Psychology Notes Abnormal Psychology (2nd year) Notes
These notes cover antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, psychopathy, and externalising disorders (ADHD, Conduct Disorder, and ODD).
Characteristics, prevalence rates (including gender differences), causes (environmental, genetic), risk factors, comorbidity, deficits, and treatments of each are outlined. Evidence from studies is also provided....
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PERSONALITY DISORDERS
Personality = collection of charac or traits that we have developed growing up and something which makes each of us an individual
Including the ways we think, feel and behave
Different kinds of personality disorders research suggests 3 groups:
Cluster A: Odd or Eccentric
Cluster B: Dramatic, Emotional, or Erratic
Cluster C: Anxious and Fearful
BORDERLINE PERSONALITY DISORDER
BPD = emotional instability, fears of abandonment, impulsivity, self-mutilating behaviours, unstable sense of self intense and stormy personal relationships
Long term
Frequent change in emotions
Marked impulsivity
Associated with a wide variety of disorders
Epidemiology
Leichsenring et al., 2011:
USA population sample: 0.5-5.9%
In clinical sample: 10% all psychiatric outpatients; 15-25% inpatients
Non clinical: 5.9% (many individuals fail to seek appropriate treatment)
DIAGNOSIS: DSM-V CRITERIA
The essential features of a PD are impairments in personality functioning and the presence of pathological personality traits
To diagnose BDP, the following criteria must be met:
A Sig impairments in personality functioning manifest by: | Impairments in self functioning (a or b) | a: identity b: self-direction |
---|---|---|
Impairments in interpersonal functioning (a or b) | a: empathy b: intimacy | |
B Pathological personality traits in the following domains: | Negative Affectivity, characterised by: | a: emotional liability b: anxiousness c: separation insecurity d: depressive |
Disinhibition, characteristied by: | a: impulsivity b: risk taking | |
Antagonism, characterised by: | a: hostility |
High prevalence of aggression
Newhill et al., 2009: 73% of BP patients have engaged in aggressive behaviour over 1 year
LIFE COURSE AND COMORBIDITY
Co-morbidity
Unipolar/bipolar mood, anxiety disorders, substance-use, eating disorders
Paris, 2007: 50% those with BPD also qualified for a mood disorder
Co-morbid with other PDs especially histrionic, dependent, antisocial and schizotypal
Tomko et al., 2014:
Results suggest that 2.7% of adults in the USA meet diagnostic criteria for BPD
High rates of the disorder in F, people in lower income brackets, people younger than 30, and individuals who are separated/divorced
BPD individuals were likely to have co-occurring lifetime mood disorders, anxiety disorders, substance use disorders, and other personality disorders
84.8% of individuals with BPD also had a lifetime anxiety disorder, 82.7% had a lifetime mood disorder/episode, and 78.2% were diagnosed with a lifetime substance use disorder
Karsten et al., 2016:
BPD women (compared to psychiatric patient none-BPD F):
More likely to have been abused as children
More likely to have a history of outpatient treatment
Less likely to be convicted for homicide
More likely to be comvited for arson
More likely to have comorbid substance abuse
Incidents towards others and themselves were more violent
Several risk factors for BPD F:
Poor behavioural control
Impulsivity
Irresponsibility
F diagnosed with BPD are a subgroup within the F psychiatric population
Lieb et al., 2004: NEUROBEHAVIORAL MODEL OF BPD
Genetics factors
Adverse childhood experience
Emotional dysreg/impulsivity
Dysfunctional behaviour
All interlink and worsen each other
Leichsenring et al., 2011: BIOPSYCHOSOCIAL MODEL OF BPD
Genetic factors + Adverse childhood experiences
Leads to biological dysfunctions and Psychosocial factors (personality traits)
Leads to BPD
RISK FACTORS
Genetics
Hooley et al., 2010: personality traits of affective instability and impulsivity are heritable
Lid et al., 2007: certain parts of 5-HTT gene implicated in depression may also be asoc with BPD
Hooley et al., 2001: link with other genes involved in regulating dopamine
Goodman et al., 2008: in twin studies, heritability scores for the full diagnoses were .65 to .75
The serotonin system is the NT system of greatest interest in these patients, and is the assumed site of action for specific serotonin-reuptake inhibitors
Ni X et al., 2006:
Data from a candidate gene study showed an assoc between a haplotype containing the short allele in the serotonin transporter gene (the serotonin transporter-linked promoter region (5-HTTLPR in SLC6A4) and development of BPD
Presence of the short allele of 5-HTTLPR can indicate a poor treatment response to fluoxetine in BPD patients
Wagner et al.,2009: Polymorphism in 5-HTTLPR might also modulate the assoc between serious life events and the development of impulsivity in patients
Distel et al., 2008: BPD tendencies are influenced equally by genetic and non-shared environment
Hunt et al., 2015: genetic and environmental overlap between BPD and Psychopathy
Factor 1: fearless dominance adaptive features of stress immunity, social potency and fearlessness = +ve
Factor 2: impulsive-antisocial tendencies eg lack of planning and aggressiveness = highly correlated with BPD
F2 and BPD = common genetic vulnerability and non-shared environmental risk factors
Strong genetic and non-shared environmental correlations suggests that common genetic and non-shared environment contribute to both phenotypes
Negative genetic and non-shared environmental correlations between Factor 1 and BPD tendencies suggests genetic factors underlying Factor 1 serve as protective factors against BPD
Promotive effects of Factor 2
Protective effects of Factor 1
BUT others define F1 as = interpersonal and affective traits eg CU and lack of affect
Biological data
BPD and low serotonin involved in inhibiting behavioural responses, hence impulsive behaviour manifests
Disturbances in noradrenergic regulation similar to those in PTSD
Lieb et al., 2004: brain areas that inhibit aggression seem to show decreased activation
Hooley et al., 2012: reductions in hippocampal and amygdala volume, features associated with aggression ad impulsivity
Weniger et al., 2009:
Reduced amygdala (34%) and hippocampus (12%) size and sig impaired cognition
Trauma-exposed patients with BPD but without PTSD also showed sig...
Buy the full version of these notes or essay plans and more in our Abnormal Psychology (2nd year) Notes.
These notes cover antisocial personality disorder, borderline personality disorder, narcissistic personality disorder, psychopathy, and externalising disorders (ADHD, Conduct Disorder, and ODD).
Characteristics, prevalence rates (including gender differences), causes (environmental, genetic), risk factors, comorbidity, deficits, and treatments of each are outlined. Evidence from studies is also provided....
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