Recap: MOOD DISORDERS
Depressive Disorders
• Major depressive disorder
• Persistent depressive disorder (dysthymia)
• Pre-menstrual dysphoric disorder (PMDD)
• Disruptive mood dysregulation disorder
Bipolar Disorders
• Bipolar Type I
• Bipolar Type II
• Cyclothymia
CAUSES OF MOOD DISORDERS
A. Biological Dimensions
1.Family/Genetic Influences: Increasing severity, recurrence of major
depression, and earlier age of onset in the proband is associated with the
highest rates of depression in relatives (genetic contributions to depression:
40% (F) 20% (M))
2.Neurotransmitter Systems: low levels of serotonin in relation to other
neurotransmitters
3.Endocrinesystem: overactivity in the HPA axis which produces stress
hormones (elevated cortisol levels, low hippocampal volume)
CAUSES OF MOOD DISORDERS
B. Psychological Dimensions
1.Stressful life events
2.Learned helplessness
The depressive attributional style is
(1) internal, in that the individual attributes negative events to personal
failings (“it is all my fault”);
(2) stable, in that, even after a particular negative event passes, the
attribution that “additional bad things will always be my fault” remains;
and,
(3) global, in that the attributions extend across a variety of issues.
CAUSES OF MOOD DISORDERS
B. Psychological Dimensions
1.Stressful life events
2.Learned helplessness
The depressive attributional style is
(1) internal, in that the individual attributes negative events to personal
failings (“it is all my fault”);
(2) stable, in that, even after a particular negative event passes, the
attribution that “additional bad things will always be my fault” remains;
and,
(3) global, in that the attributions extend across a variety of issues.
CAUSES OF MOOD DISORDERS
C. Social/Cultural Dimensions
1. Gender
2. Social support
Personality Disorders
Overview of Personality Disorders
• When personality characteristics interfere with relationships
with others, cause the person distress, or in general,
disrupt activities of daily living, we consider these to be
“personality disorders”
• chronic; they do not come and go but originate in childhood
and continue throughout adulthood
• Personality disorder is a persistent pattern of
emotions, cognitions, and behavior that
results in enduring emotional distress for the
person affected and/or for others and may
cause difficulties with work and
relationships.
Overview of Personality Disorders:
Dimensions or Categories
• Many researchers and clinicians see personality disorders as
extremes on one or more personality dimensions. Yet because of
the way people are diagnosed with the DSM, the personality
disorders—like most other disorders—end up being viewed in
categories.
• Are personality disorders extreme versions of otherwise typical
personality variations (dimensions) or ways of relating that are
different from psychologically healthy behavior (categories)?
• Currently, there is an alternative model of personality disorders
included in the section on “emerging measures and models” in
DSM-5 that is included for further study.
