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chapter 16 abnormal psych

Terms in this set (50)

3 groups (clusters)
odd or eccentric behavior ( paranoid, schizoid, and schizotypal personality disorder)

dramatic behavior ( antisocial, borderline, histrionic, and narcissistic)

high degree of anxiety (avoidant, dependent, and obsessive compulsive)

characterized by a group of problematic personality symptoms

categorical approach- the dsm's listing of 10 distinct personality disorders, assumes that problematic personality traist are either present or absent in ppl, a personality disorder is either displayed or not displayed by a person, a person who suffers from a personality disorder is not markedly troubled by personality traits outside of that disorder

overlap so hard to distinguish one disorder from another , some have more than one
lack of agreement has raised serious questions about the validity (accuracy) and reliability (consistency) of 10 dsm categories

challenge categorical approach- say personality disorders differ more in degree than in type of dysfunction and should instead be classified by the severity of personality traits rather than by the presence or absence of specific raits, a procedure called dimensional approach
each trait is seen as varying along a continuum extending from nonproblematic to extremely problematic , display extreme degrees of problematic traits in ppl w personality disorders (ones not commonly found in general public)

more enthusiasm for dimensional approach
proposed a largely dimensional system that would allow many additional kinds of personality problems to be classified as personality disorders and would require clinicians to assess the severity of each problematic trait exhibited by a person who recieves a diagnosis of personality disorder but raised concern and criticism so dsm 5 framers stuck w categorical approach
dsm5 describes alternative dimensional approach for the future

clear that diagnosises are assigned too often, only maladaptive distressful, and inflexible ones are considered disorders
a personality disorder marked by a pattern of distrust and suspiciousness of others
everyone out to get them, shun close relationships
trust in own ideas and abilities can be excessive

on guard and cautious and sees threats everywhere, expect to be targets of some trickery
hidden meanings, usually belittling or threatening, in everything
study- more likely to read hostile intentions into the actions of others, more often chose anger as the appropriate role-play response
quick to challenge the loyalty or trustworthiness of acquaintances, ppl w paranoid personality remain cold and distant
suspicions are normally not delusional the idease are not so bizarre or firmly held as to clearly remove the individuals from reality
critical of weakness and fault in others esp at work
unable to recognize own mistakes, extremely sensitive to criticism
blame others for things that go wrong in their lives, bear grudges
4.4% of adults have this, more common in men than women
women avoid confiding in anyone, men example as persistant questioning in wifes faithfulness

little research
psychodynamic theories (oldest of explanations) trace the pattern to early interactions w demanding parents, particularly distant, rigid fathers and overcontrolling, rejecting mothers/ some ppl come to view their environment as hostile as a result of their paren'ts perisitently unreasonable demands, must always be on high alert bc cant trust others, and are likely to develop feelings of extreme anger , project feelings onto others, feel increasingly persecuted as result
cognitive-broad maladaptive assumptions, people are evil and evil will attack you if given the chance
biological- genetic causes study- if one win was excessively suspicious the other had an increased likelihood to be suspicious, may be cause of common environmental experiences

typically dont see themselves as needing help, few come to treatment willingly, many who are in treatment view role of patient as inferior and distrust and rebel against their therapists, therapy has limited effects and moves very slowly
object relations therapists- psychodynamic therapists who give center stage to relationships- try to see the patients anger and work on what they view as his or her deep wish for a satisfying relationship
selftherapists- psychodynamics who focus on need for a healthy and unified self- try to help clients reestablish self cohesion (unified personality) which they believe has been lost in the person's continuing negative focus on others
cog and beh- have been used and often combined into an integrated cog beh approach, beh side helps clients to master anxiety-reduction techniques and to improve their skills at solving interpersonal problems, cog side guides the clients to develop more realistic interpretations of other ppl's words and actions and to become more aware of other ppl's points of view
antipsychotic drug therapy seems to be of limited helps
personality disorder characterized by persistent avoidance of social relationships and little expression of emotion, no close ties to ppl, not bc of suspicion like paranoid but genuinely prefer to be alone
no efforts to start or keep friendships, take little interest in having sexual relationships, indifferent to their families
seek out jobs that require little or no contact w others
can form work relations to a degree if needed, but prefer to keep to themselves, live by themselves mostly
social skills are weak
if they get married, lack of interest in intimacy may create marital or family problems
focus mainly on themselves and are generally unaffected by praise or criticism, rarely show feelings, neither joy nor anger, no need for attention or acceptance
typically cold, humorless, or dull, succeed in being ignored
3.1% of adult population, men more likely to have it and may also be more impaired by it

