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TN Psychiatry > 17. Personality Disorders > Flashcards

17. Personality Disorders Flashcards

1
Q

Describe: Personality Disorders (6)

A
  • an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture; manifested in two or more of:…
  • inflexible and pervasive across a range of situations
  • pattern is stable and well established by adolescence or early adulthood (vs. a sudden onset)
  • associated with many complications, such as depression, suicide, violence, brief psychotic episodes, multiple drug use, and treatment resistance
  • relationship building and establishing boundaries are important; focus should be placed on validating, finding things to be truly empathetic about, and speaking to the patient’s strengths
  • mainstay of treatment is psychotherapy, add pharmacotherapy to treat associated psychiatric disorders (i.e. depression, anxiety, substance abus
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2
Q

A personality disorder is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture; manifested in two or more of what? (5)

A
  • cognition
  • affect
  • interpersonal
  • functioning
  • impulse
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3
Q

A flag for personality disorders in clinical setting is what? (1)

A

the reaction that a patient is eliciting in you

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4
Q

Name Personality disorders with familial associations (3)

A

Schizotypal, Antisocial, and Borderline

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5
Q

Describe classification of personality disorders (3)

A

personality disorders are divided into three clusters (A, B, and C), with shared features among disorders within each

  • Cluster A “Mad”
  • Cluster B “Bad”
  • Cluster C “Sad”
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6
Q

Describe Cluster A Personality Disorders (3)

A
  • Patients seem odd, eccentric, withdrawn
  • Familial association with psychotic disorders
  • Common defense mechanisms: intellectualization, projection, magical thinking
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7
Q

Name Cluster A Personality Disorders (3)

A
  • Paranoid Personality Disorder
  • Schizotypal Personality Disorder
  • Schizoid Personality Disorder
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8
Q

Name diagnosis criteria: Paranoid Personality Disorder (7)

A

Pervasive distrust and suspiciousness of others, interpret motives as malevolent

Blame problems on others and seem angry and hostile

Diagnosis requires 4+ of: SUSPECT

  1. Suspicious that others are exploiting or deceiving them
  2. Unforgiving (bears grudges)
  3. Spousal infidelity suspected without justification
  4. Perceive attacks on character, counterattacks quickly
  5. Enemies or friends? Preoccupied with acquaintance trustworthiness
  6. Confiding in others is feared
  7. Threats interpreted in benign remarks
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9
Q

Name diagnosis criteria: Schizotypal Personality Disorder

A

Pattern of eccentric behaviours, peculiar thought patterns

Diagnosis requires 5+ of: ME PECULIAR

  1. Magical thinking
  2. Experiences unusual perceptions (including body illusions)
  3. Paranoid ideation
  4. Eccentric behaviour or appearance
  5. Constricted or inappropriate affect
  6. Unusual thinking/speech (e.g. vague, stereotyped)
  7. Lacks close friends
  8. Ideas of reference
  9. Anxiety in social situations

(Note: Rule out psychotic/pervasive developmental disorders - this is not part of the criteria)

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10
Q

Name diagnosis criteria: Schizoid Personality Disorder (7)

A

Neither desires nor enjoys close relationships including being a part of a family; prefers to be alone.

Lifelong pattern of social withdrawal. Seen as eccentric and reclusive with restricted affect

Diagnosis requires 4 of: DISTANT

  1. Detached/flat affect, emotionally cold
  2. Indifferent to praise or criticism
  3. Sexual experiences of little interest
  4. Tasks done solitarily
  5. Absence of close friends (other than first-degree relatives)
  6. Neither desires nor enjoys close relationships (including family)
  7. Takes pleasure in few (if any) activities
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11
Q

Describe: Cluster B “Bad” Personality Disorders (3)

A
  • Patients seem dramatic, emotional, inconsistent
  • Familial association with mood disorders
  • Common defense mechanisms: denial, acting out, regression (histrionic PD), splitting (borderline PD), projective identification, idealization/devaluation
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12
Q

Name: Cluster B “Bad” Personality Disorders (4)

A
  • Borderline Personality Disorder (2-4%)
  • Narcissistic Personality Disorder (2%)
  • Antisocial Personality Disorder (M: 3%, F: 1%)
  • Histrionic Personality Disorder (1.3-3%)
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13
Q

Name diagnosis criteria: Borderline Personality Disorder (9)

A
  • Unstable moods and behaviour, feel alone in the world, problems with self-image.
  • History of repeated suicide attempts, self-harm behaviours.
  • Inpatients commonly report history of sexual abuse.
  • Tends to fizzle out as patients age.
  • Dialectical behaviour therapy (DBT) is the principal treatment
  • **10% suicide rate**

