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5. Psychiatry > 3- Personality D/O > Flashcards

3- Personality D/O Flashcards

1
Q

Personality is defined as unique emotional and behavioral traits used to respond to environment/ relationships. Personality is usually stable or unstable? Predictable or unpredictable?

A

Stable and predictable

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2
Q

What characteristics do individuals with personality disorders display regarding their disorder?

A

Denial, alloplastic, ego-syntonic, disinterested in tx

alloplastic: attempt to alter external environment, not themselves

ego-syntonic: believe behaviors are normal to suit self-image

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3
Q

What disorders are classified as cluster A PD’s and what general characteristics do they display?

A

Paranoid, Schizoid, Schizotypal

Odd, eccentric

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4
Q

What disorders are classified as cluster B PD’s and what general characteristics do they display?

A

Antisocial, Borderline, Histrionic, Narcissistic

Dramatic, emotional

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5
Q

What disorders are classified as cluster C PD’s and what general characteristics do they display?

A

Avoidant, Dependent, Obsessive-compulsive

Anxious, fearful

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6
Q

What are the most common etiologies/ RFs for PD’s?

A

Family hx

Early childhood neglect/ abuse

Parental behavior (harsh, low affection)

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7
Q

What is the DSM-5 criteria for paranoid personality disorder?

A

Pervasive distrust/ suspiciousness of others w/o justification + 4 of:

  1. Suspicious of being exploited, harmed, deceived
  2. Doubts loyalty of others
  3. Fears info to others will be maliciously used
  4. Mitrust
  5. Grudges
  6. Perceives attacks not apparent to others/ reacts angrily
  7. Questions fidelity of partner
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8
Q

What is the typical onset of PD’s?

A

Late adolescence/ early adulthood

(then stable through time)

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9
Q

What is the DSM-5 criteria for schizoid personality disorder?

A

Social detachment w/ restricted affect + 4 of:

  1. Neither desires/ enjoys close relationships
  2. Chooses solitary activities
  3. Little interest in sexual experiences
  4. Little/ no pleasure in activities
  5. No close friends (except 1 deg relatives)
  6. Indifferent to praise/ criticism
  7. Emotional detachment
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10
Q

What is the DSM-5 criteria for schizotypal personality disorder?

A

Discomfort/ reduced capacity for close relationships + perceptual disortions and eccentricities of behavior + 5 of:

  1. Ideas of reference
  2. No close relationships
  3. Behavior is odd
  4. Thinking/ speech is odd
  5. Paranoid ideation
  6. Constricted affect
  7. Social anxiety
  8. Odd beliefs/ magical thinking
  9. Unusual perceptions/ body illusions
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11
Q

What is the DSM-5 criteria for antisocial personality disorder?

A

Disregard for/ violation of rights of others since age 15 (hx of conduct disorder sxs before age 15), must be at least 18 yo, + 3 of:

  1. Disregard for social norms
  2. Deceitfulness/ conning
  3. Impulsivity
  4. Aggressiveness
  5. Reckless disregard for safety
  6. Irresponsibility
  7. Lack of remorse
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12
Q

Aggression against people/ animals, destruction of property, deceitfulness, and serious violation of rules prior to age 15 are sxs suggestive of what disorder and may then develop into what adult personality disorder?

A

Sxs of conduct disorder

Can develop into antisocial personality disorder

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13
Q

Learning disability, ADHD, ODD, and conduct disorder are predisposing conditions for what personality disorder?

A

Antisocial personality disorder

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14
Q

What is the DSM-5 criteria for borderline personality disorder?

A

Unstable interpersonal relationships, self-image, affects and poor impulse control + 5 of:

  1. Frantically avoid abandonment
  2. Unstable relationships
  3. Identity disturbance
  4. Impulsivity in 2+ areas, self-damaging
  5. Recurrent suicidal behavior
  6. Affect instability
  7. Feelings of emptiness
  8. Intense anger
  9. Transient paranoid ideation, psychotic episodes
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15
Q

What is the DSM-5 criteria for histrionic personality disorder?

A

Excessive emotionality and attention seeking, + 5 of:

  1. Center of attention
  2. Sexually seductive
  3. Rapid shifting/ shallow emotions
  4. Physical appearance to attract attn
  5. Speech excessively impressionistic
  6. Dramatic
  7. Suggesstible/ easily influenced
  8. Considers relationships to be more intimate than they are
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16
Q

What is the DSM-5 criteria for narcissistic personality disorder?

A

Grandiosity, need for admiration, lack of empathy + 5 of:

  1. Grandiose sense of self-importance
  2. Fantasies of unlimited success/ power/ brilliance/ beauty/ love
  3. Associates only w/ others who are unique/ exceptional
  4. Needs excessive admiration
  5. Sense of entitlement
  6. Exploitive
  7. Lacks empathy
  8. Envious of others
  9. Arrogant
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17
Q

What is the DSM-5 criteria for avoidant personality disorder?

A

Social inhibition, feelings of inadequacy, and hypersensitivity + 4 of:

  1. Avoids occupations, fear of criticism, disapproval, rejection
  2. Restrained in relationships, fear of shame/ ridicule
  3. Preoccupation w/ criticism/ reject
  4. Inhibited in new interpersonal situations, feelings of inadequacy
  5. Views self as socially inept
  6. Reluctant towards new activities, fear of embarassment
  7. Unwilling to get involved w/ people unless certain of being liked
18
Q

Do individuals with avoidant personality disorder desire to have attachments with others?

A

Yes

19
Q

What is the DSM-5 criteria for dependent personality disorder?

