Chapter 10: Personality Disorders Multiple-Choice Questions 1. There is a general agreement among researchers that personality a. is mainly learned. b. can be characterized by five basic trait dimensions. c. has an infinite number of possible trait dimensions. d. is mainly genetic. Answer: b. can be characterized by five basic trait dimensions. 2. Individuals with personality disorders a. comply with societal expectations. b. reject societal expectations. c. are unable to perform some roles expected by society. d. have a strong sense of self. Answer: c. are unable to perform some roles expected by society. 3. Personality disorders were once known as a. character disorders. b. identity disorders. c. conduct disorders. d. maladaptive behavioral patterns. Answer: a. character disorders. 4. Unlike disorders like depression and PTSD, a. personality disorders develop gradually. b. multiple causal events can be identified when a personality disorder has developed. c. those with personality disorders experience considerable subjective distress. d. personality disorders are emotional disorders. Answer: a. personality disorders develop gradually. 5. Which statement about personality disorders is accurate? a. The category is broad and encompasses behavioral problems that vary widely in form and severity. b. The personality disorders are considered situation-specific problems in behaving. c. Most of the personality disorders are extreme reactions to stressful life events. d. Even the milder cases of personality disorders produce severe impairments in social and occupational functioning. Answer: a. The category is broad and encompasses behavioral problems that vary widely in form and severity. 6. Because they were regarded as being different from standard psychiatric syndromes, the personality disorders in DSM-IV were a. not listed. b. categorized as emotional disorders. c. separated from mood disorders. d. given what is called a "provisional" category. Answer: c. separated from mood disorders. 7. The behavioral patterns of individuals with personality disorders a. tend to fluctuate over time. b. tend to normalize with experience as an individual matures. c. are thought to be relatively consistent over time, with little adaptation to new kinds of experiences. d. are remarkable in their tendency to shift dramatically from one kind of disorder to another. Answer: c. are thought to be relatively consistent over time, with little adaptation to new kinds of experiences. 8. According to the DSM-5, which of the following must be true for a personality disorder diagnosis? a. The patient's behavior must reflect a lack of impulse control. b. The patient must experience mild irritability. c. Signs of psychosis must be present. d. The person's behavior problems must cause them distress or impairment. Answer: d. The person's behavior problems must cause them distress or impairment. 9. People find Adam difficult to be around. His behavior is unpredictable and erratic but most often is annoying to others. He doesn't seem to learn from his bad experiences, instead he keeps repeating the same mistakes over and over. His family says Adam has been like this since at least junior high school. Adam most likely has a. a mood disorder. b. an anxiety disorder. c. a dissociative disorder. d. a personality disorder. Answer: d. a personality disorder. 10. Misdiagnoses are common when looking at potential personality disorders because a. the diagnostic criteria are objective. b. many of the personality disorders share common features. c. most of those in treatment for personality disorders are heavily medicated. d. it is usually not possible to determine when the problematic behavior began. Answer: b. many of the personality disorders share common features. 11. Since there are substantial problems with reliability and validity of the diagnoses of personality disorders, a. they are rarely used in clinical practice. b. it is less likely that research on a disorder will be able to be replicated by other researchers. c. they are considered by clinicians only as suggestions and do not have an impact on treatment decisions. d. very little research or search for treatments is done. Answer: b. it is less likely that research on a disorder will be able to be replicated by other researchers. 12. The five- factor model a. is a model of normal personality that includes an expanded description of the five basic personality dimensions. b. is a model that attempts to explain personality disorders by dividing them into five main categories. c. is a model that explains the causes of personality disorders by describing the five most important factors that lead to their development. d. is a five-step model for the treatment of personality disorders. Answer: a. is a model of normal personality that includes an expanded description of the five basic personality dimensions. 13. Which of the following is a factor that complicates determining the causes of personality disorders? a. The high likelihood that an individual with one personality disorder may also have another b. The availability of only prospective data c. The wealth of biological data available d. The inability to gather information from the patients themselves, due to the prevalence of memory disorders among those with personality disorders Answer: a. The high likelihood that an individual with one personality disorder may also have another 14. The finding that temperament may play a role in the etiology of personality disorders suggests that a. all personality disorders have a biological basis. b. learning plays a significant role in the development of personality disorders. c. the environment does not play a causal role in the development of mood disorders. d. a susceptibility to the development of a personality disorder may be inherited. Answer: d. a susceptibility to the development of a personality disorder may be inherited. 15. The best description of the biological component of personality disorders is a. they are directly inherited disorders. b. they have no biological component, they are learned. c. personality traits are inherited that predispose a person to developing a personality disorder. d. people inherit the trait of anxiety, which underlies all of the personality disorders and predisposes people to developing a personality disorder. Answer: c. personality traits are inherited that predispose a person to developing a personality disorder. 16. The "clusters" of personality disorders found in the DSM-5 are grouped based on a. similar etiologies. b. level of dysfunction. c. symptom or feature similarities. d. expected prognosis. Answer: c. symptom or feature similarities. 