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Psych 111 (Abnormal Psychology)

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The 3 models that are used by psychologists to understand mental disorders.
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Medical, behavioral, and sociocultural model.
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Medical Model
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Sigmund Freud, Look at mental disorders like illnesses—”mental illness”
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Behavioral Model
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Behaviorists like Skinner say mental disorders are a result of maladaptive learning. – Behaviorists believe that everything is learned so disorders are abnormal things (harmful patterns of behavior) people have learned.
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Sociocultural Model
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Mental disorders are symptoms of cultural psychopathology; look at the culture to explain the mental illness. i.e., Eating disorders – young women are heavily influenced by cultural beliefs that skinny is good, thin is beautiful as portrayed in media.
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3 types of causes of mental disorders
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Predisposing, precipitating, and maintaining cause.
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Predisposing Cause
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Genetics, something about a person that has something within them that just lies there, however, person is made more susceptible given a stressful situation to develop disorder.
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Precipitating cause
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The situation that occurs that makes you feel stressed. When you feel your life is threatened/ endangered –> disorder. Example: Combat is stressful= veterans may develop.
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Maintaining cause
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Once the disorder has manifested itself, it leads the person to not get the treatment to help them. Examples: People with schizophrenia may not take meds because of the side effects and homeless people who do not go for treatment.
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What is name of the manual used by psychologists to classify mental disorders?
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Diagnostic and Statistical Manual IV (DSM-IV)
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Statistical
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Epidemiology—when you measure how many individuals have each of these disorders. The study of the prevalence of disorders.
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Diagnostic
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Observe them, talk to them, and give them test. Determine what someone has. Diagnose them standardized, someone with something in Cali should be diagnosed the same compared to someone with something in Kansas. Uniformity is very important.
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Name of specific criteria outlined in this manual to diagnose individual mental disorders.
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Specific diagnostic criteria (IDEA)
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Essential features of the disorder
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Symptoms that are only seen in that disorder. Example: Hallucinations and delusions for schizophrenia.
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Associated features of the disorder
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Symptoms seen in a variety of disorders. Example: Schizophrenia -Flat affect and social isolation are part of the disorder, but a lot of disorders have these characteristics associated with them as well.
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Diagnostic criteria
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The number of symptoms that the DSM says a person must have from a list to be diagnosed with a disorder -it’s a collection of symptoms leading to diagnosis; people must have a certain # of symptoms
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Information on differential diagnosis
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Some disorder are very similar to one another. So DSM offers information about how to distinguish. Example: OCD and hypochondriasis.
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DSM-IV: Five Diagnostic Axes
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1. Clinical syndrome: Mental disorder, primary diagnosis. 2. Personality disorders or mental retardation: Someone who has both is given a dual diagnosis. -Personality disorders= mental disorder, external locus of control range 3. General medical disorders: Are there any contributing factors to the person’s health? Does the person have any medical disorders? 4. Psychosocial and environmental problems: Who do you live with and where do you live? These are social variables important in terms of maintaining causes 5. Global assessment of functioning: To end report, put together by a referral agent. Rate the person on a scale of 0-100, over the last month and over the last 6 months, how well were they functioning? You get an idea of how they are doing. A referral agent usually fills this out and the clinician diagnoses them and sends them to another clinician who can help them
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What is meant by the terms neurotic and psychotic?
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• Neurosis/ Psychosis= archaic terms. These terms aren’t used in the DSM but people still use them • Neurotic/ Neurosis= a mental disorder that is marked by high levels of anxiety. • Psychotic/ Psychosis= a mental disorder that is marked by a break with reality.
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What is the current status of the terms neurotic and psychotic in the classification of mental disorders?
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Neurosis= Anxiety disorder, best treated through psychotherapy (mind therapy), comes from a disorder of the nervous system. o Psychosis= schizophrenia and bipolar disorder, require drugs, pharmacology, comes from a disorder of the mind. Ironic because Neurosis comes from a disorder of the NS and instead of treating this with drugs, we are treating this with mind therapy. As for psychosis which is a disorder of the mind, it is treated with drugs instead of mind therapy! Ha, interesting!