psychodynamic theorists (particularly object relations)- roots in an unsatisfied need for human contact, parents may be unaccepting or abusive of their children like in paranoid
paranoid ppl react to parenting w distrust, schizoid reacts by being unable to give or receive love and cope by avoiding all relationships
cognitive theorists- ppl w schizoid suffer from deficienceies in their thinking, thoughts tend to be vague, empty, and without much meaning, and have trouble scanning the environment to arrive at accurate perceptions. unable to pick up emotional cues from others, they cant respond to emotions, develop language and motor skills very slowly, whatever their intelligence is

social withdrawals prevents them from entering therapy unless another disorder like alcoholism makes treatment necessary
remain emotionallly distant from therapist, dont care about own treatment, make limited progress at best
cog beh- sometimes able to help them experience more positive emotions and more satisfying social interactions, cog side includes presenting clients w lists of emotions to think about or having them write down and remember pleasurable experiences, beg side has some success w teaching social skills to clients, role playing, exposure techniques, and homework assignments as tools
group therapy- apparently useful when it offers a safe setting for social contact, may resist pressure to take part
drug therapy offers limited help
characterized by extreme discomfort in close relationships, very odd patterns of thinking and perceiving and behavioral eccentricities
anxious around others, seek isolation, few close friends, some feel intensely lonely, more severe than paranoid and schizoid
noticeably disturbed
ideas of reference- beliefs that unrelated events pertain to them in some important way
bodily illusions- sensing external force or presence
a number see themselves w having special extrasensory abilities, and some believe that they have magical control over others
eccentricities- repeatedly arranging cans to align their labels, organizing closets extensively, or wearing an odd assortment of clothing
emotions are inappropriate flat and humorless
difficult to keep their attention focused, convos are typically digressive and vague sometimes w loose associations
drift aimlessly, lead an idle unproductive life
choose undemanding jobs in which they can work below their capacity and are not required to interact w other ppl
3.9% of adults, slightly more males

similar factors as schiz bc relation to schiz symptoms
-schizotypal symptoms like schizophrenic's, linked to family conflicts and to psychological disorders in parents, defects in attention and short term memory may contribute like they do to schiz also
ppl with either disorder perform poorly on backward masking- lab test of attention that requires a person to identify a visual stimulus immediately after a previous stimulus has flashed on and off screen, have hard time shutting out the first stimulus in order to focus on the second
linked to same biological factors as schiz, like high activity in neurotransmitter dopamine, enlarged brain ventricles, smaller temporal lobes, loss of gray matter, that may have genetic base
- also been linked to disorders of mood, more than half also suffer from major depressive disorder at some point in their lives, relatives of ppl w depression have a higher than usual rate , so not exclusively tied to schiz