17. What do all of the Cluster A disorders have in common? a. Lack of emotional expression b. Oddness or eccentricity c. Clear link to schizophrenia d. Trust in other people Answer: b. Oddness or eccentricity 18. Which of the following is a Cluster B personality disorder? a. Depressive b. Schizoid c. Paranoid d. Borderline Answer: d. Borderline 19. Individuals who seem odd and eccentric to others may have personality disorders from a. Cluster A. b. Cluster B. c. Cluster C. d. proposed diagnostic categories needing further study. Answer: a. Cluster A. 20. Helen is suspicious and doubts the loyalty of even her friends. She is unwilling to forgive perceived insults and never forgets a grudge. She is most likely to be diagnosed with ___________ personality disorder. a. paranoid b. histrionic c. schizoid d. schizotypal Answer: a. paranoid 21. The best single-word description for the person with paranoid personality disorder is a. delusional. b. impulsive. c. unemotional. d. mistrustful. Answer: d. mistrustful. 22. Unlike the person with paranoid schizophrenia, the person with paranoid personality disorder a. becomes delusional in response to an actual betrayal or hurtful incident with another person. b. has persistent loss of reality contact. c. tends to confide in others and assume the loyalty of his or her friends. d. is in contact with reality, although he or she may have transient psychotic symptoms. Answer: d. is in contact with reality, although he or she may have transient psychotic symptoms. 23. Which basic personality traits from the five-factor model seem most important in the development of paranoid personality disorder? a. Introversion and openness to feelings b. Excitement seeking and neuroticism c. Antagonism and neuroticism d. Fantasy proneness and tough mindedness Answer: c. Antagonism and neuroticism 24. Sam shows little emotion and is a loner. He has no social relationships, other than his family, and he seems to experience little pleasure, if any. What personality disorder might Sam have? a. Paranoid b. Schizoid c. Borderline d. Narcissistic Answer: b. Schizoid 25. Greg has been diagnosed with schizoid personality disorder. Knowing this, which of the following jobs would he be most likely to enjoy? a. Night-time security guard who works alone b. Receptionist at a busy dentist's office c. Insurance inspector who uncovers clues that criminal behavior has occurred d. Elementary school teacher who works with children who have emotional problems Answer: a. Night-time security guard who works alone 26. The central problem of schizoid personality disorder is a. recurrent depression. b. a marked disregard for the feelings of others. c. cognitive and perceptual distortions. d. an inability to form attachments to other people. Answer: d. an inability to form attachments to other people. 27. Which basic personality traits from the five-factor model seem most important in the development of schizoid personality disorder? a. Low agreeableness and high antagonism b. High introversion and low openness to feelings c. High introversion and low agreeableness d. Low excitement seeking and high fantasy proneness Answer: b. High introversion and low openness to feelings 28. Individuals with schizoid and paranoid personality disorders differ significantly in their a. ability to function. b. display of psychotic symptoms. c. level of emotionality. d. likelihood of recovery. Answer: c. level of emotionality. 29. A cognitive explanation for schizoid personality disorder proposes that the individual with this disorder believes that a. he is basically alone. b. few people can be trusted. c. no one can live up to his or her expectations. d. he is misunderstood. Answer: a. he is basically alone. 30. Tom tells you that he can make his roommate take out the trash by simply thinking about his roommate doing it. He agrees with you that this could sometimes just be a coincidence, but he seems to truly believe he can sometimes get people to do things just by thinking about it. You find him understandable when he talks, but sometimes hard to follow. His clothes are messy and don't match. Tom tells you not to tell anyone about his power, because he knows that other people don't like him because they are jealous and they would hurt him if they could. The best diagnosis for Tom is a. borderline personality disorder. b. paranoid personality disorder. c. schizotypal personality disorder. d. schizoid personality disorder. Answer: c. schizotypal personality disorder. 31. Which of the following personality disorders is most likely to be mistaken for schizophrenia? a. Avoidant b. Borderline c. Schizoid d. Schizotypal Answer: d. Schizotypal 32. While the individual with ___________ personality disorder appears cool and aloof, the individual with ___________ personality disorder is best described as odd. a. avoidant; schizotypal b. schizoid; schizotypal c. schizoid; avoidant d. schizotypal; avoidant Answer: b. schizoid; schizotypal 33. Thought and speech oddities comparable to those seen in schizophrenia have been documented in ___________ personality disorder. a. paranoid b. schizoid c. schizotypal d. borderline Answer: c. schizotypal 34. Schizophrenic disorders seem to be most strongly linked genetically to ___________ personality disorder. a. schizoid b. schizotypal c. avoidant d. Both A and B. Answer: b. schizotypal 35. Transient psychotic symptoms are seen in which of the following personality disorders? a. Paranoid and schizoid b. Schizotypal and schizoid c. Schizoid and antisocial d. Paranoid and schizotypal Answer: d. Paranoid and schizotypal 36. Lori is vain and self-centered. When she goes out, it is not at all uncommon for her to do things that ensure she is the center of attention. Her close friends describe her as a "drama queen.” Assuming that her behavior is sufficient to warrant a diagnosis, which of the following personality disorders is she most likely to be diagnosed with? a. Antisocial b. Borderline c. Histrionic d. Narcissistic Answer: c. Histrionic 37. Luisa is a lively and emotional graduate student. She dresses provocatively and behaves in a very seductive manner with her male professors. She has had a long string of short-lived, stormy romances. Luisa is most likely to have a diagnosis of a. histrionic personality disorder. b. narcissistic personality disorder. c. dependent personality disorder. d. passive-aggressive personality disorder. Answer: a. histrionic personality disorder. 