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2/16: Personality and Impulse Control Flashcards

1
Q

Definition of personality disorders

A

enduring pervasive/inflexible behavior different from cultural expectations @ adolescence/early adult –> impairment
(stable over time)

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2
Q

are traits a disorder?

A

NO

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3
Q

prevalence of personality disorders

A

10-20% of general population

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4
Q

when do personality disorders typically begins?

A

start in late adolescence, often with signs in childhood

established patterns in adulthood

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5
Q

late-onset personality changes

A

suggestive of undiagnosed “other” problems (dementia, substance abuse, medical illness, neuro problems)

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6
Q

what do personality trait feature predict?

A

1) health and mortality, 2) academic success, 3) job performance, 4) capacity for lasting relationships, 5) drug abuse and criminality

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7
Q

Early experiences: Sigmund Freud

A

“fixation at an early stage prevents healthy personality development

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8
Q

Early experiences: Erickson

A

1) certain tasks need to be mastered at certain stages of development
2) must have “basic trust” (w/mistrust, the stress of chronic chaos negatively regulates neuro-bio development)

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9
Q

effects of extended early emotional trauma and abuse

A

adversely affect coping skills + brain dev

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10
Q

_ are over-represented in the medical population.

A

Traumatized pts

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11
Q

what are defense mechanisms

A

cognitive strategies to help deal with stressful information

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12
Q

examples of defense mechanisms

A

early trauma is often “repressed” (i.e. not accessible to conscious memory)

more on p77 (table 9.1)

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13
Q

three personality clusters

A

weird, wild, worried

p390 (table 49.2)

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14
Q

Cluster A

A

WEIRD:

odd and eccentric ppl

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15
Q

personality disorders of Cluster A

A

paranoid, schizoid, schizotypal, bio relatives of ppl w/schizophrenia

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16
Q

paranoid personality

A
  • always looks for wrong-doing and hidden malicious meaning
  • rigid, defensive, self-righteous
  • suspicious of partner fidelity
  • preoccupied with doubts of others’ motives
  • very unforgiving of mistakes
  • use defense mechanism of projection (blaming)
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17
Q

schizoid personality

A
  • solitary loner: do NOT want close relationships
  • take pleasure in few, if any, activities
  • emotionally cold, detached
  • choose solitary jobs and night shifts
  • may be the premorbid phase of schizophrenia
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18
Q

how does social phobia (social anxiety) differ from schizoid personality?

A

social phobia: DESIRE friends (unlike schizoid)

  • afraid of embarrassment
  • avoids social contacts bc of anxiety
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19
Q

Schizotypal personality

A

cognitive/perceptual distortions –> odd enough to think psychotic, but truly NOT (pt is still in touch w/reality)

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20
Q

Features of schizotypal

A
  • distortions when not on drugs
  • odd appearance and speech (vague, metaphorical, over-elaborate)
  • no close friends or associates
  • suspicious, magical thinking but still in touch with reality
  • can be the premorbid phase to schizophrenia
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21
Q

Cluster B

A

DRAMATIC: emotional, erratic

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22
Q

characteristics of Cluster B

A
  • impulsive erratic mood swings
  • life long pattern of instability
  • short attention span and seek excitement
  • intense, stormy relationships: multiple marriages + divorces
  • somatization (inc somatic complaints that are out of prop during stressful times)
23
Q

defense mechanisms of Cluster B

A

denial, projection, somatization

24
Q

Cluster B and bipolar illness

A
  • chaotic lifestyle, often mistaken for “bipolar”

- if Cluster B, will NOT improve with Rx (except if +psychotherapy)