need to help reconnect with the world and recognize the limits of their thinking and their powers, therapists must try to set clear limits ( ex requiring punctuality, work on helping the clients recognize where their views end and those of therapists begin, want to increase positive social contacts, ease loneliness, reduce overstimulation, help become more aware of person feelings, hard to get to therapy,
-cog beh- cog interventions to teach clients to evaluate teir unusual thoughts or perceptions objectiely and to ignore the inappropriate ones
ex therapist may keep track of clients' odd or magical predictions and later point out their inaccuracy
ex when clients begin to digress when speaking, they ask them to sum up what they wanted to say
beh methods like speech lessons, social skills training, tips on appropriate dress and manners, have sometimes helped clients learn to blend in better w and be more comfortable around others
-antispsychotic drugs have been given to ppl w schizotypal bc of the disorder's similarity to schiz, low doses of drugs help some ppl usually by reducing certain thought problems
psychopaths or sociopaths
marked by a general pattern of disregard for and violation of other ppl's rights
most closely linked to adult criminal behavior after substance use disorder
at least 18 yrs old, most ppl display antisocial patterns of misbehavior before they turn 15 including truancy, running away, cruelty to animals or ppl, and destroying property
was referred to as moral insanity during the nineteenth century
lie repeatedly
cannot work consistently at a job, they are frequently absent and are likely to quit their jobs altogether, careless w money and frequently fail to pay their debts
often impulsive, taking action without thinking of the consequences
may be irritable, aggressive, and quick to start fights, many travel from place to place
recklessness is common trait- little regard for their own safety or of others even their children, self centered and are likely to have trouble maintaining close relationships , have a knack for gaining personal profit at expense of other ppl bc the pain or damage they cause seldom concerns them, lack a moral conscience
think their victims are weak and deserve to be conned, robbed or physically harmed
3.6% of adults meet criteria, 4x more common in men than women
often arrested so researchers often look for them in prison '40% of ppl in prison meet criteria
for men, linked strongly to past arrests for crimes of violence
criminal behavior declines after age of 40 but some continue it throughout their lives
have higher rates of alcholism and substance abuse disorders (help trigger development of disorder maybe by loosening a person's inhibitions)
or may make someone more prone to abuse substances
or they might both have the same cause such as a need to take risks
drug users w personality disorder often cite the recreational aspects of drug use as reason for starting and continuing it
children w conduct disorder and an accompanying attention deficit/hyperactivity disorder have a heightened risk of developing antisocial personality disorder (often bear similarities to antisocial disorder)
these children lie and violate rules and other ppl's rights, and children w attention deficit/hyperactivity lack foresight and judgement and fail to learn from experience like antisocial
connection between childhood disorders and antisocial disorder has been difficult to pinpoint
-psychodynamic- begins w absence of parental love during infancy, leading to a lack of basic trust
some children (ones who develop antisocial disorder) respond to the early inadequacies by becoming emotionally distant, they bond w others through use of power and destructiveness
found that antisocial ppl are more likely than others to have had significant stress in their childhoods particularly w family poverty, family violence, child abuse, parental conflict or divorce

-behavioral- learned through modeling or imitation
higher rate of antisocial found in parents of ppl w disorder
parents unintentionally teach antisocial behavior by rewarding children's aggressive behaviors/ when child misbehaves or becomes violent in reaction to parent's requests or orders, the parents may give in to restore peace, which could teach the child to be stubborn and even violent

-cog- hold attitudes that trivialize the importance of other ppl's needs, such philosophies of life may be much more common in our society than ppl realize
genuine difficulty recognizing points of view or feelings other than their own

-biological- may play important role
antisocial ppl, particularly highly impulsive and aggressive, have lower serotonin activity than others, linked to this behavior in other studies too
studies say display deficient functioning in frontal lobes, particularly prefrontal cortex which helps ppl plan and execute realistic strategies and to have personal characteristics such as sympathy, judgment and empathy, all antisocial behaviors
research found that antisocial ppl often feel less anxiety than other ppl so lack a key ingredient for learning, they have trouble learning from neg life experiences or tuning in to the emotional cues of others/ antisocial ppl respond to warnings or expectations of stress w low brain and bodily arousal such as slow autonomic arousal and slow eeg waves, bc of low arousal they tune out threatening or emotional situations easily, and are unaffected by them
argued that antisocial ppl are more likely than other ppl to take risks and seek thrills due to physical underarousal, may meet an underlying biological need for more excitement and arousal, antisocial and sensation seeking behavior go hand in hand
psychologists dont have enough research or effective interventions for this yet

killing of 4 or more ppl in same location at around the same time
on average mass killings occur in us every 2 weeks, 75% involve 1 killer, 67% involve use of guns, most are committed by men
number of mass killings is not on the rise overall
certain kinds of mass killings are increasing though
pseudocommando mass murders for example are on the rise-"kills in public place during the daytime, plans his offense in advance and comes prepared w a powerful arsenal of weapens, no escape planned and expects to be killed during the incident"
also autogenetic (self generated) massacres are rising- where individuals kill ppl indiscriminately to fulfill a personal agenda

number of factors to explain autogenetic, pseudocommando and other mass killings: availability of guns, bullying behavior, substance abuse, proliferation of violent media and video games, dysfunctional homes, contagion effects and mental illness
most suffer from mental disorder (which one has little agreement but these are most likely):
antisocial, borderline, paranoid, schizotypal, schiz or severe bipolar, intermitent explosive disorder (impulse control disorder featuring repeated unprovoked verbal and or behavioral outbursts, severe mood stress or anxiety disorder
none have received clear support

several variables emerged:
severe feelings of anger and resentment, feelings of being persecuted or grossly mistreated, desires for revenge,

mostly driven by set of feelings
should focus less on diagnosis but more on identifying and understanding these particular feelings