38. Like many individuals with personality disorders, individuals with histrionic personality disorder are rarely able to maintain relationships over time. Why? a. Their extreme distrust makes lasting relationships impossible. b. Their self-reliance leads them to feel that they do not need anyone else. c. Their exaggerated sense of self-importance is generally off-putting. d. Their need for attention and manipulation is likely to drive others away. Answer: d. Their need for attention and manipulation is likely to drive others away. 39. Histrionic personality disorder is most likely to be diagnosed in people who a. are emotionally unexpressive and prefer living alone. b. later develop schizophrenic symptoms. c. are attention-seeking and overly emotional. d. depend on others because they do not feel competent. Answer: c. are attention-seeking and overly emotional. 40. Which basic personality traits from the five-factor model seem most important in the development of histrionic personality disorder? a. Low openness to feelings and high fantasy proneness b. High extraversion and high neuroticism c. High neuroticism and low agreeableness d. High conscientiousness and low assertiveness Answer: b. High extraversion and high neuroticism 41. Which of the following best accounts for why women are more likely to be diagnosed with histrionic personality disorder than men? a. Women are more likely to develop this disorder. b. The symptoms tend to be maladaptive exaggerations of traits normally seen in women. c. Women are naturally more likely than men to engage in attention-seeking behaviors. d. The primary feature of this disorder is emotionality and women are more emotional than men. Answer: b. The symptoms tend to be maladaptive exaggerations of traits normally seen in women. 42. Which of the following is most typical of the interpersonal attitudes and behaviors of someone with histrionic personality disorder? a. Vacillation between overidealization and bitter disappointment b. Excessive trust and dependence on others' opinions c. Cruel and callous exploitation of others for personal gain d. Repeated manipulation of others to gain attention Answer: d. Repeated manipulation of others to gain attention 43. Which of the following core dysfunctional beliefs might explain the development of histrionic personality disorder? a. "I need a man to define me." b. "I am the only one I can trust." c. "I am completely helpless." d. "If I am not fun, they will abandon me." Answer: d. "If I am not fun, they will abandon me." 44. Which of the following personality disorders might be the female equivalent of antisocial personality disorder? a. Avoidant b. Schizotypal c. Histrionic d. Schizoid Answer: c. Histrionic 45. Hope believes that she is the "star" of her graduate class and that the other students dislike her because they are jealous of her superior intelligence. She believes that she is entitled to be exempted from an important exam because of her outstanding performance in class. Hope probably suffers from a. histrionic personality disorder. b. narcissistic personality disorder. c. dependent personality disorder. d. schizoid personality disorder. Answer: b. narcissistic personality disorder. 46. Which of the following distinguishes narcissistic personality disorder from the other Cluster B disorders? a. Emotionality b. Grandiosity c. Impulsivity d. Vanity Answer: b. Grandiosity 47. Some people always think that everyone is looking at them and talking about them, wishing to be like them. This self-focused view of the world would be expected in someone with ___________ personality disorder. a. borderline b. histrionic c. narcissistic d. paranoid Answer: c. narcissistic 48. Why is it that people with narcissistic personality disorder are unlikely to seek treatment? a. They are suspicious that therapists will steal their ideas. b. They afraid they will become dependent on the therapist. c. They are hypersensitive to criticism. d. They think they are nearly perfect and in no need of change. Answer: d. They think they are nearly perfect and in no need of change. 49. The histrionic seeks ________, while the narcissist needs ________. a. attention; admiration b. acceptance; admiration c. admiration; attention d. acceptance; approval Answer: a. attention; admiration 50. Parental overvaluation is associated with which personality disorder? a. Antisocial b. Borderline c. Histrionic d. Narcissistic Answer: d. Narcissistic 51. At a young age, children are not able to understand that the world that others experience is different from their own. Children also tend to overestimate their own abilities. A failure to outgrow these youthful characteristics might explain the development of ___________ personality disorder. a. antisocial b. borderline c. histrionic d. narcissistic Answer: d. narcissistic 52. Early criminal behavior is most characteristic of a. antisocial personality disorder. b. borderline personality disorder. c. schizoid personality disorder. d. schizotypal personality disorder. Answer: a. antisocial personality disorder. 53. ___________ personality disorder is much more common in men than women and involves the exploitation of others without remorse. a. Antisocial b. Histrionic c. Borderline d. Paranoid Answer: a. Antisocial 54. Which of the following is most typical of the interpersonal attitudes and behaviors of someone with antisocial personality disorder? a. Vacillation between overidealization and bitter disappointment b. Excessive trust and dependence on others' opinions c. Irritable and aggressive pattern of irresponsible behavior d. Repeated manipulation of others to gain attention Answer: c. Irritable and aggressive pattern of irresponsible behavior 55. Symptoms of what disorder are present in individuals who later develop antisocial personality disorder? a. Attention-deficit disorder b. Attachment disorder c. Conduct disorder or oppositional defiant disorder d. Depression Answer: c. Conduct disorder or oppositional defiant disorder 56. Antisocial personality disorder differs from the other Cluster B disorders in that a. a lack of concern for the feelings of others is not displayed. b. a need for approval or attention is not displayed. c. symptoms are only present after age 15. d. it is seen equally on men and women. Answer: b. a need for approval or attention is not displayed. 57. Henry was a charming middle-aged man who came to the attention of authorities on bigamy charges. He had a long history of courting and supposedly marrying elderly widows, then absconding with their money. His diagnosis is most likely a. narcissistic personality disorder. b. borderline personality disorder. c. histrionic personality disorder. d. antisocial personality disorder. Answer: d. antisocial personality disorder. 