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psychiatry > 9B. Personality disorders: diagnostic criteria (clusters a-b-c) and clinical management > Flashcards

9B. Personality disorders: diagnostic criteria (clusters a-b-c) and clinical management Flashcards

1
Q

Personality disorders DEFINITION

A

are pervasive, inflexible, and maladaptive personality patterns

that lead to significant distress and/or functional impairment.
Deviates from exprectations of an individuals culture

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2
Q

Age of onset of personality disorders

A

late childhood or adolescence

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3
Q

personality disorders and which gender they are most common in

A

Male individuals:
* antisocial (Severe, impairing)
* narcissistic personality disorders
* paranoid
* schizoid
* avoidant
* OCPD

Female individuals:
* borderline personality disorders (Severe, impairing)
* histrionic
* dependent PD

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4
Q

which personality disorders are severely impairing

A
  • Antisocial PD (male) - incarcerated or hospitalized
  • Borderline personality disorder (common in females) - unemployed, socially isolated
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5
Q

which personality disorders are less impairing, patient can maintain job

A
  • Histrionic
  • Narcissistic PD

patients have difficulty maintaining social relationship

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6
Q

Etiology of Personality disorder

A
  • Multifactorial
  • Combination of
    1. hereditary
    2. psychosocial factors (e.g., child neglect, abuse
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7
Q

DSM 5 criteria of personality disorders

A
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8
Q

cluster A personality disorders

A
  • Paranoid
  • schizoid
  • schizotypal PD
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9
Q

Cluster A personality disorders characteristic behavior

A

“Weird”

  • odd
  • eccentric
  • unable to form close interpersonal relationships
  • typically: no psychosis
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10
Q

cluster A PD are commonly associated with which condition

A

psychotic disorders ( eg schizophrenia)

PaSS

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11
Q

Cluster B personality disorders

A

Antisocial
Borderline
Histrionic
Narcissistic

BANHed

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12
Q

Cluster B personality disorders characteristic behavior

A

“wild”

  • Dramatic
  • emotional
  • Unpredictable/ inconsistent
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13
Q

cluster b commonly associated with

A
  • mood disorders
  • recreational drug use
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14
Q

Cluster C personality disorders

A
  • Avoidant
  • Dependent
  • Obsessive-compulsive PD

DOA

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15
Q

Cluster C personality disorders characteristic behavior

A
  • fearful
  • avoidant
  • anxious
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16
Q

Cluster C personality disorders associated with

A

anxiety disorders

17
Q

Clinical features common to all personality disorders

A

*Affected individuals consider their symptoms normal and nonproblematic
*Thinking and behavior that significantly differ from cultural expectations

18
Q

Treatment of personality disorders

A
  • Psychotherapy, dialectical behavior therapy, group therapy, and/or cognitive therapy
  • Medical therapy (for symptomatic relief)

o Mood stabilizers: valproate, topamirate, and lamotrigine
▪Decrease symptoms such as affective dysregulation, impulsivity, and aggression

o Antipsychotics: for symptoms of delusion
o Antidepressants: SSRIs

19
Q

Paranoid personality disorder diagnostic criteria

A

▪At least 4 of the following criteria must be met
*Pervasive distrust of others
*Unjustified fear that others will use information against them
*Unjustified suspicion about the loyalty of friends and family
*Unjustified suspicion that others are deceiving or harming them
*Suspicions of infidelity in sexual partners/spouse
*Disproportionate reactions to perceived attacks
*Perceives benign remarks as hidden humiliations
*Holding grudges

20
Q

Schizoid personality disorder
o Diagnostics: according to the DSM-5

A

At least 4 of the following criteria must be met
* Voluntary social withdrawal (e.g., family)
* Enjoys few activities
* Prefers solitary activities
* Lack of interest for close relationships
* Lacks people to trust or close friends
* Indifferent to praise or criticism
* Restricted emotional expression, flattened affect

Other features: comfortable with social isolation (unlike in avoidant personality disorder)

21
Q

schizoid PD vs avoidant

A

schizoid PD is comfortable with social isolation (unlike in avoidant personality disorder)

22
Q

Schizotypal personality disorder diagnostic

A

At least 5 of the following criteria must be met
* Odd and eccentric behavior or physical appearance
* Magical thinking
* Social awkwardness
* Excessive social anxiety
* Ideas of reference
* Unusual perceptual experiences (e.g., body illusions)
* Bizarre thinking/speech
* Paranoia and suspicion of others
* Constricted affect
* Few or no close friends
* Social anxiety and preference for social isolation because of paranoia that they cant connect with others