Cluster A Personality Disorders:
PARANOID PERSONALITY DISORDER
• are excessively mistrustful and suspicious of others without
any justification
• they assume other people are out to harm or trick them;
therefore, they tend not to confide in others - extends to
people close to them, making meaningful relationships difficult
• Causes: (1) biological, (2) early mistreatment or traumatic
childhood experiences, (3) cognitive (basic mistaken
assumptions about others as a result of their upbringing)
• Treatment: cognitive therapy to counter the person’s mistaken
assumptions about others, focusing on changing the person’s
beliefs that all people are malevolent and most people cannot
be trusted
Cluster A Personality Disorders:
SCHIZOID PERSONALITY DISORDER
• show a pattern of detachment from social relationships and a
limited range of emotions in interpersonal situations
• neither to desire nor to enjoy closeness with others, including
romantic or sexual relationships thus they appear cold and
detached and do not seem affected by praise or criticism
• Causes: It is possible that a biological dysfunction found in
both autism and schizoid personality disorder combines with
early learning or early problems with interpersonal
relationships to produce the social deficits that define schizoid
personality disorder
• Treatment: Therapists often begin treatment by pointing out
the value in social relationships; need to be taught the
emotions felt by others to learn empathy; social skills training
Cluster A Personality Disorders:
SCHIZOTYPAL PERSONALITY DISORDER
• have psychoticlike (but not psychotic) symptoms (such as
believing everything relates to them personally), social
deficits, and sometimes cognitive impairments or paranoia
• often considered odd or bizarre because of how they relate to
other people, how they think and behave, and even how they
dress
• have ideas of reference
• Causes: (1) genetic, (2) childhood maltreatment or traumatic
childhood experiences, (3) mild-to-moderate decrements in
their ability to perform on tests involving memory and learning
• Treatment: antipsychotic medication, social skills training,
cognitive behavior therapy
Cluster B Personality Disorders:
ANTISOCIAL PERSONALITY DISORDER
• tend to have long histories of violating the rights of others
• often described as aggressive and indifferent to the concerns
of other people
• show no remorse or concern over the sometimes devastating
effects of their actions
• separate diagnosis for children who engage in behaviors that
violate society’s norms: conduct disorder
• Causes: (1) genetic (gene-environment interaction), (2)
underarousal and fearlessness hypotheses
• Treatment: Given the ineffectiveness of treatment for adults,
prevention may be the best approach to this problem.
Cluster B Personality Disorders:
BORDERLINE PERSONALITY DISORDER
• tend to have turbulent relationships, fearing abandonment but
lacking control over their emotions
• often engage in behaviors that are suicidal, self-mutilative, or
both
• The characteristic of instability (in emotion, interpersonal
relationships, self-concept, and behavior) is seen as a core
feature with some describing this group as being “stably
unstable”
• Causes: (1) genetic/biological, (2) early trauma
(sexual/physical), (3) insecure attachment style / parental
emotional under-involvement
• Treatment: dialectical behavior therapy (DBT)
Cluster B Personality Disorders:
HISTRIONIC PERSONALITY DISORDER
• inclined to express their emotions in an exaggerated fashion
• tend to be vain, self-centered, and uncomfortable when they
are not in the limelight
• often seductive in appearance and behavior, and they are
typically concerned about their looks
• seek reassurance and approval constantly and may become
upset or angry when others do not attend to them or praise
them
• Causes: ancient Greek philosophers point to ‘hysteria’
Cluster B Personality Disorders:
NARCISSISTIC PERSONALITY DISORDER
• have an unreasonable sense of self-importance and are so
preoccupied with themselves that they lack sensitivity and
compassion for others
• require and expect a great deal of special attention
• tend to use or exploit others for their own interests and show
little empathy
• when confronted with other successful people, they can be
extremely envious and arrogant
• because they often fail to live up to their own expectations,
they are often depressed
• Causes: profound failure by the parents of modeling empathy
early in a child’s development
Cluster C Personality Disorders:
AVOIDANT PERSONALITY DISORDER
• extremely sensitive to the opinions of others and although
they desire social relationships, their anxiety leads them to
avoid such associations
• their extremely low self-esteem—coupled with a fear of
rejection—causes them to be limited in their friendships and
dependent on those they feel comfortable with
• Causes: (1) may be born with a difficult temperament, (2)
childhood experiences of neglect, isolation, rejection, and
conflict with others
• Treatment: behavioral intervention techniques for anxiety and
social skills problems
Cluster C Personality Disorders:
DEPENDENT PERSONALITY DISORDER
• sometimes agree with other people when their own opinion
differs so as not to be rejected
• other behavioral characteristics include submissiveness,
timidity, and passivity
• feelings of inadequacy, sensitivity to criticism, and need for
reassurance are overcome by clinging to relationships
Cluster C Personality Disorders:
OBSESSIVE-COMPULSIVE PERSONALITY
DISORDER
• characterized by a fixation on things being done “the right
way”
• preoccupation with details prevents them from completing
much of anything
• Causes: (1) genetic
• Treatment: cognitive behavior therapy