58. What "border" did the term "borderline" in borderline personality refer to? a. The border between mood and anxiety disorders b. People with borderline personality disorder were thought to be on the brink of psychosis, on the border between sanity and insanity. c. Because people with borderline personality disorder behave normally much of the time, they were thought to only be on the edge of mental illness. d. The behaviors exhibited by people with borderline personality disorder lie on continuum between neurotic and psychotic disorders. Answer: d. The behaviors exhibited by people with borderline personality disorder lie on continuum between neurotic and psychotic disorders. 59. Impulsivity and extreme instability in interpersonal relationships, self-image, and mood best characterize a. histrionic personality disorder. b. antisocial personality disorder. c. avoidant personality disorder. d. borderline personality disorder. Answer: d. borderline personality disorder. 60. Which of the following is most typical of the interpersonal attitudes and behaviors of someone with borderline personality disorder? a. Vacillation between overidealization and bitter disappointment b. Excessive trust and dependence on others' opinions c. Cruel and callous exploitation of others for personal gain d. Repeated manipulation of others to gain attention Answer: a. Vacillation between overidealization and bitter disappointment 61. Loretta has a long history of first idealizing men and then feeling they have abandoned her. Feelings of emptiness change into reckless acts of sexual promiscuity, gambling, and suicide attempts. She feels that she has never had a sense of self. Loretta probably has ___________ personality disorder. a. narcissistic b. histrionic c. dependent d. borderline Answer: d. borderline 62. Self-mutilation, such as is seen in borderline personality disorder, is a. a form of suicidal behavior. b. a form of self-punishment. c. done to reduce depression. d. associated with an increase in anxiety and depression. Answer: b. a form of self-punishment. 63. Glenna believed that Sam loved her and that she could not live without him. When he told her he did not want to see her again, she became violently angry and manipulated him into staying with her by threatening suicide. Which of the following personality disorder does Glenna's behavior suggest she might have? a. Narcissistic b. Histrionic c. Dependent d. Borderline Answer: d. Borderline 64. Transient psychotic and dissociative experiences can occur in ___________ personality disorder. a. borderline b. antisocial c. narcissistic d. obsessive-compulsive Answer: a. borderline 65. Which basic personality traits from the five-factor model seem most important in the development of borderline personality disorder? a. High extraversion and low fantasy proneness b. High impulsivity and affective instability c. High antagonism and low neuroticism d. High agreeableness and low excitement seeking Answer: b. High impulsivity and affective instability 66. The borderline personality differs from histrionic disorder in that a. impulsive behavior is rare. b. a need for others is not exhibited. c. comorbid diagnoses are rare. d. the central role of sexuality is not present. Answer: d. the central role of sexuality is not present. 67. The main difference between borderline personality disorder and antisocial personality disorder is that a. while both have impulsive sex, the person with borderline personality disorder uses others and the person with antisocial personality disorder really cares about others. b. both avoid abandonment, the person with borderline personality disorder because they love others and the person with antisocial personality disorder because they need others to love them. c. both exploit others but the person with borderline personality disorder does it due to an angry reaction to disappointments and the person with antisocial personality disorder does it for gain and without guilt. d. both show suicidal behavior, the person with borderline personality disorder because he or she wants to die and the person with antisocial personality disorder to get attention. Answer: c. both exploit others but the person with borderline personality disorder does it due to an angry reaction to disappointments and the person with antisocial personality disorder does it for gain and without guilt. 68. According to Paris (2007), a key causal factor in borderline personality disorder seems to be a. inconsistent or highly punitive discipline in childhood. b. impulsivity and affective instability interacting with such factors as trauma or loss. c. a negative attributional style. d. an inability to empathize with other people. Answer: b. impulsivity and affective instability interacting with such factors as trauma or loss. 69. About half of the individuals with borderline personality disorder also qualify for a diagnosis of ___________ at some time. a. antisocial personality disorder b. schizophrenia c. a mood disorder d. histrionic personality disorder Answer: c. a mood disorder 70. In which of the following disorders is a comorbid diagnosis of depression most commonly seen? a. Antisocial personality disorder b. Obsessive compulsive personality disorder c. Dependent personality disorder d. Histrionic personality disorder Answer: c. Dependent personality disorder 71. According to Paris' multidimensional theory of borderline personality disorder (BPD), people with high levels of impulsivity and affective instability a. are likely to develop BPD in response to even minor stressors. b. are likely to develop BPD if they are exposed to trauma. c. come mainly from intact homes and are unlikely to develop BPD. d. come to enjoy acting out. Answer: b. are likely to develop BPD if they are exposed to trauma. 72. The research on the association between borderline personality disorder and childhood sexual abuse a. proves child sexual abuse is the leading cause of borderline personality disorder. b. are problematic - the abuse most likely is occurring with other factors that might be more important. c. has shown that the reports of sexual abuse were mostly false reports. d. suggests that some genetic component underlies both the disorder in the child and the parents' tendency to abuse. Answer: b. are problematic - the abuse most likely is occurring with other factors that might be more important. 