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What are the anxiety disorders?
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1. Panic Disorder 2. Generalized Anxiety Disorder 3. Phobias 4. OCD (Obsessive Compulsive Disorder) 5. Post-traumatic Stress Disorder, PTSD
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Panic Disorder
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• A person is doing something, and then they just have this wave of a sympathetic response (heavy breathing, sweating), panic attack occurs. • Intervening periods: periods in between when not having panic attacks, but panic attacks are so aversive that they fear they will have another one during this time (extreme fear). • Derealization (feel they are dreaming) / depersonalization (person reports they feel like they leave their bodies & they can see themselves). • Emergency room: People having panic attacks have a false belief they are having a heart attack, so panic attacks are diagnosed in the hospital. • People report inescapable doom= something bad is going to happen and the person can’t get away from it. • These people often develop agoraphobia (a-gora-phobia): fear of open places and being outside. • Caffeine: If you drink a lot of caffeine, you can induce panic attacks
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Generalized Anxiety Disorder
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• Not just one specific thing, anxious about a lot of things. • Chronic state of diffuse anxiety: always anxious, but unfocused. • Restlessness • Irritability: can’t sleep and are so stressed, so irratable • Insomnia is experienced • Resting state of panic disorder: Some people think GAD may not be its own disorder but rather the intervening period for those who have panic disorder.
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Phobias
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• PhobiaIntense, focused, irrational fear. A fear of something that can’t really hurt you. Example: fear of needles, clowns, claustrophobia. • Behavioral psychologists say phobias develop because you have had an unpleasant experience and you associated it with some object. Others/ Ethologists say it may be genetic – fears of things like snakes that can be dangerous to people o These are all simple or specific phobias—fears of animals, blood, etc. • Social phobiamore harmful, but makes more sense in some ways more realistic than other phobias and more impairing b/c public scrutiny can actually be really bad. Have fears of things like public speaking, eating in public, and public bathrooms
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OCD (Obsessive Compulsive Disorder):
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• Perform rituals like cleaning or checking to feel safe, ward off anxieties. • Obsession= thought, recurring thoughts they have • Compulsion= behavior, can’t keep themselves from doing these things. Cleaning and checking rituals like washing hands.
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Post-traumatic Stress Disorder, PTSD
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This happens to veterans a lot; they have a severe reaction to traumatic events and they keep re-experiencing the trauma (flashbacks); may experience insomnia/irritability and hypervigilance Hypervigilance: most people habituate to sounds so stop having anxiety reactions to it. People with PTSD don’t calm down, they are always on edge. Factors influencing strength of PTSD= how well they were before the trauma, do they feel guilt and how close to the events they were.
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Identify each mood disorder
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1. Unipolar depression (Major Depressive Disorder) 2. Bipolar Disorder—Manic Depression 3. Dysthymia 4. Cyclothymia 5. Seasonal Affective Disorder (SAD)
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Unipolar depression (Major Depressive Disorder)
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This is severe depression. Example: Someone close to you dies. Symptoms: • Depressed mood • Anhedonia= inability to experience pleasure, stop doing things you used to do/ liked because you no longer have activity in the reward pathway. • Disturbance of appetite= you have decreased activity so you eat more to stimulate the pathway for more pleasure, or if you are very depressed, you stop eating altogether. • Sleep disturbance: you have hyperinsomnia (sleep too much) or if you are really depressed, you have anxiety which causes insomnia (not sleeping). • Psychomotor retardation/ agitation: walk around slow, with shoulders down and slumped but when depression is severe, can lead to agitation (can have panic attacks in the midst of it). • Loss of energy • Feeling of worthlessness or hopelessness- “I can’t do anything. I suck at everything” • Difficulty in thinking: harder to do normal activities (schoolwork) Depression leeks over into cognitive abilities.
