding among Veterans of war in Afghanistan
Disasters and stress disorders
- Acute or PTSD may also follow natural and accidental disasters
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Types of disasters include earthquakes, floods, tornadoes, fires, airplane
crashes, and serious car accidents
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Because they occur more often, civilian traumas have been implicated in
stress disorders at least 10 times as often as combat traumas
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Traumas that are deliberately human caused are more traumatic than
human caused accidents and natural disasters
- Victimized and stress disorders
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people who have been abused or victimized often experience lingering stress
symptoms
- Terrorism and torture
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The experience of terrorism of the threat of terrorism often lead to PTSD, as does the
experience of torture
- Stockholm Syndrome
Combat Trauma takes the stand
- PTSD can sometimes be a factor in the commission of crimes
- How much should injuries and judges take a defendant’s PTSD into consideration
arriving at a verdict.
Why do people develop acute and PTSD?
o Biological and genetic factors
o Traumatic events trigger physical changes in the brain and body that may lead to severe
stress reactions and, in some cases, to stress disorders.
o Some research suggests abnormal neurotransmitter and hormone activity (especially
norepinephrine and cortisol)
o Evidence suggests that once a stress disorder sets in, further biochemical arousal and
damage may also occur (especially in the hippocampus and amygdala)
o There may be a biological/genetic predisposition to such reactions
Dissociative Disorders
- The key to our identity – the sense of who we are and where we fit in our environment –
our memory.
o Our recall of past experiences helps us to react to present events and guides us in
making decisions about the future
o People sometimes experience a major disruption of their memory
- When such changes in memory lack a clear physical cause, they are called dissociative
disorder.
o In such disorders, one part of the person’s memory typically seems to be dissociated,
or separated, from the rest.
Types of Dissociative Disorders
- Dissociative Amnesia
o people with Dissociative amnesia are unable to recall important information, usually
of an upsetting nature, about their lives.
o Loss of memory is much more extensive than normal forgetting and is not caused by
physical factors
o Often an episode of amnesia is directly triggered by a specific upsetting event.
o Localized – most common type: loss of memory events occurring within limited
period
o Selective: loss of memory for some, but not all, events occurring within a period.
o generalized: loss of memory beginning with an event, but extending back in time;
may lose sense of identity; may fail to recognize family and friends
o Continuous – forgetting continues into the future; quite rare remains intact
o Clinicians do not know how common
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- Dissociative fugue: people with Dissociative fugue not only forget their personal idenityt
and details of their past, but also flee to an entirely different location.
o For some, the fugue is brief – a matter of hours or days – and ends suddenly
o For others, the fugue is more severe: people may travel far from home, take a new
name and establish new relationships, and even a new line of work; some display new
personality characteristics
o When people are found before their fugue has ended, therapists may find it
necessary to continually remind them of their own identity
o The majority of people regain most or all of their memories and never have a
recurrence
- Dissociative identity (Multiple personality)
o A person with dissociative identity disorder develops two or more distinct
personalities each with a unique set of memories, behaviors, thoughts, and emotions.
o At any given time one of the subpersonalities dominates the personality
- Depersonalization decreolization disorder.