many mass murders survive their crimes
a personality disorder characterized by repeated instability in interpersonal relationships, self image, and mood and by impulsive behavior
relationships are very unstable

swing in and out of very depressive, anxious, and irritable states that last anywhere from a few hours to a few days or more
emotions always in conflict w the world around them/prone to bouts of anger, sometimes leading to physical aggression and violence, often direct impulsive anger inward and inflict bodily harm on themselves also
many troubled by deep feelings of emptiness
complex and one of more common conditions in clinical practice
many ppl who go to emergency rooms are ppl w this disorder who intentionally hurt themselves
impulsive, self destructive activities from alcohol to substance abuse to delinquency to unsafe sex, and reckless driving
self injurious or self mutilation behaviors such as cutting or burning themselves or banging their heads
behavios cause immense physical suffering but feel physical discomfort offers relief from their emotional suffering, distraction from emotional or interpersonal upsets snapping them out of an emotional overload
hurt themselves to deal w their chronic feelings of emptiness, boredom, and identity confusion, scars prove evidence of emotional distress
borderline patterns are more severe among those who injure themselves
suicidal threats and actions are common
75% of ppl w borderline personality disorder attempt suicide at least once in their life, 10% actually commit suicide
enter clinical treatment by emergency room after suicide attempt is common
form intense conflict ridden relationships in which their feelings are not necessarily shared by the other person.
idealize another person's qualities and abilities after just a brief first encounter
may violate boundaries of relationships, think in black and white terms they quickly feel rejected and become furious when their expectations are not met, yet they remain very attached to the relationships
recurrent fears of impending abandonment and frequently engage in frantic efforts to avoid real or imagined separations from important ppl in their lives
cut themselves or carry out self destructive acts to prevent partners from leaving
have dramatic identity shifts
unstable sense of self, goals, aspirations, friends, and even sexual orientation may shift rapidly
sense of dissociation or detachment from their own thoughts or bodies
may have no sense of self at times , leaving them to feel empty

5.9% of adult pop
75% are women,
course of disorder varies from each person
most commonly a persons instability and risk of suicide peak during young adulthood then gradually wane w advancing age
chaotic and unstable relationships so interferes w job performance even more than other personality disorders
-psychodynamic-early parental relationships bc fear of abandonment
object relations theorists say that an early lack of acceptance by parents may lead to a loss of self esteem, increased dependence and an inability to cope w separation
research is consistent w early childhoods of borderline ppl
when children, parents rejected them or neglected them verbally abused them or behaved inappropriately
marked by multiple parent substitutes, divorce, death, or traumas such as physical or sexual abuse
early sexual abuse is a common contributor to development of disorder
children who are abused are 4x more likely to develop disorder
many ppl who are abused physically, sexually or psychologically do not go on to develop this disorder

-biological- overly reactive amygdala (closely tied to fear and other neg emotions) , an underactive prefrontal cortex ( brain region linked to planning self control and decision making)
ppl w disorder who are particularly impulsive- those who attempt suicide or are very aggressive toward others have lower brain serotonin activity
lower activity could be linked to abnormality of 5htt gene (serotonin transporter gene) which has also been linked to major depressive disorder, suicide, aggression, and impulsivity
close relatives are 5x more likely to have same disorder

-biosocial theory- results from combo of internal forces (like difficulty identifying and controlling one's emotions, social skill deficits, abnormal neurotransmitter reactions) and external forces (like environment in which a childs emotions are punished ignored trivialized or disregarded)
parents can misinterpret their childs intense emotions as exaggerations or attempts at manipulation rather than as serious expressions of a n unsettled internal state
if they have intrinsic difficulty identifying and controlling their emotions and if their parents teach them to ignore their intense feelings, they may never learn how to properly recognize and control their emotional responses

biosocial theory is similar to explanation for eating disorders, parents who dont respond accurately to childrens internal cues may never learn to identify cues of hunger, may lead to eating disorder, many borderlines have eating disorder

-sociocultural- emerge in cultures that change rapidly , when a culture loses stability it inevitably leaves many of its members w problems of identity, sense of emptiness, high anxiety, and fears of abandonment
family units may come apart leaving ppl w little sense of belonging
changes of these kinds may explain growing reports for borderline disorder

-pscyhotherapy- some degree of improvement for ppl, difficult for a therapist to strike a balance between empathizing w borderline's dependency and anger and challenging his or her way of thinking
emotionally draining, so some therapists wont treat them
the fluctuating interpersonal attitude of them makes it hard to have collaborative working relationships w them
these ppl may violate client therapist relationship lines