23
Q

Antisocial personality disorder diagnostic criteria

A

Adult
Criminal
Impulsive
Disregard for safety
Lying/cheating
Irresponsible
Aggression
Remorselessness

▪ The patient is at least 18 years of age
▪ 3 or more of the following symptoms of conduct disorder are present from at least 15 years of age
* Deceiving, manipulation
* A history of hostility and repeated aggression
* Repeatedly engaging in criminal activity
* Impulsivity/failure to plan ahead
* A reckless disregard for one’s own safety and/or the safety of others
* A failure to fulfill work-related or financial obligations
* A lack of empathy, remorse for their actions
▪ Antisocial behavior that is not only due to manifestations of bipolar disorder or schizophrenia

treatment is very difficult

24
Q

Borderline personality disorder diagnostic crit

A

▪ At least 5 of the following criteria must be met

  • Unstable mood (e.g., irritability, anxiety)
  • Intense anger that can be difficult to control
  • Feelings of emptiness
  • Self-damaging acts (e.g., unsafe sex, substance abuse, reckless behavior)
  • Self-harm, suicidal behavior
  • Unstable self-image
  • Suspicion about what others think of them, even paranoid ideation and/or dissociative episodes
  • Unstable personal relationships
  • Fear of abandonment

Other features: splitting; a defense mechanism in which relationships are all good or all bad

25
Q

treatment of borderline PD

A

Treatment: dialectical behavior therapy

26
Q

Histrionic personality disorder
o Diagnostics: according to the DSM-5

A

▪ At least 5 of the following criteria must be met
* Attention-seeking: drawing attention to oneself by way of physical appearance
* Uses dramatic speech
* Exaggerated emotional expression
* Not being the center of attention causes discomfort
* Feelings are often shallow and unstable
* Exhibiting inappropriate, sexually provocative, and/or seductive behavior during interactions with others
* Easily influenced by others or circumstances
* Overestimating the degree of intimacy in relationships

27
Q

Narcissistic personality disorder
o Diagnostics: according to the DSM-5

A

▪ At least 5 of the following must be met
* Excessive sense of self-importance
* Fantasizes disproportionately about success, power, etc.
* Believe in being special and a feeling of superiority
* Great need for admiration
* Expecting favorable treatment from others
* Exploitation of others to achieve their own goals
* Lack of empathy
* Often envious of others
* Often behaves arrogant and/or snobbish
o Other features: difficulty dealing with criticism, fragile self-esteem

28
Q

Classification: 3 subtypes Narcissistic personality disorder

A

Grandiose, overt

High-functioning

Vulnerable/covert

29
Q

Avoidant personality disorder
o Diagnostics: according to the DSM-5

A

▪ At least 4 of the following criteria must be met
* Avoidance of interpersonal contact due to fear of criticism or rejection
* Only interacts with people if certain of being liked by them
* Restrained in intimate relationships due to fear of being ashamed
* Preoccupation with and hypersensitivity to criticism
* Feelings of inadequacy resulting in involuntary social withdrawal
* Low self-esteem
* Avoids taking risks and seldomly engages in new activities
▪ Strong desire for social relationships (unlike schizoid personalities), but limited by extreme shyness and social anxiety

30
Q

Dependent personality disorder
o Diagnostics: according to DSM5

A

▪ At least 5 of the following must be met

  • Disproportionate need for support
  • Difficulty making everyday decisions (requiring others to assume responsibility)
  • Avoids disagreeing with others due to fear of losing their support
  • Difficulty initiating projects because of a lack of self-confidence
  • Makes extreme efforts to obtain support from others even if these efforts are unpleasant
  • Feelings of helplessness when alone
  • Urgently seeking new relationships when one fails
  • Both afraid of being abandoned and afraid to abandon their partner

o Other features: often stuck in abusive relationships; associated with increased risk of suicide

31
Q

Obsessive-compulsive personality disorder
o Diagnostics: according to DSM-5

A

▪ At least 4 of the following must be met
* Excessive preoccupation with rules, lists, details, etc.
* Obsession with work and productivity that often occurs at the expense of occupational success (e.g., missing deadlines), social relationships (e.g., excluding social activities to complete tasks), and pleasurable activities
* Perfectionism that often interferes with task completion
* Unwillingness to delegate work or to collaborate with other people
* Great conscientiousness and fastidiousness, inflexible about matters of morality or ethics
* Cling to worn-out/worthless items (even if they have no sentimental value)
* Often show miserliness (e.g., obsessed with saving money for future disasters)
* Rigid routines

31
Q

OCPD VS OCD

A

▪ In contrast to OCS, intrusive thoughts and repetitive behaviors are not present

psychiatry (10 decks)

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