Cluster B Flashcards

1
Q

What are the cluster B PDs?

A

Histrionic,
Narcissistic,
Antisocial,
Borderline

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2
Q

What are the clinical features of Antisocial personality disorder?

A

Failure to comply with social norms: problems with the law/prison

Violation of the rights of others
Irresponsible, impulsive (anxiety, substance, somatic d/o, gambling), and deceitful

Lack of conscience, empathy, and remorse

Deceit & manipulation are core features

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3
Q

What are the causes of antisocial PDs?

A

Genetics-increased incidence in families with PD (males APD & substance use, Females - somatic symptoms)

Environmental factors

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4
Q

What is APD comorbid with?

A

substance abuse, other PD’s, sexual dysfunction, paraphilias, mood disorders, anxiety disorders

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5
Q

When should you Dx conducT disorder instead of APD?

A

greater than 18 y/o

only if criteria is not met for APD

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6
Q

When should you Dx APD vs conduct disorder?

A

at least 18

symptoms of conduct disorder before 15

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7
Q

What is the DSM 5 criteria for APD

A

3 or more criteria in the past 12 months, with at least 1 criterion present in the past 6 months of

aggression toward people or animals
Destruction of property
Deceitfulness or theft
Serious violation of rules

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8
Q

What are differential DX of APD?

A

Overlooked neurological disorder/mental disorder
Substance

if started at same time then both should be Dx if APD is secondary to substance APD is not needed

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9
Q

What are the treatments for APD?

A

Few seek treatment voluntarily

May remit after age 40
Emphasis is placed on prevention and rehabilitation

Group therapy

Pharmacotherapy

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10
Q

What are clinical features of Borderline personality disorder?

A

Unstable affect, mood swings
Intense anger

impulsivity, fear of abandonment

emptiness or borebom

suïcidaal gestures (warrants suicide assesment)

Cutting behaviors as a means of relief of pain

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11
Q

What is boderline PD comorbid with?

A

: Major Depressive Disorder, Alcohol Use

Disorder, Substance Abuse

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12
Q

What is the primary defense machanism of Boderline PD?

A

Splitting – “good v evil”

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13
Q

What is the cause of Boderline PD?

A

Runs in families often along with Bipolar Disorder and/or Major Depression

Reports of childhood sexual, physical, and/or emotional abuse

disruption in early development individuation-separation between
the child and mother = problems with identity

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14
Q

In who does borderline PD in which type of families?

A

in families of patients with

BPD along with Major Depression and Bipolar D/O

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15
Q

What is the treatment of borderline ?

A

Antidepressents (SSRI)
Mood Stabilizers
First generation and atypical antipsychotics
Psychotherapy: Dialectial behavior therapy

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16
Q

What are predictors of poor outcome with BPD?

A

antisocial behaviors
chronic anger
overuse of medical facilities
often sabotage tx going well

17
Q

what is a better outcome with BPD?

A

-higher intelligence superior social supports

increased self-discipline

18
Q

What are clinical features of historonic PD?

A

Overly dramatic, sensational, and sexually provocative

impulsive and need to be the center of attention

Suggestible- easily influenced

Thinking and emotions are perceived as shallow

Common diagnosis in females,; may be overlooked in men

Tend to improve over time, regardless of tx.

19
Q

What is the cause of histrionic?

A

Unknown maybe genetic

Major Depressive Disorder and/or an Anxiety D/O (anti-depressant meds)

20
Q

What are the clinical features of Narcissistic PD?

A

Exaggerated and unreasonable sense of self-importance/entitlement, believe they are special

Preoccupied with fantasies of success

Require admiration from others

Lack sensitivity and empathy for other people

May react with rage to criticism (narcissistic injury), envious, and arrogant

21
Q

What is the cause of Narcissistic PD?

A

Failure to learn empathy as a child
Lack of clear parental appreciation of the child’s
accomplishments; conversely – excessive attention
Sociological view – product of the “me” generation
Treatment options

22
Q

What are treatments of Narcissistic PDs?

A

Focus on grandiosity, lack of empathy, unrealistic thinking

May also address co-occurring depression

Can be confused with hypomania