25
Antisocial personality disorder
SOCIAL, but defies social rules (≠antisocial) | -must be 18 or older for dx, shown evidence of conduct disorder with onset before age 15
26
key feature of antisocial personality
``` No conscience ("moral imbecile") -life long pattern, never at fault/no guilt or remise, social class differences, attracted to other Cluster B partners, chaotic family life, multiple marriages-superficial charmers ```
27
histrionic personality disorder
- multiple somatic complaints - highly suggestible, naive - sexually seductive, often unaware - emotionally labile - imprecise and global in verbal descriptions - FHx of antisocial and EtOH - choatic family
28
narcissistic personality
- grandiose sense of self-importance and entitlement - *overlaps with antisocial* - preoccupied with self - may be arrogant, devalues others - demanding of special tx - may become suicidal when rejected - chaotic family life
29
borderline personality
- unstable moods/mood swings - stormy relationships, poor choices - often confused with "bipolar" - all or nothing thinking (known as splitting) - chaotic family lives
30
features of borderline
- substance abuse/mis-use - hx of severe physical, emotional, or sexual abuse - alcoholic or mentally ill parent - self-injurous behavior (e.g. wrist slashing, self-stabbing, piercing, cutting to see blood) - suicidal gestures and attempts - chronic feeling of emptiness, relieved by pain and by seeking relationships
31
defense mech of borderline
splitting
32
examples of borderline behavior
- pt in acute emotional distress - seems to require "special" tx - causes a great deal of strife and confusion - splitting - rapid shifts in mood and manner - boundary issues - unstable relationships
33
splitting
- seeing the world in black and white - playing ppl against each other - causes discord and stress in environment - a defense mech - feel despair and agitation
34
Cluster B disorders
antisocial, histrionic, narcissistic, borderline
35
Cluster C
WORRIED: anxious, fearful
36
Cluster C disorders
OCD, dependent, avoidant | "compulsive, clingy, cowardly"
37
obsessive-compulsive PERSONALITY disorder
- rigid, orderly, miserly, "anal" - excessive devotion to work, humorless - hoarders - sticklers for rules, details - schedule everything - upset when things don't go by plan
38
dependent personality
- excessive need to be cared for - urgently seek attachments - cannot be alone or make independent decisions - clinging, insecure
39
avoidant personality
- closely linked to anxiety disorder - can't take risks - avoid conflict, responsibility - procrastinate - passive-aggressive behavior - go to great lengths to avoid being judged - example: can't finish college degree for fear of judgment and having responsibility
40
approaching tx of personality disorders
1) listen 2) maintain calm and good, firm boundaries 3) find and support the pts strengths - psychological issues (including dysfx defense mech) must be considered
41
impulse control disorders
oppositional-defiant disorder intermittent explosive disorder (losing self-control) Kleptomania (habitual stealing) pyromania (habitual fire-setting) pathological gambling trichotillomania *all are closely linked to antisocial personality disorder
42
gambling disorder
addictive disorder + impulse problem
43
trichotillomania
impulsive hair pulling | -impulse problem + OCD
44
excoriation
skin picking | -impulse problem + OCD
45
tx options for personality disorders
- antisocial personality: legal - other disorders: supportive and caring approach that includes firm limits and boundaries - psychotherapy - meds if the pt is also suffering from a mood or anxiety disorder
46
contextual model for psychotherapy
``` therapist confidence belief in tx relationship b/w pt and therapist rational for the tx the pt's meaning to the therapy ```
47
defense mechanism of paranoid personality
projection ("blaming")
48
how does OCD differ from OCPD?
OCPD: behavior consistent w/one's own beliefs and attitudes OCD: aware of the disorder and don't like it
49
intermittent explosive disorder
experience sudden bursts of anger, assault of others, or destruction of property; aggression disproportionate to the triggering event, and not seen b/w episodes; men + 1˚ relatives of affected persons at higher risk
50
intermittent explosive disorder + predisposing factors
perinatal trauma, head trauma, encephalitis, hyperactivity, disrupted psychosocial environment
51
intermittent explosive disorder + best tx
psychotherapy + Rx (SSRIs-fluoxetine, paroxetine, sertaline)
52
kleptomania
impulse sto steal, relief of tension after the act reinforces the behavior, MC in women
53
kleptomania + assoc w/?
brain disease, mental retardation, faulty monoamine metabolism, cortical atrophy, enlargement of lateral ventricles, focal neuro signs
54
pyromania
repetitive, deliberate fire-setting; relieves tension or from attraction to fire/firefighting equipment; Men + ppl w/mentally retardation, alcoholism, or delinquent traits

Psych (17 decks)

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