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NMSK Exam 1 > 18. Personality Disorders > Flashcards

18. Personality Disorders Flashcards

1
Q

What is a personality disorder?

A

Fixed, rigid pattern of behavior and way of acting in the environment that causes distressess and impaired funcitoning.

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2
Q

In personality disorders,

  1. ​Is the person aware of the problem?
  2. When do they usually present?
  3. Diagnosing personality disorders in elderly is…
A
  1. No
  2. Early adulthood (not dx until 18 YO): generally not diagnosed in children and adolescents because personality is not fully developed and some traits may go away in adulthood.
  3. Unreliable: may be due to medical condition/dementia
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3
Q

What are the 3 clusters of personality disorder

A
  1. Cluster A (weird; odd or eccentric)
  2. Cluster B (Bad; dramatic, erratic or emotional behavior)
  3. Cluster C (anxious or fearful behavior)
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4
Q

Cluster A (Weird; odd or eccentric behavior) PD

A
  1. Paranoid PD
  2. Schizoid PD
  3. Schizotypal PD
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5
Q

Cluster B (Bad; dramatic, erratic or emotional behavior) PD

A
  1. Antisocial PD
  2. Borderline PD
  3. Histrionic PD
  4. Narcisstic PD
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6
Q

Cluster C (Anxious or fearful) PD

A
  1. Obsessive Compulsive PD
  2. Avoidant PD
  3. Dependent PD
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7
Q

Paranoid Personality Disorder

A

Suspicious and distrust of thers, even friends and family.

    • think others are exploiting/deceiving you
    • hidden meanings in comments/events
    • hard time building relationships: think spouse or partner is cheating
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8
Q

Person with Paranoid Personality Disorder is at risk for having what?

A
  1. Agoraphobia
  2. Major depression
  3. OCD
  4. Substance abuse
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9
Q

Halmark ego defense of someone with Paranoid Personality Disorder

A

Projection: attribute unacceptable thoughts to others; accue others of being suspcisiou

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10
Q

Schzoid Personality Disorder

A
  • Chooses social isolation; more comfortable alone
  • Thinks close relationships are pointless: no close friends
  • Flat affect: indifferent to praise or critisism
  • No hobbies
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11
Q

Person comes to hospital with uncontrolled illness: lives alone, no kids, same job for 35 years. Goes from work => home, repeat and is COMPLETELY OKAY WITH IT.

A

Schizoid Personality Disorder

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12
Q

Schizotypal Personality Disorder

A

Fear of social interaction and few close friends (does not go away with familiarity) + odd beliefs/thinking

  • Ideas of reference: think everything is related to them (think they’re center of ATN)
  • Superstitions, telepathy, 6th sense
  • KEY = open to challenging beliefs (not fixed = diff from delusions)
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13
Q

What makes the odd beliefs in Schizotypal Disorder different from delusions?

A
  • Beliefs are NOT fixed. They are open to challenging them.
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14
Q

CLUSTER B

  • Antisocial Personality Disorder
A
  1. Disregard for the law and rights of others
  2. Aggressive, pervasive lying and deception
  3. NO remorse
  4. Irresponsible in work and family
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15
Q

In order to be diagnosed with Antisocial Personality Disorder, what criteria must you meet.

A
  1. > 18 YO
  2. Must have had conduct disorder before 15 YO
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16
Q

What is the child form of Antisocial Personality Disorder

A

Conduct disorder (< 18YO)

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17
Q

Antisocial Personality Disorder

  1. MC in:
  2. At risk for developing what?
A
  1. M
  2. At risk for getting
    1. Anxiety disorders
    2. Substance abuse
    3. Somatozation disorder
    4. Gambling
18
Q

Borderline Personality Disorder

A
  1. Unstable relationships (Attached, fear of abandonment): “all people are very good or bad: boyfiriend is the BEST/devil”
  2. Mood swings (v bad anger)
  3. Chronic feeling of emptyiness
  4. Impulsive in at least 2 areas that are self-damaging (sex, substance abuse, reckless driving)
  5. Manipulative
  6. Immature personality traits: teddy bear sign or tweety bird sign
  7. Paranoia/dissoaciation
19
Q

Borderline Personality Disorder:

  1. Patients are at increased risk for:
  2. BPD is often triggered by what?
  3. High rate of what comorbidities??
A
  1. Suicide (due to fear of abandoment: ill kill myself bc you dont care) or self mutilation
  2. Sexual/emotional abuse
  3. Major deppresion
20
Q

When treating patients with BPD, be sure to do what?