73. The individual with avoidant personality disorder behaves most similarly to someone with ___________ personality disorder. a. antisocial b. borderline c. schizoid d. schizotypal Answer: c. schizoid 74. The individual with avoidant personality disorder is unlikely to develop lasting relationships as a result of his or her a. callousness. b. fear of rejection. c. desire to control others. d. lack of interest. Answer: b. fear of rejection. 75. Stu has no friends except his brother. He would desperately love to date women but is certain no woman would be interested in him. He tried a dating service but was convinced that the secretary was trying to get rid of him because he was such a poor candidate. The most likely diagnosis for Stu is a. avoidant personality disorder. b. schizoid personality disorder. c. paranoid personality disorder. d. schizotypal personality disorder. Answer: a. avoidant personality disorder. 76. Helena has avoidant personality disorder. She is likely to a. engage in a series of intense, unstable relationships. b. have no interest in social relationships. c. avoid achievement situations where she might fail. d. be hypersensitive to any sign of criticism or rejection. Answer: d. be hypersensitive to any sign of criticism or rejection. 77. In contrast to schizoid individuals, those with avoidant personality disorder a. are emotional and dramatic. b. are impulsive and self-destructive. c. are extremely upset by their lack of social relationships. d. are exploitive rather than compliant. Answer: c. are extremely upset by their lack of social relationships. 78. Sharon says, "I would love to be in an intimate relationship. My life is terribly boring and lonely. But I am extremely shy and I would fall apart if any man criticized me in the slightest." This description best matches the symptoms of ___________ personality disorder. a. antisocial b. dependent c. avoidant d. borderline Answer: c. avoidant 79. Which basic personality traits from the five-factor model seem most important in the development of avoidant personality disorder? a. High extraversion and low openness to feelings b. High introversion and high neuroticism c. High antagonism and low neuroticism d. High agreeableness and high angry hostility Answer: b. High introversion and high neuroticism 80. Avoidant personality disorder is extremely similar to and hard to distinguish from a. generalized social phobia. b. schizoid personality disorder. c. generalized anxiety disorder. d. paranoid personality disorder. Answer: a. generalized social phobia. 81. Emily calls her husband every day at work to ask him what she should make for dinner. She spends her days at her mother’s, because Emily worries that something will go wrong in her own home that she won't be able to handle. Even though she paints and draws well, Emily has never tried to take a class or use her talent, because she says she knows she really isn't good enough. Emily's most likely diagnosis is a. borderline personality disorder. b. dependent personality disorder. c. schizoid personality disorder. d. paranoid personality disorder. Answer: b. dependent personality disorder. 82. Involvement in an abusive relationship (as the one who is abused) would be most expected of the individual with ___________ personality disorder. a. antisocial b. borderline c. dependent d. schizotypal Answer: c. dependent 83. Hattie has a dependent personality disorder. This means that she a. experiences little distress in her life. b. has difficulty in initiating relationships. c. has acute discomfort when she is alone. d. prefers being alone rather than being with people who might criticize her. Answer: c. has acute discomfort when she is alone. 84. People who lack self-confidence despite good skills, who panic at the possibility of being separated from their spouse, and remain in abusive relationships have many of the symptoms of ___________ personality disorder. a. histrionic b. dependent c. avoidant d. narcissistic Answer: b. dependent 85. The fear of abandonment is seen in both borderline and dependent personality disorder. A key difference is their reaction to it: a. The person with borderline personality disorder gets depressed, and the person with dependent personality disorder gets angry. b. The person with borderline personality disorder gets angry, and the person with dependent personality disorder becomes submissive. c. The person with borderline personality disorder goes to other people for a replacement, and the person with dependent personality disorder stays alone and sad. d. The person with borderline personality disorder tries to resolve the issues rationally, and the person with dependent personality disorder is afraid to seek out new relationships. Answer: b. The person with borderline personality disorder gets angry, and the person with dependent personality disorder becomes submissive. 86. Which basic personality traits from the five-factor model seem most important in the development of dependent personality disorder? a. High neuroticism and high agreeableness b. High introversion and low conscientiousness c. High fantasy proneness and low neuroticism d. High excitement seeking and low openness to feelings Answer: a. High neuroticism and high agreeableness 87. What core belief might explain the behavior of the individual with dependent personality disorder? a. "I am helpless." b. "I don't know who I am without you." c. "Unless I make people laugh, they will not like me." d. "Others exist to benefit me." Answer: a. "I am helpless." 88. John has a great need for order and perfectionism. He can't leave the house until every hair is in place, and he has been known to iron the same shirt over and over to ensure that he is wrinkle-free. What personality disorder does John's behavior suggest? a. Avoidant b. Dependent c. Obsessive-compulsive d. Narcissistic Answer: c. Obsessive-compulsive 89. The individual with ___________ personality disorder is likely to be described as rigid and cold. a. borderline b. histrionic c. obsessive-compulsive d. dependent Answer: c obsessive-compulsive 90. Harold is perfectionistic and extremely concerned with maintaining a set routine. He probably suffers from ___________ personality disorder. a. schizoid b. obsessive-compulsive c. dependent d. avoidant Answer: b. obsessive-compulsive 91. What is the main difference between Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Personality Disorder (OCPD)? a. People with OCD are more perfectionistic than people with OCPD. b. People with OCPD are less conscientious about their rituals than people with OCD. c. People with OCPD do not have true obsessions or compulsions like people with OCD have. d. People with OCD can do a compulsion once and feel better, people