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CLUSTER A (odd, eccentric, distrust, suspiciousness, social detachment),…
CLUSTER A (odd, eccentric, distrust, suspiciousness, social detachment)
PARANOID
characteristics
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also suspicions, without justification, regarding fidelity of spouse
not usually psychotic: most of the time in clear contact w/ reality; BUT during periods of high stress may experience transient psychotic symptoms (few mins - few hrs)
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SHIZOID
characteristics
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loners, introverts, solitary interests/occupations
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a general apathetic mood, indifferent to praise or criticism of others (no lows, no highs)
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5 factor model
extremely high levels of introversion (low on warmth, gregariousness, and positive emotions
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SHIZOTHPAL
characteristics
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cognitive and perceptual distortions (but contact w/ reality is usually maintained, except under extreme stress), superstitious thinking, belief in magical powers, ideas of reference, odd speech, paranoid beliefs....
prevalence
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liability for shizophrenia (deficits in cognitive functioning, deficits in working memory, attention) -- high levels of distractibility and difficulty staying focused
5 factor model
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other aspects, like cognitive and perceptual distortions, are not adequately explained by the model (better explained by the trait of psychoticism - unusual beliefs and experiences, eccentricity, and cognitive and perceptual dysregulation
treatment
antipsychotics (modest), antidepressants (modest); nothing is a 'cure' yet :(
PSYCHOPATHY
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highly heritable, poor conditioning of fear, abnormalities in selective attention (single-minded pursuit of the goal), general emotional deficits, early parental loss, parental rejection, inconsistency
treatment: using their abilities to get their needs met in more prosocial ways, no biological treatments, CBT (greatest promise; modest changes that do not generalize to real world circumstances), cognitive remediaton
CLUSTER B (dramatic, emotional, erratic)
HISTRIONIC
characteristics
self-dramatization, overconcern with attractiveness
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appearance and behavior are quite theatrical, emotional, and sexually provocative (attempting manipulation through seductive behavior and emotional manipulation)
reactive, shallow, insincere, self-centered, vain
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5 factor model
very high levels of extraversion (gregariousness, excitement seeking, positive emotions)
high levels of neuroticism (depression, self-consciousness)
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NARCISSISTIC
characteristics
grandiosity, preoccupation with receiving attention
self-promoting, self-importance
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two types
grandiose
extreme grandiosity, aggression, dominance
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sense of entitlement, easily take offense
vulnerable
very fragile and unstable sense of self-esteem; arrogance is a facade for intense shame an hypersensitivity to rejection and criticism
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5 factor model
both: high levels of interpersonal antagonism / low agreeableness, low altruism, lack of empathy
grandiose: low on neuroticism, high on extraversion
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BORDERLINE
characteristics
impulsiveness, inappropriate anger; erratic, self-destructive behavior
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affective instability (drastic and rapid emotional shifts), highly unstable self-image (chronic feelings of emptiness, difficulty forming a sense of who they are)
fearful of abandonment -- unstable, stormy interpersonal relationships
cognitive symptoms; short out of touch with reality episodes, hallucinations, paranoid ideas, severe dissociative symptoms (present at times of stress, but at other times too)
prevalence
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comorbidity: mood, anxiety, substance abuse, other personality
super heritable, runs in families
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treatments
challenging for therapists: overwhelmed by the intense emotions, difficulty forming / maintaining boundaries
DBT (dialectical behavior therapy) -- encouraging patients to accept this negative affect without engaging in self-destructive or maladaptive behaviors, increasing coping skills (effective, not more than regular treatments)
transference-focused psychotherapy -- stregthening the weak ego, focus on primitive defense mechanisms (as effective as DBT which s more established)
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antidepressants (not very effective, good when there is a comorbid depressive disorder), antipsychotics and mood stabilizers (short-term reduction of symptoms)
ANTISOCIAL
characteristics
lack of moral or ethical development; failure to conform to social norms with respect to lawful behaviors
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deceitfulness, shameless manipulation of others, lying, conning for personal profit or pleasure; lack of remorse
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irritability, aggressiveness
prevalence
1% females, 3% males point; males > females
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CLUSTER C (anxiety, fearfulness)
DEPENDENT
characteristics
difficulty in separating in relationships, discomfort at being alone
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lack of self-confidence in judgement or abilities, feeling uncomfortable or helpless when alone (exaggerated fears of being unable to care for themselves)
prevalence
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comorbidity: mood, anxiety, eating, and somatic symptom disorders, also other personality disorders
difference between borderline & dependent: borderline = intense, stormy relationships (feelings of rage or emptiness when abandonment occurs); dependent = submissiveness and appeasement, urgent seeking of new relationship
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AVOIDANT
characteristics
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shyness, insecurity in social interaction and initiating relationships
fear of criticism, disapproval -- limited social relationships, extreme social inhibition and introversion
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wants interpersonal contact but is shy, insecure, and hypersensitive to criticism (unlike shizoid)
less clear distinction w/ social anxiety disorder :/, somewhat higher levels of dysfunction and distress, more feelings of low self-esteem
prevalence
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moderately heritable (partially shared w/ social anxiety disorder), 'inhibited' child
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OBSESSIVE-COMPULSIVE
characteristics
excessive concern w/ order, rules, and trivial details, perfectionistic
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often use their time poorly - never finishing what they started, perfectionism is dysfunctional
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