10/10 Personality Disorders - Tobia Flashcards
personality
definition
cognition: process of taking stimuli from environment and obtaining rxn from organism
affectivity: ability to contain one’s emotions
interpersonal functioning: 8 marriages of Elizabeth Taylor
impulse control: ability to think before you act
personality disorder
- deficit in 2 of 4 spheres
- pervasive across social situations (not just isolated to one setting)
- stable pattern with onset in adolescence or early adulthood
- clinically significant
- not accounted for by another mental disorder, substance, or another gen medical cond
personality disorders: etiology
amalgam of all of our ego defense mechanisms in a maladptive state
3 clusters of personality disorders
based on similarities of characteristics:
- odd and eccentric
- dramatic and emotional
- anxious and fearful
Cluster A
odd and eccentric
- paranoid
- schizoid
- schizotypal
all may be premorbid (ex. schizophrenia)
any of the above may be risk factor for developing psychotic disorder
definitions
reaction formation
denial
sublimation
projection
reaction formation: dealing with inability to express a feeling by expressing opposite (saying I hate you instead of I like you)
denial
sublimation: transformation of an impulse into artistic form
projection: attribution of one’s undesired impulses onto another
paranoid personality disorder
- pervasive distrust, suspiciousness
- lifetime prevalence of 2.5-4.5%
- incr prevalence among relatives of schizophrenics
schizoid personality (SPD)
schizotypal personality (StPD)
vs PPD
[PPD ddx]
PPD patient will avoid due to pervasive distrust/suspicion
SPD patient will avoid but be content
PPD patient will avoid due to pervasive distrust/suspicion
StPD will avoid and demonstrate some eccentricity of behavior
schizoid personality disorder
emotionally detached from social relationships
restricted range of emotions in interpersonal settings
NO DESIRE for close relationships
ex. hermit (content!)
childhood neglect is hypothesized to play a role → fantasy as an autistic retreat involving creation of imaginary lives to avoid social relationships
SPD ddx
diffs between SPD and PPD/StPD
SPD is content in detachment
- PPD will avoid others due to pervasive distrust/suspiciousness
- StPD will demonstrate some eccentricity of behavior
schizotypal personality disorder
discomfort with close relationships
eccentricities of behavior
“magical thinking”
StPD ddx
StPD demonstrates some eccentricity of behavior
- PPD will avoid due to pervasive distrust and suspiciousness of others
- SPD will be content in their detachment
Cluster B
antisocial
borderline
histrionic
narcissistic
antisocial personality disorder
ADULT-ONLY illness (18 or older)
- show onset of Conduct Disorder before 15
- harsh/violent/criminal environment can predispose
disregard for/violation of rights of others
- acting out
harsh/violent/criminal environment can predispose
- 3% men, 1% women
- half arrested → 75% of incarcerated have APD
may remit with age (4th decade)
borderline personality disorder
features
prevalence
etiology
aspects of general definition
- instability in relationships
- impulsivity
pattern of inflexible defense mechanisms
- affective instability; ‘splitting’
- suicidal behavior, gestures (passive aggression + manifestation of inward turning of outward feelings)
- dissociation
prevalence: 1.5-6%
- 5x as common in FDR of borderline patients
- incr rates in families of alcoholics, antisocial PD, mood disorders
etiology:
- BPD women frequently have suffered from sexual/physical trauma
- greater stability in relationships/vocational fx in 30s, 40s
histrionic personality disorder
excessive, superficial emotionality
powerful need for attention
-
dissociation: temp and drastic replacement of unpleasant mood state with a pleasant one
- often seen as dramatizing, emotionally shallow
prevalence: 1-2%
* link to somatization and antisocial PD
narcissistic personality disorder
extremely low self-esteem
need for admiration
grandiosity
lack of empathy
[kind of a hybrid between antisocial/histrionic]
- interpersonally exploitative
- twinship transferrance aka alter ego tran
prevalence: 5% (50-75% diagnosed…men!)
Cluster C
anxious/fearful
- avoidant
- dependent
- obsessive-compulsive
avoidant personality disorder
presents similar to schizoid
- avoidance
- defense against shame
- feelings of inadequacy
differences
- DESIRE for close relationships, but avoid them bc of anxiety produced by sense of inadequacy
avoidance behavior results in absence/removal which allows for avoidance of potential humiliation/embarrassment →→→ reinforces avoidance behavior
prevalence: 2.5%, equal in M/F
learning/reinforcement
2x2 table
dependent personality disorder
excessive need to be taken care of
submissive/clingy behavior
defense against aggression; fear of separation
- separation anxiety
- normal between 10-16 months
- stranger anxiety
may remit with age
obsessive compulsive personality disorder
patients are perfectionists (more like TypeA personality disorder)
- misnomer: DO NOT have to be obsessive or compulsive!
maybe associated with anxiety/mood disorders
pattern of inflexible defense mechs
- isolation (of affect) → manifests as ritualistic cleaning, etc
- undoing
- rxn formation → manifests inner chaos as order/perfectionisms
prevalence: 2-8%, 2x common in men
which conditions may remit with age?
APD (antisocial)
BPD (borderline)
avoidant
dependent