with OCPD never feel better no matter how many times they do them. Answer: c. People with OCPD do not have true obsessions or compulsions like people with OCD have. 92. Which basic personality traits from the five-factor model seem most important in the development of obsessive compulsive personality disorder? a. High conscientiousness and low compliance b. High extraversion and high openness to feelings c. High excitement seeking and low openness to feelings d. High fantasy proneness and high agreeableness Answer: a. High conscientiousness and low compliance 93. Why does the person with obsessive-compulsive personality disorder have problems in interpersonal relationships? a. They have no interest in having relationships. b. They have no time for relationships due to excessive devotion to work. c. They are too emotionally expressive. d. Their manipulative behavior tends to destroy relationships. Answer: b. They have no time for relationships due to excessive devotion to work. 94. Which of the following best explains why it is such a challenge to treat personality disorders? a. They develop early in life. b. The diagnostic criteria for these disorders suffers from subjectivity. c. Comorbid diagnoses are the norm, not the exception. d. By definition, they are enduring patterns of thought and behavior. Answer: d. By definition, they are enduring patterns of thought and behavior. 95. Which of the following statements is NOT true of treating personality disorders? a. Individuals with personality disorders from Clusters A and B are more difficult to treat because of their interpersonal difficulties and reluctance to enter therapy. b. Treatment for individuals with dependent personality disorder ought to be altered so that excessive dependency is not fostered. c. People with personality disorders have trouble establishing good therapeutic relationships with their therapist. d. People with both a personality disorder diagnosis and another type of disorder are easier to treat than people with just a personality disorder because they have more distress. Answer: d. People with both a personality disorder diagnosis and another type of disorder are easier to treat than people with just a personality disorder because they have more distress. 96. Why is the use of medication for borderline personality disorder controversial? a. Because it is unethical to alter someone's personality through chemical means b. Because research shows it clearly doesn't help c. Because it is frequently associated with suicidal behavior d. Because of the possibility of severe side effects Answer: c. Because it is frequently associated with suicidal behavior 97. Donna has borderline personality disorder. She is in therapy, but progress is slow. One problem is that some days she thinks her therapist is the most wonderful person in the world. On other days, she thinks he is worthless and untrustworthy. This type of thinking is called a. dialectical. b. splitting. c. entitlement. d. psychopathological. Answer: b. splitting. 98. Dialectical behavior therapy is a. a promising, problem-focused treatment for borderline personality disorder. b. a long-term therapy for borderline personality disorder that focuses on personality change. c. an old, long-term therapy for borderline personality disorder that has been found to be ineffective. d. is a short-term therapy for borderline personality disorder that involves medication and brief hospitalization. Answer: a. a promising, problem-focused treatment for borderline personality disorder. 99. Which of the following is a part of the clinical picture in antisocial personality and psychopathy? a. Careful planning of future activities that will help their families. b. Using charm to make a strong first impression. c. Strong feelings of remorse after wronging others. d. A total lack of desire to maintain friendships with others. Answer: b. Using charm to make a strong first impression. 100. Which of the following is true about the connection between psychopathy and antisocial personality disorder? a. Psychopathy is another name for antisocial personality disorder. b. Many people who have antisocial personality disorder do not have psychopathy. c. Psychopathy is a less severe form of antisocial personality disorder. d. Psychopathy is a more easily treated form of antisocial personality disorder. Answer: b. Many people who have antisocial personality disorder do not have psychopathy. 101. Antisocial personality disorder differs from psychopathy in that antisocial personality disorder a. is an older diagnosis. b. focuses more on personality characteristics. c. focuses more on observable behaviors. d. is a less severe and more treatable form of the disorder. Answer: c. focuses more on observable behaviors. 102. The presence of psychopathy a. is the single best predictor of future violence and crime recidivism. b. means that a person also has antisocial personality disorder. c. means a person is less likely to be violent and to repeat crimes. d. is the single best predictor that treatment will be successful. Answer: a. is the single best predictor of future violence and crime recidivism. 103. An employee evaluation: "He takes what he wants rather than earns it. He hates routine and boredom more than anything else. Thrill-seeking and impulsive actions have gotten him fired from this job. It will get him fired at many others." What kind of disorder does the employee illustrate? a. Histrionic personality disorder b. Psychopathy c. Borderline personality disorder d. Substance abuse Answer: b. Psychopathy 104. The best current research shows that children of parents with antisocial personality disorder who were adopted into other families a. did not develop antisocial personality disorder. b. developed antisocial personality disorder at higher rates regardless of the quality of their adoptive family. c. developed antisocial personality disorder at higher rates only if their adoptive family had problems, such as marital conflict. d. developed antisocial personality disorder at a later age than if they had been raised by their biological parents. Answer: b. developed antisocial personality disorder at higher rates regardless of the quality of their adoptive family. 105. In research studies, in addition to failing to learn to avoid punishment, psychopaths a. did not cognitively understand the connection between a behavior and its consequence. b. felt a great deal of anticipatory anxiety about punishment, leading to impulsive behaviors. c. did not show normal fear potential startle responses. d. showed larger than normal fear potential startle responses. Answer: c. did not show normal fear potential startle responses. 