Clinical approach to personality Disorders

Question 1

Are patients usually aware that they have a personality disorder? When do they present?

Answer 1

• No
• Early adulthood

Question 2

What is the diagnostic criteria for personality disorders?

Answer 2

Essentially two manifestations of inner experience or behavior that fall outside of cultural norms.

• cognition
• affect
• interpersonal functioning
• impulse control

Question 3

Do we diagnose patients under the age of 18 with personality disorders?

Answer 3

No

Question 4

What are the three different personality disorders that would fall under cluster A personality disorders?

Note: When you think cluster A think Avoidant

Answer 4

Paranoid personality disorder, schizoid, schizotypal

Question 5

What does paranoid personality disorder?

Answer 5

fear of others deceiving them, exploiting them, untrusting of others, think spouse or partner is unfaithful… Irrational fears

Question 6

How would you differentiate schizoid vs. schizotypal?

Answer 6

• schizotypal has very odd behavior (psychotic) plus isolation.
• Schizoid is isolation, little pleasure in activities, lack of close friends.

Note: Hill said schizotypal patients look psychotic, willy wonka (johnny depp).

Question 7

When thinking about cluster B disorders think “Bad” as in these are bad disorders (serial killers).

What are the four types?

Answer 7

• antisocial personality disorder (sociopath)
• borderline personality disorder
• histrionic personality disorder
• narcissistic

Question 8

What characterizes antisocial personality disorder (sociopath)?

Answer 8

• repeated law violations, no remorse, lying, deception, aggressive, reckless.

Heath Ledger as the Joker

• Note Dr. Hill said these are the kids that killed small animals, set fires, and peed on the dead animals they killed. Very disturbed.

Question 9

What are patients with antisocial personality disorders often at risk for?

Answer 9

• Substance abuse, anxiety disorder, pathological gambling

Question 10

What are some of the characteristics of Borderline Personality Disorder?

Answer 10

• frantic effort to not be abandoned
• unstable, intense personal relationships
• suicidal with threats of self harm

Very Manipulative

Question 11

What was Dr. Hill’s point of “teddy bear sign” or “Tweety Bird Sign”?

Answer 11

Essentially if patients in their 40s have a teddy bear in their hospital bed and looney tunes pajamas he said think Borderline personality disorder.

Need ridgid boundaries when treating theses patients. Get in and get out. Do not talk extra to them because they will manipulate and draw emotions out of you.

Question 12

What was the common phrase of someone who has borderline personality disorder?

Hint: remember that they are manipulative and are afraid of abandonment

Answer 12

“I Hate you, Dont leave me”

• these people are abusively manipulative but have a fear of abandonment. super toxic.

Question 13

What is Histrionic personality disorder?

“Bright Red Dress at a funeral”

Answer 13

• attention seeking, sexually provocative, seductive.
• hill said half of hollywood, miley cyrus, nicki minaj.

- Overly eccentric for the sake of attention

Question 14

What is Narcissistic Personality Disorder?

“Im great, you suck”

Answer 14

These people have exaggeration of their own abilities. No one is better then them, they lack empathy. They envy others but would never say that.

• Dr. Hill said Surgeons

God Complex

Question 15

What are people with narcissistic behavior at risk for?

Answer 15

anorexia nervose, substance abuse, depression

Question 16

How should we think of Cluster C disorders?

Answer 16

anxious and fearful

Question 17

What is avoidant personality disorder?

Answer 17

social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction.

Question 18

How is avoidant personality disorder different then a schizoid type?

Answer 18

• Schizoid are isolated and want to be isolated
• Avoidant personality disorder people still have a longing for relationships but have low self esteem and fear.

Question 19

What is Dependent Personality Disorder?

Answer 19

Drastic dependence on another person for decision making etc…

• Need someone else to take responsibility, initiative. Because of this they do not initiate or make decisions on their own, which can lead to isolation.

“fears of being left to fend for themselves”

Question 20

What is Obsessive Compulsive personality Disorder?

Note: This is NOT OCD

Answer 20

These are the my way or the highway people.

• very ridgid and unchanging, inflexible, perfectionism, and control.

Question 21

Does “Multiple Personality Disorder” exist?

What is the name of the disorder according to the DSM-5?

Answer 21

• No
• Dissociative Identity Disorder

Question 22

What is dissociative identity disorder?

Answer 22

• marked by having two or more distinct identities or personality states.
• more common in women
• associated with sexual abuse

Note: Trauma can lead to dissociations.

Question 23

What is Cognitive Behavior Therapy (CBT)?

Note: Hill said when in doubt pick this answer choice because it can treat a wide range of disorders. He said if its a vague question about treatment this is a good choice.

Answer 23

• Deals with how people think about their world and their perception of it.

Question 24

What is the main treatment for Borderline Personality Disorder?

Answer 24

Dialectical Behavior Therapy (DBT)

• he did not explain really what this was.

Question 25

Are medications curative for personality disorders?

Answer 25

No

Question 26

Which two personality disorders had a higher risk of homicide?

Answer 26

paranoid and antisocial personality disorder (sociopath)