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Showing posts with label dsm categories. Show all posts
Showing posts with label dsm categories. Show all posts

Monday, December 22, 2014

9 personality disorders: getting to the bottom of who and why - organized by 3 DSM clusters


Cluster A Personality Disorders

Paranoid Personality Disorder


Suspects, without sufficient basis, that others are exploiting or deceiving them.

Preoccupied with unjustified doubts about loyalty.

Is reluctant to confide in others because of unwarranted fear that the information will be used against him/her.

Persistently bears a grudge.

Perceives attacks on character that are not apparent to others.

Recurrent suspicions without justification regarding fidelity of a spouse or partner.

Schizoid Personality Disorder


Neither desires nor enjoys close relationships, including being part of a family.

Almost always chooses solitary activities.

Little, if any, interest in having sexual experiences with another person.

Takes pleasure in few, if any, activities.

Lacks close friends or confidants other than first- degree relatives.

Appears indifferent to praise and criticism.

Emotional coldness, detachment or flattened affect.

Schizotypal Personality Disorder


Ideas of reference (excluding delusions of reference).

Odd beliefs or magical thinking that influence behaviors and are consistent with cultural norms.

Unusual perceptual experiences, including bodily illusions. Odd thinking and speech.
Suspiciousness or paranoid ideation.
Inappropriate or constricted affect.

Behavior or appearance that is odd, eccentric.

Lack of close friends or confidants other than first-degree relatives.

Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments.

Cluster B Personality Disorders

Antisocial Personality Disorder


Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest.

Deceitfulness, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure.

Impulsivity or failure to plan ahead.

Irritability and aggressiveness, as indicated by repeated physical fights or assaults.

Reckless disregard for safety of self or others.

Consistent irresponsibility – i.e. lack of consistent work behavior or honoring financial obligations.

Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Borderline Personality Disorder


Frantic efforts to avoid real or imaginary abandonment.

A pattern of unstable and intense interpersonal relationships categorized by alternating between extremes of idealization and devaluation.

Identity disturbance: persistent and markedly disturbed, distorted, or unstable self-image or sense of self.

Impulsivity in at least two areas that are potentially self- damaging (spending, substance abuse, binge eating, etc.).

Recurrent suicidal behavior, gestures, or threats or self mutilating behavior.

Affective instability due to marked reactivity of mood. Chronic feelings of emptiness.
Inappropriate, intense anger or lack of control of anger.

Transient, stress related paranoid ideation or severe dissociative symptoms.

Histrionic Personality Disorder


Uncomfortable in situations in which he or she is not the center of attention.

Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.

Displays rapidly shifting and shallow expression of emotions.

Consistently uses physical appearance to draw attention to self.

Style of speech that is excessively impressionistic and lacking in detail.

Self-dramatization, theatricality, and exaggerated expression of emotion.

Suggestible, i.e., easily influenced by others or circumstances.

Considers relationships to be more intimate than they actually are.

Cluster C Personality Disorders

Avoidant Personality Disorder

Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection.

Is unwilling to get involved with people unless certain of being liked.

Restraint within intimate relationships due to the fear of being shamed or ridiculed.

Preoccupation with being criticized or rejected in social situations.

Inhibited in new interpersonal situations because of feelings of inadequacy.

Belief that one is socially inept, personally unappealing, or inferior to other.

Is usually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Dependent Personality Disorder


Is unable to make everyday decisions without an excessive amount of advice and reassurance from others.

Needs others to assume responsibility for most major areas of his or her life.

Has difficulty expressing disagreement with others because of fear of loss of support or approval.

Has difficulty initiating projects or doing things on his/her own due to lack of self confidence in judgment or ability

Goes to excessive lengths to obtain nurturance and support from others, to the point volunteering to do things that are unpleasant.

Feels uncomfortable or helpless when alone, because of exaggerated fears of being unable to care for oneself.

Urgently seeks another relationship as a source of care and support when a close relationship ends.

Unrealistic preoccupation with fears of being left to take care of himself or herself.

Obsessive-Compulsive Personality Disorder

Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

Perfectionism that interferes with task completion.