- traditional pscyhoanalysis has not been affective
they often think therapists' reserved style and encouragement of free association is suggesting disinterest and abandonment
can have difficulty tolerating interpretations made by therapists as attacks

-contemporary pscyhodynamic-
like relational psychoanalytic therapy in which therapists take a more suportive and egalitarian posture has been more effective than traditional
provides empathetic setting where borderline ppl can explore their unconsciouss conflicts and pay particular attention to their central relationship disturbance, poor sense of self and pervasive loneliness and emptiness
sometimes helps reduce suicides, self harm behaviors, and number of hospitalizations and bring at least some improvement to borderline ppl

-dialectical behavior therapy (DBT)
treatment of choice
grows from cog beh model
applies alot of the same cognitive and behavioral techniques that are applied to other disorders like homework, psychoeducation, teaching social and other skills, modeling by the therapist, clear goal setting, reinforcements for appropriate behavior, ongoing assessment of children's behaviors and treatment progress, and collaborative examinations by the client and therapist of the client's way of thinking
also borrows from humanistic and contemp psychodynamic approaches placing client therapist relationship itself at he center of treatmet interactions, to make sure there are appropriate boundaries and providing an environment of acceptance and validation of the client
DBT therapists regularly empathize w their clients w emotional turmoil they are experiencing, local the truths of client's complaints or demands, and examine alternative ways for them to address valid needs
often supplemented by clients participation in social skill building groups where they practice new ways of relating to other ppl in a safe environment and receive validation and support from other ppl
more research support on this than other treatment for borderline
ppl are more able to tolerate stress, develop new more appropriate social skills, respond more effectively to life situations, develop a more stable identity
sig fewer suicidal behaviors and require fewer hospitalizations
more likely to remain in treatment, and report less anger more social gratification, improved work performance, and reductions in substance abuse

-antidepressant, antibipolar, antianxiety and antipsychotic drugs have helped calm emotional and aggressive storms of some ppl
use of drugs is controversial bc of number of suicide attempts
many adjust or discontinue their meds without consulting clinicians
belief that psychotropic drug treatment should be used largely as an adjunct to psychotherapy approaches and many clients seem to benefit from a combo of psychotherapy and drug therapy
have more theories than other approaches
begin w cold rejecting parents
spend their lives defending against feeling unsatisfied, rejected, unworthy, ashamed, and wary of the world
repeatedly telling themselves they are actually perfect and desirable
seek admiration from others
object relations theorists (psychodynamic theorists who emphasize relationships) interpret grandiose self image as a way for these ppl to convince themselves they are totally self sufficient and without need of warm relationships w parents or anyone else
children who are abused or who lose parents through adoption, divorce or death are at particular risk for the later development of disorder
ppl w disorder do indeed earn relatively high shame and rejection scores on various scales and believe that other ppl are basically unavailable to them

-cog beh
may develop when ppl are treated too positively rather than too negatively early in life
hold that certain children acquire a superior and grandiose attitude when their admiring or doting parents teach them to overvalue their self worth, repeatedly rewarding them for minor accomplishments or for no accomplishments at all

-sociocultural links disorder and eras of narcissism in society
suggest family values and social ideals in certain societies periodically break down, producing generations of young ppl who are self centered materialistic and have short attention spans
westernized cultures encourage self expression, individualism, and competitiveness, are likely considered to produce such generations of narcissists
study-respondents from us had highest narcissism scores followed by europe, canada, asia, and middle east
90% of teens have posted a photo of themselves online
word of the year in 2013
psychologists think taking selfies is form of narcissistic behavior or can view it more positively

-many sociocultural theorists see a link between narcissism and eras of narcissism in society, suggest that social values in society break down periodically producing generations of self centered materialistic youth, aka selfie generation
not supported by research
no relationship between number of selfies posted w how high they score on narcissism scale
does not mean they are harmless though, near reflexive instinct to photograph oneself may limit deeper engagements w the environment or experiencing events to their fullest , ppl that post alot of selfies are often seeking external validation of their self worth, even if that pursuit may not rise to level of clinical narcissism
too many selfies ay alienate those who view the poster's social media profile
ppl often take negative view of friends and fam who excessively post photos to facebook