106. Carl has psychopathy. You would expect him to a. be very concerned about possible punishment and to try to avoid it as much as possible. b. be very interested in rewards and to continue his behavior even when the rewards don't come as often as they did. c. only be interested in rewards occasionally and to change his behavior quickly if rewards don't come as often as they did. d. be equally interested in rewards and punishments and do his best to get the first and avoid the second. Answer: b. be very interested in rewards and to continue his behavior even when the rewards don't come as often as they did. 107. Who is most likely to develop antisocial personality disorder? a. A child with attention-deficit/hyperactivity disorder b. A child with oppositional defiant disorder c. A child with conduct disorder d. A child with conduct disorder and A or B Answer: d. a child with conduct disorder and A or B 108. Which type of child is most likely to show the personality traits of a psychopath as an adult? a. One who has fearlessness, low anxiety, and high callousness b. One who has high fear and high callousness c. One who has trouble regulating emotions and high levels of emotional reactivity, including aggression d. One who has high depression, high anxiety, and is quick to anger Answer: a. One who has fearlessness, low anxiety, and high callousness 109. Which of the following seems to have the most impact in decreasing the amount of criminal activities of people with psychopathy and antisocial personality disorder? a. Cognitive behavioral treatment b. Medication c. Growing older d. Nothing has any impact Answer: c. Growing older 110. Which of the following is a common component of cognitive behavioral treatments for antisocial personality? a. Punishment b. Relaxation c. Self-critical thinking d. Response-prevention training Answer: c. Self-critical thinking 111. According to your textbook, each very high-risk antisocial youth may cost society between ____ and ____ in rehabilitation, incarceration, and costs to victims. a. $12,000; $20,000 b. $120,000; $200,000 c. $1.2 million; $2 million d. $12 million; $20 million Answer: c. $1.2 million; $2 million 112. One proposed revision for the DSM-5 pertaining to the diagnosis of personality disorders did not occur. Which change was this? a. All existing personality disorders will be split into two sub-categories (chronic and intermittent) b. All existing personality disorders will be removed and only mood disorders will remain c. A categorical approach will be used to achieve diagnosis d. A dimensional approach will be used to achieve diagnosis Answer: d. A dimensional approach will be used to achieve diagnosis Fill-in-the-Blank Questions 1. Cluster __________ Personality Disorders include Schizoid and Schizotypal Answer: A 2. People with __________ are usually unable to form social relationships and have little interest in them. Answer: Schizoid Personality Disorder 3. People with __________ have more selfish, callous, and exploitative behaviors than those with antisocial personality disorder. Answer: psychopathy 4. Cluster __________ personality disorders include Histrionic and Borderline Answer: B 5. Cluster __________ Personality disorders include avoidant and dependent personality disorders. Answer: C Short Answer Questions 1. Briefly describe the general characteristics of a personality disorder. Answer: This is a disorder in which personality traits and behavior patterns are maladaptive, inflexible, and not readily adaptive to new situations. The behavior patterns are stable and of long duration. They do not stem from reactions to stress, but involve the gradual development of behavior patterns. They usually significantly impair social or occupational functioning and in some cases cause a good deal of subjective emotional distress. 2. What complicates the diagnosis of personality disorders? Answer: Personality disorders are often not diagnosed or may be misdiagnosed. Personality disorders may never be diagnosed or treated due to their basic nature - personality disorders define the personality of the individual with the disorder, and it is difficult to determine when a problematic personality becomes a disordered personality. Misdiagnosis is common as the diagnostic criteria are not precise and lack objective behavioral standards. Diagnosis is vulnerable to subjective interpretation of traits and behaviors as being maladaptive or not. The criteria for the disorders is not exclusive of other diagnoses. While clinicians are likely to agree that an individual has a personality disorder, there may not be agreement as to which disorder the individual has. 3. How does temperament relate to personality disorders? Answer: Temperament is inherited and may predispose people to develop particular personality traits and disorders. This can make personality disorders seem inherited, but it is the traits that predispose people to the disorders that are inherited. 4. What does the five-factor model tell us about personality disorders? Answer: The model that has perhaps been most influential is the five-factor model. This builds on the five-factor model of normal personality mentioned earlier to help researchers understand the commonalities and distinctions among the different personality disorders by assessing how these individuals score on the five basic personality traits 5. Compare and contrast paranoid personality disorder and schizophrenia. Answer: While both disorders are characterized by paranoid delusions, the individual with paranoid personality disorder does not exhibit the overall cognitive impairment that is seen in schizophrenia. The paranoid personality is characterized by paranoia in the absence of the hallucinations and break with reality that is characteristic of schizophrenia. 6. Which of the personality disorders appears to be most related to schizophrenia? What evidence is there of this relationship? Answer: While all of the cluster A personality disorders are characterized by different features of schizophrenia, schizotypal personality appears to be the most strongly related to schizophrenia. This disorder is characterized by abnormalities in behavior that are often seen in those with schizophrenia, and there is evidence that those with schizotypal personality disorder are at greater risk of developing schizophrenia. 