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Summary Taak 4 histrionic and narcissistic PD

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Taak 4 histrionic and narcissistic PD MHS4503 personality disorders Master Mental Health

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  • 4 november 2019
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  • 2019/2020
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Taak 4 Histrionic and Narcissistic PD
Histrionic PD
Sprock Gender typed behavioural examples of histrionic PD
- Findings that clinicians diagnose Histrionic Personality Disorder more frequently in
women may be due to the feminine gender weighting of the criteria or because the
diagnostic label elicits a feminine stereotype. Using a method derived from the act-
frequency approach, undergraduates generated behavioral examples of the DSM-IIIR
and DSM-IV Histrionic criteria without regard to sex or according to sex role
instructions that elicited masculine or feminine sex roles. A national sample of
psychologists and psychiatrists rated the representativeness of the symptoms for the
Histrionic criteria or for Histrionic Personality Disorder. Feminine behaviors were
rated more representative of Histrionic Personality Disorder and somewhat more
representative of the Histrionic criteria than masculine behaviors suggesting that the
feminine sex role is more strongly associated with the label than the criteria.
Masculine behaviors were also rated less representative than sex-unspecified
examples. Results provide a possible explanation for the higher rates of diagnosis of
Histrionic Personality Disorder in women.
- In part 1, the undergraduate participants were asked to list three behavioral examples
for each of the Histrionic criteria. A total of ten criteria were used: the eight criteria in
the DSM-IIIR plus the two new criteria in the DSM-IV. Six of the criteria in the DSM-
IIIR and DSM-IV were judged to be the same or similar in content but reworded. One
third (20 males, Histrionic Personality Disorder 111 20 females) were assigned to each
of the three instruction conditions: masculine instruction condition (asked to list three
behavioral examples of each HPD criterion that would be typical for males), feminine
instruction condition (asked to list three behavioral examples for each criterion that
would be typical for females), or sex-unspecified instruction condition (asked to list
three behaviors per criterion).
- In part 2, psychologists and psychiatrists received a letter requesting their participation
along with the list of behaviors to be rated and a demo- 112 Sprock graphic and
professional experience questionnaire. A pre-addressed stamped envelope was
included to return the materials. The mailings proceeded in two stages: DSM-IIIR
based behaviors and ratings, DSM-IV based behaviors and ratings. Half of the
psychologists (n 150) and half of the psychiatrists (n 150) were randomly assigned to
the group asked to rate the representativeness of the behaviors for the HPD diagnostic
criteria; the remaining half were asked to rate how well the behaviors represented the
construct of HPD. Participants in both rating conditions received a subset
(approximately one tenth) of the total list of behaviors. Clinicians assigned to rate the
representativeness of the behaviors for the diagnostic criteria received all behaviors
listed for one of the HPD criteria and were asked to rate how good an example the
behaviors were for that criterion. Clinicians assigned to rate the prototypicality of the
behaviors for HPD received a subset of behaviors from the lists across Histrionic
criteria and were asked to rate how good an example the behaviors were for Histrionic
Personality Disorder.
- Feminine gender weighting of criteria. (sex bias in criteria)
- Several studies have demonstrated sex bias in HPD criteria (change gender, keep rest
of the information the same)
- Klein maar significant verschil
- Men and women may manifest symptoms of HPD differently
- The purpose of this study was to examine the representativeness of sex-typed
behavioural examples of HPD symptoms at the criterion level and at the diagnostic

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, level in order to better understand how sex bias might occur. Specific behavioural
descriptions (acts) were used exemplify personality traits or dispositions. Specific
behavioural examples were generated for HPD criteria but sex-role instructions were
used to elicit sex typed behavioural examples and how they might be manifested in
men and women in everyday behaviours.
- Hypothesis: feminine behaviours would be rated as better examples of the criteria than
masculine behavioural examples due to feminine gender weight of the criteria.
- Undergraduates created the behavioural examples, psychologists and psychiatrists
rated the prototypicality of the behaviours.
- Feminine behavioural examples of HPD were rated as somewhat better examples of
the HPD criteria and as more representative of the construct of HPD than masculine
behavioural examples.
- The feminine sex-role stereotype is more strongly associated with the diagnostic label
than the criteria.
- Mannen meer indirect gedrag
- Non sex typed behaviours were rated as highly as feminine behaviours. So, masculine
behaviours are seen as less representative of HPD criteria and the construct of HPD.
- Underdiagnosis in men may help explain the higher diagnosis rate in women.
Lobbestael
- Aandachtsbias
- Snelle opgevers, alleen doorzetters op het gebied van aandacht zoeken
Hysterie: voorspelbaarder in gedrag, breder begrip
Histrionoisch: meer afhankelijk, meer labiel en instabiel en
Overlap: dramatisch, oppervlakkige emoties
Wondering uterus: hysterie werd veroorzaakt door losse baarmoeder die naar de hersenen
ging volgens hypocrates. Die baarmoeder in de hersenen zorgde voor hysterische symptomen.

Narcissistic PD
Campbell Do narcissists dislike themselves deep down inside?
- Subjects (N = 154) completed the
Narcissistic Personality Inventory, the
Rosenberg selfesteem scale (RSES), and
the IAT. No relationship between
narcissism and implicit self esteem was
found.
- Hypothesis: explicit self-esteem hides the
implicit self esteem which is insecurity
etc.
- Our agency IAT used words that
reflected high versus low agency
(assertive, active, energetic, outspoken,
dominant, enthusiastic, quiet, reserved,
silent, withdrawn, submissive, and inhibited). The communion IAT used words that
reflected high versus low communion (kind, friendly, generous, cooperative, pleasant,
affectionate, mean, rude, stingy, quarrelsome, grouchy, and cruel). The self-esteem
IAT used positive and negative words (good, wonderful, great, right, bad, awful,
terrible, and wrong). Narcissism is associated with positive self-views in agentic
(macht en status) domains (status, intelligence etc), but not in communal (morel)
domains (kindness, morality) hier is het neutraal.


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