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Bipolar Disorder—Manic Depression
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• Individuals experience ups and downs in life more often than others Manic phase: • Elevated mood but at the same time irritable. Like an artificial elevated mood • Inflated self-esteem: you feel that you can do anything, have a rush of activity in reward pathway; may feel invincible (opposite of hopelessness) • Sleeplessness: they have no need for sleep. They feel so good that they don’t have to/feel the need to sleep. • Flight of ideas: they’ll jump from idea to idea in conversations. Very talkative, and gets easily distracted. • Distractibility: can’t filter out anything • Hyperactivity: can’t sit still • Fearless behavior: They feel like they can’t get hurt so they engage in risky behaviors like promiscuity and shopping sprees. • All of these lead to someone that feels really good but can’t get anything done.
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What are the differences between bipolar and unipolar?
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– Unipolar= more nurture (reactive), linked to low self-esteem. – Bipolar= more nature (genetic), no sex difference –> No gender difference in bipolar but women are more likely to experience unipolar disorder. Men can live better by themselves so women feel more helplessness.
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Dysthymia
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Milder form of unipolar depression
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Cyclothymia
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Milder form of bipolar disorder
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Seasonal Affective Disorder (SAD)
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• Lack of sunlight causes this, hence a winter problem. As a species, we are programmed to live in places with lots of sun, but when we live in places that don’t (i.e., Alaska) we can get some pathology (illness). • Pineal gland: secretes serotonin during day when sunlight and melatonin at night. If too much darkness/lack of sunlight, pineal gland never secretes serotonin depression. Treatment: 1. SSRIs = antidepressants = increases serotonin 2. Light therapy
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Identify each somatoform disorder.
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1. Hysteria 2. Body Dysmorphic disorder 3. Hypochondriasis 4. Somatization Disorder 5. Conversion Disorder
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Hysteria
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First somatoform disorder identified — Freud says you have an unconscious conflict that is so unpleasant it manifests itself as physical problem.
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Body Dysmorphic disorder
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Over concern with bodily flaws Leads to plastic surgery Newly classified disease—Influenced by Michael Jackson Associated with social phobia and depression: You feel you can’t go out because people will look at you.
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Hypochondriasis
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– Also called illness anxiety disorder/somatic symptom disorder/mesophobia Extreme fear of disease Pathological conviction that they will become sick Aren’t faking the symptoms—they really think they will become sick. 2 Associated with anxiety and depression o Co-morbidities: Anxiety—fear they will become sick. Depression—when they are convinced they have become sick and get upset about it Different from OCD fears of contamination (differential diagnosis) they know they won’t be ill but they won’t stop washing their hands. Hypochondriacs really believe they’ll get sick. Etiology(origin) o Overprotective mothers= maybe had parents who made them afraid of getting sick all the time. o Family member have a serious illness= Hypochondriasis is not psychotic- it’s being really frightened of getting sick b/c I’ve seen someone else get sick
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Somatization Disorder
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– Numerous recurrent physical complaints (they usually don’t go together) Begins by age 30 Complaints are not explained by medical treatment Different from hypochondriasis because have many varied, vague and dramatic symptoms. Symptoms: 4 pains, 2 gastrointestinal, 1 sexual and 1 that minimizes neurological problems Doctor shopping occurs a lot= they go around to different doctors because all of the doctors say there is nothing wrong with them.
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Conversion Disorder
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The updated version of hysteria. It is somebody with a psychological problem who manifests it in a physical property (symptoms). Affects voluntary motor or sensory functioning Suggestive of a neurological or other general medical condition Not intentionally produced (feigned) Cannot be fully explained by a general medical conditioned Symptoms/types: o Hysterical blindness: Person can’t see — They have convinced themselves they can’t see BUT their eyes are actually working – if a person is hysterically blind, they won’t walk into a stool if it’s in their path. o Hysterical paralysis: Person can’t move o Hysterical anathesia: Can’t feel part of their body
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Identify each dissociative disorder
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1. Dissociative Amnesia 2. Dissociate Fugue (flee) 3. Dissociative Identity Disorder
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Dissociative Amnesia
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Repressing stressful, traumatic info –> didn’t want to know it, so do something to avoid it (i.e. lose memory of it)
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Dissociate Fugue (flee)
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You lose your memory and you leave the place you live and go somewhere else; traveling amnesia. *Happens in women who have been battered- can get out of the house and flee somewhere else, but then they can’t remember what happened to them
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Dissociative Identity Disorder
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Used to be referred to as multiple personality disorder. • Split Personality – Alternating personalities: co-conscious, they both know that each other exist – Primary personality is aware of all subordinate personality. However, the subordinate personality is not aware of primary personality • Multiple personalities: Three or more personalities—central and subordinates – The subordinates come out when appropriate and they do not know each other exist. Only the main personality knows of the subordinate personalities.
