7.1.2 Personality Disorders

Question 1

What developmental traumatic event is often seen in the history of patients with borderline personality disorder?

Answer 1

Childhood sexual abuse

Question 2

Which personality disorder has compromise of temporal lobe and basal striato-thalamic structures?

Answer 2

Schizotypal

Question 3

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Obsessive compulsive personality disorder

Answer 3

Characterized by rigid conformity to rules, perfectionism and control (least pathological, moralistic, diligent, responds well to therapy)

Question 4

How does stress relate to the hippocampus?

Answer 4

Increased stress/cortisol = reduced bilateral hippocampal volumes

Question 5

How are cluster C personality disorders described? What disorders fall into this category?

Answer 5

“Anxious, Avoidant and Fearful” Cluster

Obsessive-Compulsive, Dependent, Avoidant Personality Disorder

Question 6

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Dependent

Answer 6

Pervasive psychological need to be cared for by other people

Question 7

What are some personality disorders with greater response to CBT-spectrum counseling?

Answer 7

Borderline (Dialectical Behavior Therapy)

Obsessive-compulsice

Avoidant

Dependent

Question 8

Dysfunction of prefrontal-limbic circuits is associated with which two personality disorders?

Answer 8

Antisocial and Borderline (lower volume of hippocampus, LPFC, cingulate in borderline)

Question 9

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Avoidant

Answer 9

Cluster C

Pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation

Strong social anxiety

Question 10

What is the pharmacological treatment for personality disorders?

Answer 10

There aren’t any approved by the FDA at this point

Question 11

What are the three core features of a personality disorder?

Answer 11

Present by adolescence (age 15)

Pervasive and inflexible

Associated with impaired functioning (social, occupational)

Question 12

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Paranoid

Answer 12

Cluster A

Characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent

Question 13

How are cluster A personality disorders described? What disorders fall into this category?

Answer 13

“Odd or Eccentric” Cluster

Paranoid, Schizoid, Schizotypal Personality Disorder

Question 14

How are cluster B personality disorders described? What disorders fall into this category?

(B for big group b/c it has more than 3)

Answer 14

“Dramatic, Emotional, Erratic” Cluster

Borderline, Narcissistic, Histrionic, Antisocial Personality disorder

Question 15

What does this graph show?

Answer 15

This graph shows increased amygdala response in BPD and SPD as compared to the control. This is thought to be due to the fact that the healthy controls have a more robust response throughout the whole brain rather than localized to the amygdala.

Question 16

What are the general signs of a personality disorder in a patient?

Answer 16

Frequent mood swings, stormy relationships, social isolation, angry outbursts, suspicion and mistrust of others, difficulty making friends, a need for instant gratification, poor impulse control, alcohol or substance abuse

Question 17

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: histrionic

Answer 17

Cluster B

Pervasive pattern of attention-seeking behavior and excessive emotions

Seduction/manipulation of others

Ex: giving an excessively long toast at someone else’s wedding to gain attention

Question 18

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Antisocial

Answer 18

Cluster B

Pervasive pattern of disregard for and violation of the rights of others, lack of empathy; must first have hx of Conduct Disorder during childhood

Question 19

What are some of the brain areas that may contribute to the clinnical manifestation of personality disorders? In regards to cortisol.

Answer 19

PFC - executive functions, emotion regulation (controlled)

OFC - executive functions, emotion regulation (controlled)

ACC - emotion regulation (automatic)

HPC - memory function

Question 20

What developmental traumatic event(s) is often seen in the history of patients with antisocial personality disorder?

Answer 20

Childhood psychological abuse, parental marital abuse, poverty, foster care

Question 21

What are some personality disorders with less response to psychotherapy?

Answer 21

Cluster A spectrum, antisocial personality disorder

Question 22

What is acceptance according to Marsha Linehan?

Answer 22

Question 23

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Narcissistic

Answer 23

Cluster B

A pervasive pattern of grandiosity (profound self love), need for admiration, and a lack of empathy

Question 24

What are common comorbidities associated with personality disorders?

Answer 24

Mood disorders

Anxiety disorders

Adjustment Problems

Substance abuse

Frequent ER visits

Social problems

Illegal activities

Poor inflexible coping strategies

Question 25

Identify the cardinal features and typical traits for the following personality disorders and be able to identify them in a vignette: Borderline

Answer 25

Cluster B

Pervasive pattern of instability in relationships, self-image, identity, behavior and affect often leading to self-harm and impulsivity

Often mistaken for Bipolar Mood Disorder (Borderline patients react negatively to stimuli; bipolar is organic and happening on its own)

Question 26

What is a personality disorder?

Answer 26

When personality features are extreme or skewed they can be maladaptive/inflexible and represent a disorder that requires treatment