A

Excessive need to be cared for leading to submissive behavior and fears of separation + 5 of:

  1. Unable to make own decisions
  2. Needs to be taken care of
  3. Difficulty expressing disagreement
  4. Difficulty initiating projects
  5. Goes to excessive lengths to be dependent on others, regardless of cost to self
  6. Helpless when alone
  7. Urgently seeks another relationship when a close one ends
  8. Preoccupied w/ fears of taking care of self
20
Q

What is the DSM-5 criteria for obsessive compulsive personality disorder?

(ALL aspects of personality vs ONE behavior in OCD)

A

Preoccupation w/ orderliness, perfectionism, control, at expense of flexibility, openness, efficiency + 4 of:

  1. Preoccupied w/ detailes, lists, rules, organization
  2. Perfectionism interferes w/ task completion
  3. Excessively devoted to work
  4. Over-conscientious, inflexible about morality/ ethics
  5. Unable to discard worn-out/ worthless objects
  6. Reluctant to delegate tasks
  7. Miserly spending style toward self/ others
  8. Stubborn
21
Q

What are the goals of treatment for personality disorders?

A

Facilitate most flexible degree of adaptive interpersonal functioning

Ensure connection to therapist, clinic, group, institution

22
Q

What is the target of psychotherapy in the treatment of PD’s?

A

Personality structure

23
Q

What are the requirements for the use of psychotherapy in the tx of PD’s?

A

Motivation to change

Capacity for insight

Capacity to engage in therapeutic relationship

24
Q

What type of psychotherapy is thought of to be particularly beneficial for PD’s?

A

DBT

(core mindfullness, emotional regulation, interpersonal effectiveness, distress tolerance)

25
Q

What is the target of psychopharmacologic tx of PD’s?

A

Symptom management

26
Q

What is used in the tx of cognitive disortions such as paranoia in the tx of PD’s?

A

Low dose antipsychotics

27
Q

What is used for the tx of irritability, impulsivity, rage and violence a/w PD’s?

A

Mood stabilizers

SSRIs

Antipsychotics

28
Q

What is used for the tx of emotional/ affect instability a/w PD’s?

A

Mood stabilizers

29
Q

What is used for the tx of persistent anxiety a/w PD’s?

A

Anti-anxiety meds (Buspar)

BBs

SSRIs

30
Q

What is used for the tx of dysphoria and depression a/w PD’s?

A

Antidepressants

Lithium

31
Q

What is used for the tx of acute insomnia a/w PD’s?

A

Low dose Trazodone

Sedating TCA

32
Q

What is used for the tx of persistent/ pervasive attention difficulties a/w PD’s?

A

Stimulants

Buproprion

33
Q

What is used for the tx of severe obsessive-compulsive sxs a/w PD’s?

A

Clomipramine or SSRIs

34
Q

52 yo man lives in high rise apt complex. Constantly accuses neighbors of plotting to refuse to pay rent/ fees. He writes angry letters to management company and has initiated several lawsuits. He lives alone and does not socialize. What PD are you concerned for?

A

Paranoid personality disorder

35
Q

33 yo man lives alone and works as a security guard on 11pm-7am shift. He ignores social invites from coworkers and has no outside interests. He does not date and has no interest in having sexual experiences. He is satisfied w/ his solitary life. What PD are you concerned for?

A

Schizoid personality disorder

36
Q

38 yo oddly dressed man is preoccupied w/ studying and brewing herbal teas. He associates many peculiar powers w/ consumption of these teas and says that plants sometimes whisper to him. He spends all his time alone, often taking walks in the wilderness for days to collect herbs for his teas. He has no hx or disorganized behavior. What PD are you concerned for?

A

Schizotypal personality disorder

37
Q

29 yo woman is taken to ER after she calls suicide hotline telling them she has taken an OD of Tylenol PM after her boyfriend left her. She has a hx of multiple suicide gestures which usually follow break ups. She confided that she has called emergency #’s giving a similar story. She also has a hx of abusing alcohol and cocaine. What PD are you concerned for?

A

Borderline personality disorder

38
Q

35 yo woman detained by police after becoming highly disruptive during an argument w/ her boyfriend. She is provacatively dressed and mildly intoxicated. She has had similar episodes in the past. She is described by acquaintances as “highly emotional” and “always calling attention to herself”. What PD are you concerned for?

A

Histrionic personality disorder

39
Q

48 yo man who is a partner in a PA practice refuses to comply w/ unanimous wishes of the group. He states he is only interested in getting his share of the profits and has no interest in the well-being of other employees. He states he is the most productive and talented of the group so why should he be required to compromise. What PD are you concerned for?

A

Narcissistic personality disorder

40
Q

44 yo man dreads an upcoming holiday party b/c he believes he is incapable of engaging in conversations or dancing. He thinks he will become the object of pity/ ridicule if he tries. As a result he anticipates another lonely weekend in his apt. What PD are you concerned for?

A

Avoidant personality disorder

41
Q

25 yo man brought to ER after sustaining severe lacerations during a sadistic episode with his girlfriend. Pt is extremely concerned that the police will be called and he will have to report what happened. Pt does not want to upset his girlfriend and cause her to leave him. He knows he needs her in order to be able to function and make decisions. What PD are you concerned for?

A

Dependent personality disorder

42
Q

39 yo woman seeks psychotherapy b/c of her impending divorce. She says she has driven her spouse away with her demands that the house be kept spotless, that extremely detailed and fixed work and recreational schedules be maintained and that rigid dietary habits be followed. She is constantly making lists that her husband must adhere to w/o exception. What PD are you concerned for?

A

Obsessive-compulsive personality disorder

5. Psychiatry (19 decks)

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