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Personality Disorders, (2. Borderline Personality Disorder (BPD): is a…
Personality Disorders
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Cluster B Personality Disorders (dramatic, emotional, or erratic behaviors)
1. Antisocial Personality Disorder: a pattern of disregard for the violation of rights of others that has occurred since age 15 and involves at least 3 charct. sxs:
- failure to conform to social norms with respect to lawful behavior
- deceitfulness
- impulsivity
- irritability and aggressiveness
- reckless disregard for safety of self/others
- consistent irresponsibility
- lack of remorse
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2. Borderline Personality Disorder (BPD): is a pervasive pattern of instability in interpersonal relationships, self-image, and affect, and marked impulsivity that began by early adulthood and is apparent in multiple contexts.
BPD: Needs at least 5 characteristics:
- frantic efforts to avoid abandonment
- pattern of unstable, intense interpersonal relationships that are marked by fluctuations btw idealization and devaluation
- an identity disturbance involving a persistent instability in self image or sense of self
- impulsivity in at least two areas that are potentially self damaging (sex, substance abuse)
- recurrent suicide threats or gestures
- affective instability
7.chronic feelings of emptiness, inappropriate intense anger or diff. controlling anger.
- transient stress-related paranoid ideation or severe dissociative symptoms.
Onset/course: Ages 19-34 most common to have BPD, age 40 75% no longer meet criteria
affective symptoms are the most chronic
Etiology: Adolph Stern: proposes that BPD is secondary to narcissim which resulted in early disturnbance in mother child relationship.
Object relations theories: due to mother child relationship
Mahler says it's due to fixation in the rapprochement phase of separation individuation- fear of abandonment as well.
Kernbergs: due to adverse, unpredictable caregiver-child interactions that alternate between rejection and smothering. This produces a insecure ego and relies on primitive defense mechanisms, especially splitting- all good or all bad view.
Linehan's biosocial model says due to interaction between biological and enviornmental factors. They have emotional dysregualtion which leads to excessive emotional vulnerability-- enviornment is constantly labeling them as incorrect or inappropriate.
TX: Dialectical Behavior Therapy (DBT)(Linehan's): combines CBT with Rogerian assumptions of acceptance.
3 basic strategies:
a) group skills training to help clients regulate their emotions and improve their social and coping skills.
b) individual outpatient therapy to strengthen clients' motivation AND newly acquired skills
c) telephone consultations to provide additional support and between sessions "coaching"
3. Histrionic Personality Disorder: Pervasive pattern of emotionality and attention seeking. Need at least 5 characteristics sx present:
- discomfort when not the center of attention
- inappropriately sexually seductive or provacative
- rapidly shifting and shallow emotions
- consistent use of physical apperance to gain attention
- excessively imperssionistic that is lacking details
- exaggerated expressions of emotion
- easily influenced by others
- considers relationships more intimate then they are.
4. Narcissistic Personality Disorder: [pattern ]of grandiosity, a need for admiration, and lack of empathy as indicated by at least 5 of the following sxs:
- grandiose sense of self-importance
- preoccupied with fantasies of unlimited success, power, beauty and love.
- believes he is unique and can be understood only by other high status people
- requires excessive admiration
- has a sense of entitlement
- is interpersonally exploitative
- lacks empathy
- envious of others or believes others are envious of them
- exhibits arrogant behaviors and attitudes
patter of bx began in early adulthood and is apparent in various contexts.