Excessive devotion to work and productivity to the exclusion of leisure activities and friendships.

Overconscientiousness, scrupulousness, and inflexibility about matters of morality, ethics, or values.

Inability to discard worn-out or worthless objects even when they have no sentimental value.

Reluctance to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

Adopts a miserly spending style toward both self and others. Rigidity and stubbornness.

82 facts about schizophrenia and other psychotic disorders: clinical diagnosis and differential assessment


Schizophrenia

POSITIVE SYMPTOMS

Thought disorder (delusions & hallucinations)

Disorganized speech or behavior

NEGATIVE SYMPTOMS

Flattened

Catatonic behavior (motor activity) - not moving, "frozen"

Emotional response lacking

Poverty of speech

Lack of initiative

Persistent inability to experience pleasure


Typical behavior of people with Schizophrenia


Often sees things, experiences sensations or hears voices that do not exist (hallucinations)

Persistently believe in fixed ideas despite proof that they are false (delusions)

Unable to think in a logical manner (thought disorder)

Lack will or motivation to complete a task or accomplish something

Function at much lower level than in the past at work, relationships or taking care of themselves

Develop symptoms of major depression or of mania along with other symptoms on this list

Have delusions involving real life situations, such as that they are being followed, poisoned, infected, loved from a distance, or deceived by a spouse.

Less common behavior of people with Schizophrenia


Talking in rambling, disconnected or incoherent ways

Make odd or purposeless movements; not talk or move at all

Repeat others’ words or mimic their gestures

Show few, if any feelings; respond with inappropriate emotions


5 Types of Schizophrenia

Disorganized Type (Hebrophrenic) Catatonic Type
Paranoid Type
Undifferentiated Type
Residual Type


Disorganized Type

Marked incoherence, lack of systemized delusions and blunted or silly affect.

Catatonic Type

Marked by stupor, negativism, rigidity, bizarre posturing, and excessive motor activity.

Paranoid Type

Marked by one or more systemized delusions, auditory hallucinations with a single theme, absence of incoherence, marked loosening of associations, flat or inappropriate affect, catatonic behavior, and grossly disorganized behavior

Undifferentiated Type

Marked by delusions, hallucinations, incoherence, and/or grossly disorganized behaviors. Diagnosed when symptoms don’t meet the criteria for one of the specific types.

Residual Type

Diagnosed when the individual is not currently displaying psychotic symptoms but has displayed these symptoms in the past and continues to exhibit residual symptoms – eccentric behavior, illogical thinking, or inappropriate affect

The Experience of Schizophrenia

Visual Experience

Heightened sensitivity to light and color

Loss of perspective of figures

Illusionary changes in faces and objects

Distortions in size

Auditory Experience


Heightened sensitivity to noise Hallucinations

Inability to screen out background noise

Distortions in voices Muting of sounds

Physical Experience


Heightened sensitivity to touch Tactile hallucinations

Inability to interpret internal sensations

Olfactory hallucinations

Cognitive Experience


Loose associations
Distractibility
Delusions
Fragmentation
Inability to filter out irrelevant data
Over stimulation of thoughts (flooding) Increased or decreased speed of thinking Idiosyncratic explanatory systems

Three phases of Schizophrenia

Prodromal or Residual Phases

Significant social isolation or withdrawal

Impairment in role functioning

Peculiar behavior

Blunted or inappropriate affect
Odd beliefs or magical thinking

Unusual perceptual experiences

Lack of initiative, interests or energy

Impaired hygiene/grooming Impaired speech


Interventions for people diagnosed with schizophrenia

First, establish a relationship by...

Respecting the client’s inner experiences

Making no suggestions of change.

Accepting client’s agenda.

Concrete and formal communication style.

Affirming strengths and sense of self.

Allowing maintenance of protective defenses.

After relationship has been established...

Education and advice Encouragement and praise.

Manipulate environment to strengthen competence.


Treating Schizophrenia:

adverse psychological effects of medication


Dependency issues

Normal ambivalence, issues of self-determination Negative self-image, inability to function without medication. Powerlessness.