Diagnosis requires 5+ of: IMPULSIVE

  1. Impulsive (min. 2 self-damaging ways, e.g. sex/drugs/spending)
  2. Mood/affect instability
  3. Paranoia or dissociation under stress
  4. Unstable self-image
  5. Labile intense relationships
  6. Suicidal gestures / self-harm
  7. Inappropriate anger
  8. aVoiding abandonment (real or imagined, frantic efforts to)
  9. Emptiness (feelings of)
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14
Q

Name diagnosis criteria: Narcissistic Personality Disorder (9)

A

Sense of superiority, needs constant admiration, lacks empathy, but with fragile sense of self. Consider themselves “special” and will exploit others for personal gain

Diagnosis requires 5+ of: GRANDIOSE

  1. Grandiose
  2. Requires excessive admiration
  3. Arrogant
  4. Needs to be special (and associate with other specials)
  5. Dreams of success, power, beauty, love
  6. Interpersonally exploitative
  7. Others (lacks empathy, unable to recognize feelings/needs of)
  8. Sense of entitlement
  9. Envious (or believes others are envious)
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15
Q

Name diagnosis criteria: Antisocial Personality Disorder (7)

A
  • Lack of remorse for actions, manipulative and deceitful, often violate the law.
  • May appear charming on first impression.
  • Pattern of disregard for others and violation of others’ rights must be present before age 15; however, for the diagnosis of ASPD patients must be at least 18.
  • Strong association with Conduct Disorder, history of trauma/abuse common
  • Diagnosis requires 3+ of: CORRUPT
  1. Cannot conform to law
  2. Obligations ignored (irresponsible)
  3. Reckless disregard for safety
  4. Remorseless
  5. Underhanded (deceitful)
  6. Planning insufficient (impulsive)
  7. Temper (irritable and aggressive)
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16
Q

Name diagnosis criteria: Histrionic Personality Disorder (8)

A
  • Attention-seeking behaviour and excessively emotional.
  • Are dramatic, flamboyant, and extroverted. C
  • annot form meaningful relationships.
  • Often sexually inappropriate
  • Diagnosis requires 5+ of: ACTRESSS
  1. Appearance used to attract attention
  2. Centre of attention (else uncomfortable)
  3. Theatrical
  4. Relationships (believed to be more intimate than they are)
  5. Easily influenced
  6. Seductive behaviour
  7. Shallow expression of emotions (which rapidly shift)
  8. Speech (impressionistic and vague)
17
Q

Describe: Cluster C “Sad” Personality Disorders (3)

A
  • Patients seem anxious, fearful
  • Familial association with anxiety disorder
  • Common defense mechanisms: isolation, avoidance, hypochondriasis
18
Q

Name: Cluster C “Sad” Personality Disorders (3)

A
  • Avoidant Personality Disorder
  • Obsessive-Compulsive Personality Disorder
  • Dependent Personality Disorder
19
Q

Name diagnosis criteria: Avoidant Personality Disorder (7)

A
  • Timid and socially awkward with a pervasive sense of inadequacy and fear of criticism.
  • Fear of embarrassing or humiliating themselves in social situations so remain withdrawn and socially inhibited
  • Diagnosis requires 4+ of: CRINGES
  1. Criticism or rejection preoccupies thoughts in social situations
  2. Restraint in relationships due to fear of being shamed
  3. Inhibited in new relationships due to fear of inadequacy
  4. Needs to be sure of being liked before engaging socially
  5. Gets around occupational activities requiring interpersonal contact
  6. Embarrassment prevents new activity or taking risks
  7. Self-viewed as unappealing or inferior
20
Q

Name diagnosis criteria: Obsessive-Compulsive Personality Disorder (8)

A
  • Preoccupation with orderliness, perfectionism, and mental and interpersonal control.
  • Is inflexible, closed-off, and inefficient
  • Diagnosis requires 4+ of: SCRIMPER
  1. Stubborn
  2. Cannot discard worthless objects
  3. Rule/detail obsessed (to point of activity lost)
  4. Inflexible in matters of morality, ethics, values
  5. Miserly
  6. Perfectionistic
  7. Excludes leisure due to devotion to work
  8. Reluctant to delegate to others
21
Q

Key Differences Among Schizoid, Schizotypal, and Schizophrenia: Thought Form

A
  • Schizoid: Organized
  • Schizotypal: Organized, but vague and circumstantial
  • Schizophrenia: Disorganized, tangential, loosening of associations
22
Q

Key Differences Among Schizoid, Schizotypal, and Schizophrenia: Thought Content

A
  • Schizoid: No psychosis
  • Schizotypal: No psychosis, may have ideas of reference, paranoid ideation, odd beliefs and magical thinking
  • Schizophrenia: Psychosis, hallucinations
23
Q

Key Differences Among Schizoid, Schizotypal, and Schizophrenia: Relationships

A
  • Schizoid: Solitary, NO desire for social relationships
  • Schizotypal: Lacks close relationships, INTERESTED in relationships but socially inept
  • Schizophrenia: Socially marginalized, but not by choice

TN Psychiatry (26 decks)

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