-belief that concerns w criticisms of selfie movement have been overstated
tech enabled self expression
confusing to individuals of predigital generation
can enhance explorations of identity, help identify one's interests, develop artistic expression, help ppl craft a meaningful narrative of their life experiences, even reflect more realistic body images (selfies w/o makeup)
selfies serve as springboard to discuss issues that clients are reluctant to broach on their own in therapy

mixed grades from psychs and practitioners

ruler of denmark had his portrait painted at least 70 times by the same artist carl pilo
marked w intense focus on orderliness perfectionism, and control that the person loses flexibility openness and efficiency
doing everything "right" impairs productivity
concern w rules and order and doing things right makes it hard for him to see the big pitcure
when given task they become so focused on organizaiton details that they fail to grasp the point of the activity, work is often late, some cant finish job, and they may neglect leisure activities and friendships
unreseaonably high standards for themselves and others, well beyond realm of conscientiousness
never satisfied w performance, but normally refuse to seek help or do work w team bc others are careless and incompetent to do the job right
reluctant to make decisions bc they are afraid of making mistakes
tend to be rigid and stubborn, particularly in morals, ethics, and values
strict personal code and measure others w it
trouble expressing affection and relationships are stiff and superficial
stingy w time and money and cannot throw out objects that are worn out or useless
7.9% of adult pop
white educated married and employed ppl receiving diagnosis the most
men twice as likely as women
this and obsessive compulsive disorder are closely related/share alot of features/most meet criteria for either/ ppl w the personality disorder are more likely to suffer from major depressive disorder, generalized disorder or substance use disorder than regular disorder/
no consistent link between the two

OCD ppl typically do not want or like the symptoms, ppl w OCPD often embrace their symptoms and rarely wish to resist them
dsm5 personality disorder must " deviate markedly from expectations of individuals culture"
striking how little multicultual reserach has been conducted
clinical theorists have suspicions but little compelling evidence that there are cultural dif in this realm or that dif are important to field's understanding and treatment of personality disorders
lack of research is special concern for borderline bc theorists are convinced that gender and other cultural dif may be particularly important in both the development and diagnosis of this disorder
75% of ppl are female w borderline
maybe more biologically prone, bias, or dif may instead be reflection of extraordinary traumas to which many women face as children ( emotional trauma, victimization, violence, abuse, sexual abuse) which can be prerequisits to development of disorder
women in our society are subjected to such experiences and so disorder should maybe be special form of posttraumatic stress disorder
alternative explanaitons like these remain untested w no treatments available
multicultural theorists believe that disorder may actually be a reaction of persistant feelings of marginality, powerlessness, and social failure
so may be subject more to social inequities (sexism, racism, homophobia) than to psych factors
multicultural studies:
-disproportionately more hispanic american clients qualified for diagnosis of borderline than whites or blacks (more likely to get it, why?)
- may be perfectly acceptable traits and behaviors in some cultures, ex puerto rican have men that are expected to have strong emotions like anger aggression and sexual attraction (could this account for higher rates w hispanics? and explain how hispanic women and men have same amounts of the disorder compared to 3-1 women to men in other cultural groups?)
need more research
alternative to big 5 for revision of dsm5
a personality disorder currently undergoing study for possible inclusion in a future revision of dsm 5, ppl would recieve diagnosis if they had significant impairment in their functioning as a result of one or more very problematic traits
list problematic traits and rate severity of impairment by them

negative affectivity:
ppl who experience neg emotions frequently and intensely
one or more of : emotional lability (unstable emotions), anxiousness, separation insecurity, perservation (repetition of certain behaviors despite repeated failures), submissiveness, hostility, depressivity, suspiciousness, and strong emotional reactions (overreactions to emotionally arousing sitations)

withdraw from other ppl and social interactions
have restricted emotional reactivity (little reaction to emoionally arousing situations), depressivity, suspiciousness, withdrawla, anhedonia (inability to feel pleasure or take interest in things), intimacy avoidance
depressivity and suspiciousness also found in neg affectivity

behave in ways that put them at odds w other ppl
hostility (also found in neg affect), manipulativeness, deceitfulness, grandiosity, attention seeking, callousness, hostility

behave impulsively without reflecting on potential future consequences
irresponsibility, impulsivity, distractibility, risk taking, imperfection/disorganization

unusual and bizarre experiences
unusual beliefs and experiences, eccentricity, cog and perceptual dysregulation (odd thought processes and sensory experiences)