Dependence on doctor or social worker.

Anger. Why me? "You've changed."
Social Stigma
Abdicate Self-Responsibility - playing the sick role. Unresponsible for behavior - problems with discrimination of can & can’t.

Flat out non-compliance and/or inappropriate activities.



Shared Psychotic Disorder

Disturbance that develops in a person who is influenced by someone else who has established delusion with similar content.


Brief Psychotic Disorders

Psychotic disturbance that lasts more than 1 day and remits within 1 month.


Schizoaffective Disorder

Disturbance in which a mood episode and the active phase symptoms of schizophrenia occur together.

Preceded or followed by at least 2 weeks of hallucinations or delusions without prominent mood symptoms.

Schizophreniform Disorder

Symptomatic presentation equivalent to schizophrenia, except for duration.

One to six months in duration.

Absence of the requirement of a decline in functioning.

Delusional Disorder

Many types of delusional disorder.

Eromantic, grandiose, jealous, persecutory, somatic (body/physical), mixed (combo).

Tend to have more ability to function "normally."

The false beliefs are not bizarre.

Saturday, November 6, 2010

Psychodiagnostic basics: DSM IV TR categories

  • Psychological Disorders – a harmful dysfunction in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable
  • DSM-IV – a widely used system for classifying psychological disorders; defines 17 major categories of ‘mental disorder,’ describes disorder and lists prevalence; no explanation of causes
  • Medical Perspective – psychological disorders or mental illnesses (psychopathology) can be diagnosed based on symptoms and then therapy is sought to cure the illness; these disorders are understood to be physical in nature and can be diagnosed, treated and cured
  • Bio-psycho-social perspective – how biological, psychological, and social factors interact to produce psychological disorders; mind and body are inseparable;
  • Anxiety disorders – psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety; involve both feeling and cognition where there is an appraisal of one’s social skill and anxiety
    • Generalized anxiety – one is continually tense, apprehensive, and autonomic nervous system is in a constant state of arousal
    • Phobias – persistent, irrational fear and avoidance of a specific object, activity, situation; irrational fears that disrupt behavior
    • Panic disorder – short-term episode of intense fear where one experiences terror and physiological sensation because something terrible is going to happen to them
    • OCD – unwanted repetitive thoughts, obsessions and/or actions
    • Learning perspective – researchers have looked at the relationship btwn anxiety and classical condition of fear; as we grow older we become conditioned to fear many things
    • Biological perspective – using natural selection researchers have argued that humans are predisposed to fear threats faced by ancestors
  • Mood disorders – psychological disorders characterized by emotional extremes; psychologists are trying to develop a theory
    • Major depressive disorder – prolonged hopelessness and lethargy until normality; longer than two weeks
    • Bipolar disorder – one alternates btwn depression and manic
      • Mania – one is characteristically overly talkative, overactive, elated, lack of sleep, loud speech, overly optimistic, high self esteem; affects about 1% of population, men and women equally
    • Biological Perspective – hereditary, women twice as vulnerable
    • Social cognitive perspective – focusing in particular on control beliefs such as self defeating beliefs which may arise from learned helplessness, making bad experiences really worse
    • Schizophrenia – disorganized or delusional thinking, disturbed perceptions and inappropriate emotions or actions – most debilitating of mood disorders
      • Disorganized thinking – fragmented and distorted ways of thinking that may result from a breakdown in selective attention
      • Delusions – false beliefs that may accompany psychotic disorders
      • Disturbed perceptions – sees things that are not there; hearing voices to seeing, feeling and smelling things that are not actually there
      • Subtypes
        • Paranoid – preoccupation with delusions or hallucinations with themes of persecution or grandiosity
        • Disorganized – disorganized speech or behavior or flat/inappropriate emotion
        • Catatonic – immobility or excessive purposeless movement, extreme negativism and/or parrot like repeating of another’s speech of movements
        • Undifferentiated – many unvaried symptoms
        • Residual – withdrawal after hallucinations and delusions have disappeared