11-11 Personality Disorders

Question 1

What are the personality disorders (by cluster)?

Answer 1

CLUSTER A (WEIRD) [ M > F! ]
—Paranoid
—Schizotypal
—Schzoid
CLUSTER B (WILD)
—Borderline
—Histrionic
—Narcissistic
—Antisocial
CLUSTER C (WORRIED)
—Avoidant
—Dependent
—Obsessive-Compulsive

Question 2

Paranoid
—cluster?
—features?
—ddx?

Answer 2

CLUSTER A
• Schizophrenia spectrum
—paranoid all the time, can’t trust others, people are out to get me
DDX
—vs. schizophrenia: no cognitive decline; doesn’t respond to anti-psychotics; though more common in families w/ schizophrenia
—vs. delusional disorder: more episodic/singular focus w/ DD

Question 3

Schizotypal
—cluster?
—prototype?
—features?

Answer 3

CLUSTER A
•	Schizophrenia spectrum
—Prototype = New Orleans
—Odd/magical belief au point d'être mauvais
—6th sense, clairvoyance

Question 4

Schizoid
—cluster?
—prototype?
—features?
—ddx?

Answer 4

CLUSTER A
—prototype = lighthouse keeper
—features: wants nothing to do with anyone
—DDX: vs. social anxiety d/o where folks desire cxns w/ others

Question 5

Borderline
—cluster?
—features?
—Tx?

Answer 5

CLUSTER B
—F>M
—common w/ h/o early sexual abuse
—underlying prob: unstable self-image (chronic emptiness)
—impulsivity in two areas
—suicidal gesturing!
—Affective instability due to a marked reactivity of mood
—anger mgmt probs
—Transient, stress-related paranoid ideation or severe dissociative symptoms
—spitting
—repeatedly hospitalized
TX
—DBT works!

Question 6

Histrionic
—cluster?
—prototype?

Answer 6

CLUSTER B
—F>M
—Marilyn Monroe, med student w/ short skirt
—uncomfort when not ctr of attn
—emptiness deep down
—Interaction w/ others often characterized by inapp seductive or provocative behav
—dramatic
—thinks relationships are more intimate than actually are

Question 7

Narcissistic Personality Disorder
—cluster?
—prototype?
—features?

Answer 7

CLUSTER B
—prototype = Ivy Leaguer at the Hanover Inn
—high suicide rate: narcissistic injury
—grandiose sense of how awesome they are
—lacks empathy; exploits others to get ahead

Question 8

Antisocial Personality Disorder
—cluster?
—a.k.a.?
—prototype?
—Dx Criteria FYI

Answer 8

CLUSTER B
M>F
—A.K.A.: Sociopathy
—prototype: the characters in Pulp Fiction
—genetic! twins; conduct d/o as kid
ASignificant impairments in personality functioning manifest by:
—1. Impairments in self functioning (a or b):
• a. Identity: Ego-centrism
• b. Self-direct: based on personal gratification
AND
—2. Impairments in interpersonal fx’ing (a or b):
• a. Empathy
• b. Intimacy:
B. Pathological personality traits in the following domains:
—1. Antagonism, characterized by:
• a. Manipulativeness
• b. Deceitfulness
• c. Callousness
• d. Hostility:
—2. Disinhibition, characterized by:
• a. Irresponsibility
• b. Impulsivity
• c. Risk taking

Question 9

Avoidant Personality Disorder
—Cluster?
—DDx?
—Tx

Answer 9

CLUSTER C
—‪↓‬ interpersonal fxn 2° to concerns about being disapproved, criticized or rejected.
—DDx: vs. schizoid b/c they want to be around people
—Exposure therapy

Question 10

Dependent Personality Disorder
—cluster?
—assoc’d with?
—features?

Answer 10

CLUSTER C
—assoc’d w/ F>M; obesity; high med costs
—needs help make decisions, initiating anything
—Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant

Question 11

Obsessive Personality Disorder
—cluster?
—Prototype?
—features?
—DDx vs. OCD

Answer 11

CLUSTER C
—prototype = Petrus
—perfectionism to the pt can’t finish anything
—Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
—spends so much time on work that family other suffer
—preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
—some hoarding
—can’t delegate
—rigid; stubborn