7. Why is histrionic personality disorder more prevalent in women? Answer: While histrionic personality disorder is more commonly diagnosed in women, it may or may not be more prevalent in this gender. Many of the behaviors that characterize this disorder can be described as "gender-related traits" that are more commonly seen in women, thus the diagnosis is more likely to be given to women. This includes traits such as vanity, overdramatization, and concern with physical appearance. 8. Why does the person with a narcissistic personality disorder have many "friends" but few intimate relationships? Answer: People with narcissistic personality disorder overestimate their own accomplishments and underestimate others'. They need friends to gain admiration and seem important, but they eventually see others as stupid or unworthy and reject them. Relationships do not last long because others become tired of the narcissistic person's lack of consideration. 9. What are examples of dangerous behavior seen in borderline personality disorder? Answer: Borderline personality disorder includes erratic and impulsive behaviors that can be self-destructive. These include reckless driving, binges of gambling, drinking, and sex, as well as self-mutilation and suicidal behavior. Self-mutilation is one of the most discriminating signs of borderline and is sometimes associated with relief from anxiety and other negative emotions. Suicidal behavior is also common and, while suicide attempts may be motivated a desire to manipulate, it is estimated that as many as 8 percent may complete a suicide. 10. What is the main distinguishing factor between borderline and histrionic personality disorders? Answer: Sexuality is central to histrionic personality disorder but not to borderline personality disorder. 11. Compare and contrast avoidant and schizoid personality disorders. Answer: While both disorders are characterized by a lack of social contact, the motivation behind the exhibited social isolation differs. Avoidant individuals are too frightened to initiate relationships. Although alone, the avoidant personality very much wants to be with others but is afraid of rejection. Schizoid individuals are alone because they have no desire to be with others and are emotionally uninvolved. 12. What are the two dimensions of psychopathy and the relationship to antisocial personality disorder? Answer: Dimension 1: Affective and interpersonal traits - lack of remorse, empathy, superficial charm, exaggerated self-worth, and pathological lying. Dimension 2: Behavior - deviant lifestyle, impulsivity, and irresponsibility. The second dimension is more related to antisocial personality disorder. Essay Questions 1. Describe and differentiate between the Cluster A personality disorders. Answer: The Cluster A personality disorders are all alike in that they are characterized by odd behavior. This cluster includes the paranoid, schizoid, and schizotypal personality disorders. All disorders share some common features with schizophrenia, but it is only thought that schizotypal personality disorder is related to schizophrenia. The paranoid personality is characterized by extreme suspicion and distrust. This is the individual who can't forgive even the smallest perceived slight. The paranoid personality is always looking for someone to do him or her wrong, but he or she is not psychotic. Despite the prevalent paranoia, the paranoid personality is firmly in touch with reality. The schizoid personality shows some of the negative symptoms of schizophrenia, social withdrawal and flat affect. This is the loner, who prefers to be alone and seems to take pleasure in nothing. The schizotypal personality is best described as odd and eccentric. They may show some bizarre thinking, but are generally in touch with reality. 2. Discuss the two theories discussed in the text about the possible causes of narcissistic personality disorder. Answer: 1. Children go through a phase of grandiosity and lack of empathy. If parents mirror some of this grandiosity, children develop normal self-confidence and self-worth. Narcissistic personality disorder develops if parents are neglectful, devaluing, or unempathic to the child. The child then keeps searching for affirmation of an idealized and grandiose sense of self. 2. Narcissistic personality disorder comes from unrealistic parental overevaluation. Parents overindulge their child and teach the child that he/she can get whatever he/she wants without effort or caring about others. 3. Compare and contrast histrionic and narcissistic personality disorder. Answer: Both disorders are characterized by a need for attention, but the motivation underlying this need differ. The histrionic personality desires attention in order to feel valued and may use manipulative means to get the attention he or she craves. The narcissistic personality appears to believe that he or she has great value, but seeks admiration to confer this belief. While the histrionic desires any attention and will do whatever is needed to get it, the narcissist desires admiration and praise. Both disorders are characterized by vanity and a lack of concern for the emotions of others. These are personality types that are needy, but in different ways. Histrionic personality disorder is a more common diagnosis for women, while narcissism is more commonly seen in men. 4. What are the research findings on psychopathy and learning? Answer: Psychopaths show deficient avoidance learning. They have a lower than normal fear potential startle response. They do not condition easily to fear. They have a deficient behavior inhibition system - the neural system underlying anxiety. This causes them to show the above-mentioned differences. Their behavioral activation system is normal or overreactive, so they tend to focus on rewards. If caught, they focus on avoiding punishment. Their dominant response set for rewards seems to interfere with their ability to use punishment as a cue to change behavior. 5. What are the two dimensions of childhood temperament related to antisocial personality disorder and psychopathy, and what is the relationship? Answer: 1. Difficulty regulating emotions plus high levels of emotional reactivity, including aggressive behaviors when responding to stress and negative emotions like anger. This increases the risk of ASPD and the antisocial dimension of psychopathy. 2. Few problems with regulating emotions, fearlessness, low anxiety and callous-unemotional traits. These children show poor development of conscience, and their aggressive behavior is more premeditated than reactive. This is correlated with the interpersonal dimension of psychopathy. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286
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