Cluster A Personality Disorders

Question 1

what is the underlying pattern in paranoid PD

Answer 1

pattern of DISTRUST and SUSPICOUSNESS such that others’ motives are interpreted as malevolent

(i.e people trying to interfere with your life)

i.e Mad Eye Moody

Question 2

what is the underlying pattern in schizoid PD

Answer 2

pattern of DETACHMENT from social relationships and a RESTRICTED range of emotional expression

i.e Argus Filch

Question 3

what is the underlying pattern in schizotypal PD

Answer 3

pattern of ACUTE DISCOMFORT in close relationships, cognitive or perceptual DISTORTIONS and ECCENTRICITIES of behaviour

i.e Luna Lovegood

Question 4

how many features are listed in criterion A for schizoid PD? how many are required to meet criteria?

Answer 4

need 4/7

Question 5

what is criterion A for schizoid PD

Answer 5

a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts as indicated by 4+ of:

1. neither desires nor enjoys close relationships, including being part of a family
2. almost always chooses solitary activities
3. has little, if any, interest in having sexual experiences with another person
4. takes pleasure in few, if any, activities
5. lacks close friends or confidants other than first degree relatives
6. appears indifferent to the praise or criticism of others
7. shows emotional coldness, detachment or flattened affectivity

Question 6

what is a mnemonic to remember the criteria of schizoid PD

Answer 6

SIR SAFE

Solitary lifestyle
Indifferent to praise or criticism
Relationships are of no interest

Sexual experiences are of little interest
Activities are not enjoyed
Friends are lacking
Emotionally cold and detached

Question 7

what is the prevalence of schizoid PD, and the gender preponderance

Answer 7

3-5%

M>F

Question 8

what are the risk factors for schizoid PD

Answer 8

relative with schizophrenia or schizotypal PD

Question 9

what tasks are generally preferred by those with schizoid PD

Answer 9

mechanical or abstract ie computer or math games

Question 10

how might someone with schizoid PD experience sensory, bodily or interpersonal experiences

Answer 10

generally reduced experiences of pleasure (i.e in response to walking on a beach at sunset, having sex)

may rarely experience strong emotions like anger or joy–> may have difficulty expressing anger, even in response to direct provocation

lives may seem directionless, and appear to “drift” i their goals

Question 11

can schizoid PD be an antecedent to SCZ or delusional disorder

Answer 11

yes can be–> those with schizoid PD may also experience brief (minutes to hours) episodes of psychosis in response to stress

Question 12

what neurodevelopmental disorder can be difficult to distinguish from schizoid PD

Answer 12

Autism

–> look for the fixed interests and stereotyped behaviours of autism

Question 13

while those with OCPD may show “social detachment” they in different from those with schizoid PD in what key feature

Answer 13

those with OCPD have underlying capacity and desire for intimacy

Question 14

those with schizoid PD may be at higher risk for what disorder

Answer 14

MDD

Question 15

schizoid PD is most often comorbid with that disorders

Answer 15

schizotypal, paranoid and avoidant PDs

Question 16

what defenses may be employed by those with schizoid PD

Answer 16

repression

suppression

isolation of affect

displacement

Question 17

what psychotherapies may be effective in schizoid PD

Answer 17

CBT

psychodynamic

*those with schizoid PD cannnnn be introspective and may be able to build trust with therapist over time

Question 18

how many features are listed in criterion A for paranoid PD? how many are required to meet criteria?

Answer 18

4/7

Question 19

what is criterion A for paranoid PD

Answer 19

a pervasive distrust and suspiciousness of othres, such that their motives area interpreted as malevolent, beginning by early adulthood and present in a variety of contexts as indicated by 4+ of the following:

1. suspects, without sufficient bases, that others are exploiting, harming, or deceiving him or her
2. is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
3. is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
4. reads hidden demeaning or threatening meanings into benign remarks or events
5. persistently bears grudges (i.e is unforgiving of insults, injuries or slights)
6. perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
7. has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

Question 20

what is the prevalence of paranoid PD

Answer 20

2-4%

Question 21

in which populations is paranoid PD more common

Answer 21

males more than females

more common in minorities

more common in those with hearing impairment

Question 22

what is a risk factor for development of paranoid PD

Answer 22

childhood trauma

those who have had physical (but not sexual) abuse

Question 23

what is the usual motivation behind antisocial behaviours seen in paranoid PD

Answer 23

desire for revenge in the context of suspiciousness (rather than for personal gain or to exploit others like in ASPD)

Question 24

what is the main psychological defense used in paranoid PD

Answer 24

projection

Question 25

what types of treatment have been recommended for paranoid PD

Answer 25

no studies done can recommend CBT, psychodynamic *focus on improving the ability of the individual to trust others, and tolerate intimacy with others

Question 26

how should clinicians act towards those with paranoid PD

Answer 26

straightforward and careful about offering interpretations, especially in topic areas that may feed into the persons suspiciousness

Question 27

how does paranoid PD change over time

Answer 27

paranoid PD has greater stability and less deterioration relative to schizoid PD

Question 28

what is a mnemonic to remember the criteria for paranoid PD

Answer 28

GET FACT Grudges held for long periods Exploitation expected (without a sufficient basis) Trustworthiness of others is doubted Fidelity of sexual partner questioned Attacks on character are perceived Confides in others rarely, if at all Threatening meanings read into events

Question 29

how do those with paranoid PD often relate to others

Answer 29

often feel need to have high degree of control over others often rigid, critical of others, and unable to collaborate--although have great difficulty accepting criticism themselves may blame others for their own shortcomings may be litigious (due to quickness to counterattack in response to perceived threats) seek to confirm their preconceived negative notions regarding people or situations they encounter may exhibit thinly hidden, unrealistic grandiose fantasies --often attuned to issues of power and rank

Question 30

how might someone with paranoid PD perceive the world

Answer 30

attracted by simplistic formulations of the world often wary of ambiguous situations may be perceived as "fanatics" and form tightly knit "cults" with others who share their paranoid belief systems

Question 31

how many features are listed in criterion A of schizotypal PD? how many are required to meet criteria?

Answer 31

5/9

Question 32

what is criterion A for schizotypal PD

Answer 32

a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behaviour: 1. ideas of reference (excluding delusions of reference) 2. odd beliefs or magical thinking that influences behaviour and is inconsistent with subcultural norms (i.e superstitiousness, belief in clairvoyance, telepathy, or "sixth sense;" in children or adolescents, bizarre fantasies or preoccupations) 3. unusual perceptual experiences, including bodily illusions 4. odd thinking and speech (i.e vague, circumstantial, metaphorical, overelaborate, stereotyped) 5. suspiciousness or paranoid ideation 6. inappropriate or constricted affect 7. behaviour or appearance that is odd, eccentric or peculiar 8. lack of close friends or confidants other than first degree relatives 9. excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative self judgments about self

Question 33

what % of those with schizotypal PD have a concurrent dx of MDD when admitted to a clinical setting

Answer 33

30-50%

Question 34

what is the course of schizotypal PD

Answer 34

relatively stable only small % go on to develop SCZ or other psychotic disorder

Question 35

what is a mnemonic to remember the criteria for schizotypal PD

Answer 35

UFO AIDER Unusual perceptions Friendless except for family Odd beliefs, thinking and speech Affect--inappropriate, constricted Ideas of reference Doubts of others--suspicious Eccentric--appearance, behaviour Reluctant in social situations, anxious