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What is the translation of the term schizophrenia?
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Schizophrenia= “split-mind.” Term originated with Blueler.
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What are the four categories of symptoms of schizophrenia?
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1. Hallucinations 2. Delusions 3. Thought disorders *These (first 3) are positive symptoms – things schizophrenics have that others don’t have 4. Negative symptoms: things schizophrenics don’t have that other people have.
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Hallucinations
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A sensory event that didn’t really happen
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Delusions
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“I think something, I think I am something” – Delusions of Reference: You believe you are so important, people must be talking about you; think everything’s about you. – Delusion of Grandeur: You think you are some historical feature or person of great importance – Delusion of persecution: You are so influential, you think people are out to get you or are plotting to kill you.
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Negative symptoms
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Things schizophrenics don’t have that other people have: – Flat affect: They look like they are depressed. They have no emotional responsiveness and don’t show emotions. – Hygiene: don’t shower or clean themselves. *These people cannot take care of the most basic aspects of their life: need a great deal of care
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Identify the subtypes of schizophrenia.
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1. Paranoid 2. Catatonic 3. Disorganized 4. Residual
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Paranoid
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Person is suspicious of everyone. They think other people are out to get them, and are completely disorganized.
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Catatonic
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Person is just completely out of it. Go through periods of being out of reach, no motion; don’t move around or respond. They sit in hall, stare, don’t move for hours a. Catatonic rigidity: someone is so tight that when you try to move them you can’t because their muscles are really tense. This disorder is very much on the nature side, predisposition for nature. b. Waxy catatonia- you can move the person and they will stay in that position and they cannot move from that – Meso Limbic Pathway: mediates schizophrenia, neurons in that pathway create dopamine. Schizophrenics have over activity in this pathway. Give this person a dopamine antagonist.
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Disorganized
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You don’t see much, they don’t have many hallucinations or delusions; their disorder is marked by mental and language disorders (thought disorder)
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Residual
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Someone who is coping properly now, but in a latency period where the symptoms will be coming back soon. They are acting normally now, but they showed schizophrenic just before. They come in and out of the disorder.
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What are the 10 personality disorders?
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1. Paranoid Personality 2. Schizotypal 3. Schizoid 4. Avoidant Personality 5. Dependent 6. Borderline 7. Histrionic 8. Narcissistic 9. Obsessive Compulsive 10. Antisocial
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Paranoid Personality
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Someone who is incredibly suspicious of other people. They think that someone is out to get them or hurt them. Does not have disorganization of schizophrenia.
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Schizotypal
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Being a little bit schizophrenic. Mild form of schizophrenia.
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Schizoid
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cold, lack of emotion, no feeling, no empathy for other people, very detached from people.
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Avoidant Personality
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The person who tries to stay away from social situations where there is a possibility of criticism or something painful, like rejection – They avoid social interactions because of fear – They fear of rejection so don’t try – It is someone who is distant
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Dependent
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Person just wants to hang around with people, the hanger on, the person who has to be around someone else; difficulty with actions based on their own goals or what they want to do.
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Borderline
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People who are paranoid about other people’s motives, but are also dependent. *You have to be with other people, but you don’t trust them.* Person who is both avoidant and dependent at the same time.
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Histrionic
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Study of acting; somebody who overly dramatizes situations that occur.
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Narcissistic
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Omg she seems so in love with herself and superficial but underneath she isn’t happy and very insecure.
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Obsessive Compulsive
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Person who has to always have everything perfectly; like that to the degree where it interferes with other functioning. –>Somebody who is extremely neat, organized, but so concerned with it that it hinders their ability to function
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Antisocial
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People who have no empathy, look in jail and in corporate boardrooms. They have no ethical qualms or conscious about doing things that are harmful to people.