Chap. 12 - Personality disorders Flashcards
Ego-syntonic behaviors
Comfortable; consistent with personality; causes little concern to the individual and no treatment is sought
Ego-dystonic behaviors
Causes discomfort to the individual; inconsistent with personality; person often seeks treatment
Personality disorder defined
Chronically maladaptive patterns of behaviors that cause functional impairment in work, school, or relationships
Four areas of functionality impacted by PDs
Affective traits
Behavioral traits
Cognitive traits
Social traits
Maladaptive affective traits are…
Overly affectual patterns of response
Maladaptive behavioral traits are…
Poor impulse control patterns of response
Maladaptive cognitive traits are…
Unrealistic perceptual patterns of response
Maladaptive social traits are…
Unsatisfying interpersonal patterns of response
With PDs, maladaptive traits are _____ and _____ across most personal and social situations
Inflexible and pervasive
PDs are coded on Axis __
II
Cluster A traits are…
Odd, unusual, eccentric
Cluster A disorders are (3)
Paranoid PD
Schizoid PD
Schizotypal PD
Cluster B traits are…
Dramatic, affective, unstable
Cluster B disorders are (4)
Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD
Cluster C traits are…
Anxious
Cluster C disorders are (3)
Avoidant PD
Dependent PD
Obsessive-compulsive PD
Psychodynamic theory of PD states that in childhood the individual did not accomplish the tasks of _____ and _____
Separation and individuation
Separation, as relates to object relations
Develop intrapsychic self-representation distinct and separate from mother
Individuation, as relates to object relations
Form distinct identity with characteristics unique to the individual
Two Bowenian risk factors for development of PD
Family enmeshment
Familial social isolation
Incidence of PD in the US
0.5% - 5.4%
Patterns of pervasive distrust and suspiciousness, with odd and unusual behavior, define Cluster __ disorders
A
Solitary; neither wants nor needs close personal or sexual relations
Paranoid PD
Affective flattening; indifferent to others; appears cold and detached
Schizoid PD
Odd beliefs and behaviors; inappropriate affect; magical thinking and ideas of reference
Schizotypal PD
Patterns of pervasive affective and interpersonal disruption define Cluster __ disorders
B
Antisocial PD is more common in _____ (gender), is frequently comorbid with ___, and is usually precursed by a dx of _____ _____ as a child.
Men
SUD
Conduct disorder
Borderline PD is more common in _____ (gender), and is often precursed with a hx of _____, _____, and/or _____.
Women
Abuse, trauma, neglect
Deceitful and lying; does not comply with social norms; frequent arrests; lacks regard for others and lacks remorse
Antisocial PD
Avoids abandonment at all costs; unstable, intense interpersonal relationships; recurrent suicidality
Borderline PD
Inappropriately seductive; uncomfortable when not the center of attention; suggestible and easily influenced; considers relationships to be more intimate than they are
Histrionic PD
Grandiose self-importance; preoccupied with fantasies of power and brilliance; requires admiration; lacks empathy
Narcissistic PD
Patterns of pervasive anxiety and fear define Cluster __ disorders
C
When considering avoidant behavior, the clinician must take into account the client’s _____
Culture
Avoidant PD: more in men, women, or equal?
Equal
Dependent PD: more in men, women, or equal?
Women
Obsessive-compulsive PD: more in men, women, or equal?
Men
Avoids social situations and relationships out of fear of not being liked or fear of shame; views self as inept or unappealing; very reluctant to take risks or engage people or activities
Avoidant PD
Difficulty making own choices or expressing disagreement; goes to obsessive lengths to obtain nurturing and support from others
Dependent PD
Preoccupied with details, order, rules; overly conscious or inflexible on issues of morality; rigid; reluctant to delegate to others
Obsessive-compulsive PD
PD differentials
Affective disorders
SUD
Pharm management - Impulsivity
SSRIs
Anticonvulsant mood stabilizers
Pharm management - Affective instability
SSRIs
Anticonvulsant mood stabilizers
Pharm management - Anxiety
SSRIs
Non-BZO anxiolytics
BZO with extreme caution
Best treatment for PD - pharm, therapy, or both?
Therapy
1 therapy for borderline PD
DBT