A

Set rigid boundaries:

    1. constantly remind them of guidelines and respsonsbilities
    1. Will often “split” staff members/docs against each other.
21
Q

Hallmark defense mechanism in Borderline Personality Disorder

A

Splitting: black and white thinking, cannot hold opposing views, doc is either great/terrible, all things in world are amazing/terrible

22
Q

What is the gold standard treatment for Borderline Personality Disorder?

A
  1. Dialectical Behavioral Therapy (Type of CBT):
    1. Treats chronic suicidality by developing coping skills to improve affective stability and impulse.
    2. Weekly therapy for 1-2 years
23
Q

Histrionic Personality Disorder

A
  • Examples= celebrities
  1. Wants to be center of attention (talks loudly, wild stories, hand gestures) and excessive emotions
  2. Dramatic, sexually provacoative, seductive (wears sexy clothes, touches others alot)
  3. Very concerned with physical apperance
  4. La belle indifference: person is unconcerned w sx
24
Q

Narcissistic Personality Disorder

A
  1. Preoccupied with self/ self-inflated and how they’re perceived by others,
  2. But envious of others
  3. Entitled
  4. Lack of empathy for others
  5. “Me first personality”
25
Q

Narcisstic Personality Disorder

  1. MC in: ___.
  2. At risk for what?
A
  1. Male
  2. At risk for:
    1. Anorexia
    2. Substance abuse
    3. Depression
26
Q

Avoidant Personality Disorder

A
  1. Avoids social interactions/”social inhibition” but wants them because they feel inadequate, ppl wont like them.
  2. Struggles with intimate relationships
27
Q

How is Avoidant and Schizoid Personality Disorder different?

A
  1. Avoidant = wants social interactions and not odd, but cant;
  2. Schizoid = prefers to be alone
28
Q

Dependent Personality Disorder

A

Dependent on others (always in relationships and hard to make decisions on own)

  1. Clingy; helpless when alone
  2. Low self-confidence, making it hard to engage in activities
  3. Need others to assume responsibility for major life events
  4. Hard time expressing opinion
29
Q

Obsessive Compulsive Personality Disorder

A
  1. EX. CEO of company “my way or highway”
  2. Preoccupied with perfection and control“loves to-do lists/always needs a plan”
  3. Inflexible and stubborn: my way or highway
  4. Even though focused, interferes with efficiency in tasks
30
Q

How is OCD different from OCPD?

A

In OCPD,

  1. MC in M
  2. Behaviors help to acheieve goals: obsessions and compulsions help to acheive goals (ego-syntonic)
  3. Not aware of problem
31
Q

Dissociative Identity Disorder

A
  1. Presence of 2 or more distinct personalities with own thoughts, behaviors and memory.
  2. May lose track of time
  3. Reported by others/or self
  4. Often caused by history of sexual abuse.
32
Q

What is Psychodynamic Psychotherapy?

How often to you go?

A
  • Looks at how people perceive events and themselves with the assumption that they are shaped by early life.
  • Finds more adaptive modes of perception and response using transference.
  • Go: several times a week - month
    *
33
Q

What is CBT?

How often to you go?

A

Deals with how people think about world and their perception of it: turns (-) thoughts into (+).

Go: 1x week for 6-20 weeks.

34
Q

Can meds cure Personality Disorders?

A
  • No meds cure personality disorder: you can use with psychotherapy so that person engages in therapy.
35
Q

Which antidepressants should you avoid/prescribe in Personality Disorder?

A

Avoid: TCAs and MAO-I

Give: SSRI and newer drugs; but rmber drugs will be less effective

36
Q

Give _____ to control impulse in person with personality disorder.

A

Valproic acid

37
Q

Give ______ to reduce transient psychotic symptoms, sometimes een in BPD.

A

Atypical antipsychotics

38
Q

Always be concerned about _____ in ppl with Personality Disorders

A
  1. Suicide
  2. Avoid benzos/narcotics
39
Q

Complications of Personality Disorder

A
  1. Suicide
  2. Substance abuse
  3. Accidental injury
  4. Depression
  5. Homicide (esp high in paranoid and a_ntisocial personality disorder_)
40
Q
  • Cluster ___ PD gets worse later in life
  • Clusters _____ PD tend to become less severe and less intense in middle-age/later life.
A
  • Cluster C = worse
  • Cluster A/B = gets better
41
Q

Which cluster has the WORST prognosis?

A

Cluster B

  • Susceptible to substance abuse
  • May die early due to: impulse control and suicidal behavior.

NMSK Exam 1 (22 decks)

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