[5] Personality Disorders Flashcards
What are personality disorders?
Ways of thinking, feeling and behaving that deviate from the expectations of the culture, cause distress or problems functioning, and last over time
What are the risk factors for personality disorders?
- Low socioeconomic status
- Positive family history
- Poor parenting and parental deprivation
- Abuse during childhood - physical, sexual, and emotional abuse, as well as neglect
What can personality disorders be divided into?
- A - Odd/eccentric
- B - Dramatic/emotional
- C - Anxious/fearful
What are the cluster A personality disorders?
- Paranoid
- Schizoid
What are the cluster B personality disorders?
- Emotionally unstable (borderline)
- Dissocial (antisocial)
- Histrionic
What are the cluster C personality disorders?
- Dependant
- Avoidant (anxious)
- Anankastic (obsessional)
What are the features of paranoid personality disorder?
- Suspicious of others
- Unforgiving
- Spouse fidelty questioned
- Perceives attack
- Envious (jealous)
- Doesn’t like criticism
- Cold affect
- Trust in others reduced
- Self-reference
What are the features of schizoid personality disorder?
- Detached (flattened) affect
- Indifferent to praise or criticism
- Sexual drive reduced
- Tasks done alone
- Absence of close friends
- No emotion
- Takes pleasure in few activities
What are the features of borderline personality disorder?
- Abandonment feared
- Mood instability
- Suicidal behaviour
- Unstable relationships
- Intense relationships
- Poor anger control
- Impulsivity
- Disturbed sense of self
- Chronic emptiness
What are the features of antisocial personality disorder?
- Callous
- Blames others
- Reckless disregard for safety
- Remorseless
- Deceitful
- Impulsive
- Temper
- Tendency to violence
What are the features of histrionic personality disorder?
- Provocative behaviour
- Concern for physical attractiveness
- Attention seeking
- Influenced easily
- Shallow
- Egocentric
- Inappropriately seductive
- Exaggerated emotions
What are the features of dependant personality disorder?
- Reassurance required
- Expressing disagreement is difficult
- Lack of self-confidence
- Initiating projects is difficult
- Abandonment feared
- Needs others to assume responsibility
- Companionship sought
- Exaggerated fears
What are the features of anxious (avoidant) personality disorder?
- Needs to be certain they are liked before getting involved with people
- Restriction of lifestyle in order to maintain security
- Inadequacy felt
- Potential for embarassment prevents involvement in new activities
- Social inhibition
What are the features of anankastic personality disorder?
- Loses point of activity due to preoccupation with detail
- Ability to compete tasks compromised due to perfectionism
- Workholic at the expense of leisure
- Fussy
- Inflexible
- Meticulous attention to detail
Stubborn
How are personality disorders investigated?
- History
- MSE
- Questionnaires, e.g. Personality Diagnostic Questionnaire, Eysenck Personality Questionnaire
- Psychological testing, e.g. Minnesota Multiphasic Personality Inventory (MMPI)
- CT/MRI head, to rule out organic causes of personality change, such as frontal lobe tumours and intracranial bleeds
What are the differential diagnoses of personality disorders?
- Mania
- Depression
- Schizophrenia
- Schizoaffective disorder
- Substance misuse
How can the management of personality disorders be outlined?
Using the biopsychosocial approach
What is included in the biological management of personality disorders?
- Atypical antidepressants may be used for the short-term management of transient psychotic periods in certain PDs, e.g. paranoid PD
- Mood stabilisers can be used in emotionally unstable PD for symptoms such as mood instability and aggression
- Small role for antidepressants
What is included in the psychological management of personality disorders?
- Cognitive behavioural therapy
- Psychodynamic psychotherapy
- Dialetical behavioural therapy
What is included in the social management of personality disorders?
- Substance misuse services
- Assistance with social problems, e.g. housing, finance, employment
- Support groups
What are the general points in the management of personality disorders?
- Recognition and treatment of co-morbid psychiatric illness and substance misuse, which is common in patients with PD
- Risk assessment, particularly in the case of unstable PD. Potential stressors taht induce crises should be identified and reduced
- Give the patient a written crisis plan. At times of crisis, if dangerous, violent, or is a suicide risk, consider the Crisis Resolution Team and detention under the Mental Health Act
