Chapter 6: Personality Disorders Flashcards
definition of personality disorder
enduring patterns of inner experience and behavior that deviate markedly from expectations of an individual’s culture.
- pervasive, MALADAPTIVE, and cause impairment in social/ occupational functioning
- often lack insight about problems, symptoms are either ego-syntonic or viewed as immutable.
- vulnerable to developing symptoms of other mental disorders during stress
dx and DSM-5 for personality disorder
2 or more of following are deviated:
- cognition
- affect
- interpersonal functioning
- impulse control
Pattern is pervasive and inflexible in a broad range of situations
stable, onset no later than adolescence
leads to significant distress
not accounted for by another mental/ medical illness/ use of a substance
mnemonic for personality disorder criteria
CAPRI Cognition Affect Personal relations Impulse control
Cluster A
shizoid, schizotypal, paranoid:
- patients seem eccentric, peculiar, or withdrawn
- familial association with psychotic disorders
Cluster B
Antisocial, borderline, histrionic, narcissistic
- patients seem emotional, dramatic, or inconsistent
- familial association with mood disorders
Cluster C
avoidant, dependent, obsessive compulsive
- patients seem anxious or fearful
- familial association with anxiety disorders
Paranoid Personality Disorder
(Cluster A) pervasive distrust and suspiciousness of others often interpret motives as malevolent blame problems on others seem angry and hostile pathologically jealous
DX and DSM 5 for paranoid personality disorder
> = 4 of following:
suspicious w ithout evidence of being exploited or deceived
preoccupation with doubting loyalty/ trustworthiness of friends
reluctance to confide in others
interpretation of benign remarks as threatening or demeaning
persistence of grudges
perception of attacks on character; not apparent to others
suspicions regarding fidelity of partner
UNLIKE SCHIZOPHRENIA- no fixed delusions
check for SOCIAL DISENFRANCHISEMENT/ ISOLATION, may be misdiagnosed
treatment of paranoid personality disorder
psychotherapy est
avoi group psychotherapy
short course of antipsychotics for transient psychosis?
Schizoid personality disorder
have a lifelong pattern of social withdrawal. Often perceived as eccentric and reclusive. Quiet and unsociable and have a constricted afect. NO desire for relationships and prefer to be alone
difference between schizoid and avoidant personality
schizoid PREFER to be alone
DX and dsm-5 criteria of schizoid personality disorder
pattern of voluntary social withdrawal and restricted range of emotional expression, beginning by early adulthood and present in a variety of contexts.
4 or more of following also:
- neither enjoying nor desiring close relationships (including family)
- generally choosing solitary activities
- little (if any) interest in sexual activity with anotehr person
- taking pleasure in few activities (if any)
- few close friends or confidants (if any)
- indifference to praise or criticism
- emotional coldness, detachment, or flattened affect
difference between schizoid and Schizophrenia/ schizotypal
Unlike with schizophrenia, pts with schizoid do not have any fixed DELUSIONS or hallucinations
Schizoid not the same eccentric behavior or magical thinking seen in patients with schizotypal.
Treatment of schizoid
group therapy may be threatening; may benefit from day programs or drop-in centers
antidepressants if comorbid major depression dx
Schizotypal personality disorder
eccentric behavior, peculiar thought patterns.
often perceived as strange and odd
this disorder developed out of the observation that certain family traits predominate in first-degree relatives of those with schizophrenia
DX and DSM-5 of Schizotypal
pattern of social deficits marked by eccentric behavior, cognitive or perceptual distortions, and discomfort with close relationships, beginning by early adulthood and present in a variety of contexts.
5 or more of following:
- ideas of reference (excluding delusions of reference)
- odd beliefs or magical thinking; inconsistent with cultural norms.
- unusual perceptual experiences (bodily illusions, e.g.)
- suspiciousness
- inappropriate or restricted affect
- odd or eccentric appearance or behavior
- few close friends or confidants
- odd thinking or speech (vague, stereotyped, etc.)
- excessive social anxiety
magical thinking may include;
- belief in clairvoyance or telepathy
- bizarre fantasies or preoccuupations
- belief in superstitions
Odd behaviors may include involvement in cults or strange religious practices
Schizotypal vs schizophrenia and Schizoid
Unlike schizophrenia, schizotypal not franky psychotic (but can become so transietnly under stress); no fixed delusions
schizoid not same eccentric behavior seen in schizotypal
RX for schizotypal
psychotherapy (help develop social skills)
short course of low-dose antipsychotics if necessary for transient psychosis.
may also help decrease social anxiety and suspicion in interpersonal relationships
Antisocial personality disorder
exploitative of others
break rules to meet their own needs
lack empathy, compassion, remorse
impulsive, deceitful, often violate the law
frequently skilled at reading social cues and can appear charming and normal to others who meet them for the first time
antisocial personality disorder mnemonic
CONDUCT
Capriciousness Oppressive Deceitful Unlawful Carefree Temper
antisocial personality treatment
psychotherapy is usually ineffective
pharmacotherapy- symptoms of anxiety or depression, but caution– high addictive potential of these patients
Borderline personality disorder
unstable moods, behaviors, and interpersonal relationships. Fear abandonment and have poorly formed identity. Relationships begin with intense attachments and end with the slightest conflict. Aggression is common. Impulsive, may have history of repeated suicide attempts/ gestures or episodes of self-mutliation.
Higher rates of childhood abuse.
