1- Mental health conditions (Personality disorders) Flashcards
define personality
individual differences in characteristic patterns of thinking, feeling and behaving
factors shaping personality
- Biological
o Genes: temperament, physical appearance/characteristics, IQ, disability - Psychological
o Early attachment and environment
o Sibling
o Peer relationships
o Schooling
o Traumas (loss, life events) - Social
o Socioeconomic status
o War/peace
o Social media
o Culture
o Climate
o Immigration
RF for PD
Prevalence of PD
- 4-13%
- 20% of GP attendees who are adults suffer from PD
- Most prevalent
o Dissociative
o Histrionic
o Paranoid
PD clusters
MAD BAD SAD
features of PD
3 Ps
- Persistent
- Problematic
- Pervasive
define PD
Conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others
or
A deeply ingrained and enduring pattern of inner experience and behaviour that deviates markedly from expectations in the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment
personality types
- 10 diff types, usually groups around 3 clusters: A, B, C
- Common to have more than 1 types of personality disorder
- People may present with traits of one type rather than the full disorder
- Scoring high on severity and across different types is a sign of increasing complexity
Cluster A PD
paranoid
schizoid
schizotypal
paranoid
present as suspicious and mistrustful, misinterpreting events as persecutory, bearing grudges, strong sense of personal right
schizoid
present as detached, solitary, aloof, little interest in people and sex, indifferent, lacking close friends
schizotypal
present as eccentric, odd behaviour and thinking, unconventional beliefs
cluster B PD
Borderline (EUPD)
Narcissistic
Antisocial/dissocial
Histrionic
borderline
(emotionally unstable personality disorder)- presents with emotional instability, impulsivity, parasuicidal acts, chronic feelings of emptiness, intense and unstable relationships, fear of abandonment
narcissistic
presents as grandiose, self-important, degrading others
antisocial/dissocial
presents with unconcern for the feelings of others, disregard for rules, impulsivity, low tolerance to frustration, failure to take responsibility (criminals)
histrionic
- presents as theatrical, dramatic, exhibit superficial emotionality, seductiveness, suggestibility
cluster C PD
Anankastic
Dependent
Anxious-avoidant
anakastic
obsessive compulsive- present as rigid, stubborn, perfectionistic, preoccupied with rules, order and routine, have a higher sense of morality
dependent
needing others to make decisions for them, fear abandonment, unable to cope alone, need reassurance
anxious avoidant
presents with persistent anxiety, sensitive to rejection, tend to avoid relationships unless acceptance is guaranteed
diagnosis/ investigations for PD
1) history
2) MSE
3) Risk assessment
4) Investigations
history
- ‘Are you ever concerned about other people in your life?’, ‘Can you rely on friends and
- ‘How do you think your friends and family would describe your personality?’
- (open question)
family?’, ‘How do you view your relationship with family?’ (paranoid) - ‘Do you work well with others?’, ‘What activities do you enjoy?’, ‘Would you say you have many close friends?’ (schizoid)
- ‘How would you describe your relationships with the people in your life?’, ‘Do other people ever say you have a temper?’, ‘Do you ever feel life is not worth living?’, ‘Do you have any worries about being alone?’ (emotionally unstable)
- ‘Have you ever got into serious trouble, for instance with the police? If so, was it your fault?’, ‘Do people ever tell you that you have a temper?’, ‘Do you like to think things through properly before carrying out an act?’ (dissocial)
- ‘Do you feel that you are easily influenced by your friends?’, ‘Do you like to be the life and soul of a party?’ (histrionic)
- ‘Is there anything you worry about or fear?’, ‘Do you struggle to make an important decision?’, ‘Place yourself on a scale ranging from very shy to confident.’ (dependent)
- ‘Tell me about your social circle’, ‘Do you ever take risks or partake in brand new activities?’, ‘Do you feel contented with yourself?’ (anxious)
- ‘Do you feel that you are a perfectionist?’, ‘Do you spend more time working or relaxing?’, ‘Do you find you are struggling to meet deadlines at work?’ (anankastic)
- A reliable collateral history is imperative: to determine the course of the symptoms, as well as identifying characteristic features which the patient may not have disclosed.
Risk assessment
suicide
self harm- esp EUPD
risk to others
