Cluster B Flashcards
What are the cluster B PDs?
Histrionic,
Narcissistic,
Antisocial,
Borderline
What are the clinical features of Antisocial personality disorder?
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
What are the causes of antisocial PDs?
Genetics-increased incidence in families with PD (males APD & substance use, Females - somatic symptoms)
Environmental factors
What is APD comorbid with?
substance abuse, other PD’s, sexual dysfunction, paraphilias, mood disorders, anxiety disorders
When should you Dx conducT disorder instead of APD?
greater than 18 y/o
only if criteria is not met for APD
When should you Dx APD vs conduct disorder?
at least 18
symptoms of conduct disorder before 15
What is the DSM 5 criteria for APD
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
What are differential DX of APD?
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
What are the treatments for APD?
Few seek treatment voluntarily
May remit after age 40
Emphasis is placed on prevention and rehabilitation
Group therapy
Pharmacotherapy
What are clinical features of Borderline personality disorder?
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
What is boderline PD comorbid with?
: Major Depressive Disorder, Alcohol Use
Disorder, Substance Abuse
What is the primary defense machanism of Boderline PD?
Splitting – “good v evil”
What is the cause of Boderline PD?
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
In who does borderline PD in which type of families?
in families of patients with
BPD along with Major Depression and Bipolar D/O
What is the treatment of borderline ?
Antidepressents (SSRI)
Mood Stabilizers
First generation and atypical antipsychotics
Psychotherapy: Dialectial behavior therapy
What are predictors of poor outcome with BPD?
antisocial behaviors
chronic anger
overuse of medical facilities
often sabotage tx going well
what is a better outcome with BPD?
-higher intelligence superior social supports
increased self-discipline
What are clinical features of historonic PD?
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.
What is the cause of histrionic?
Unknown maybe genetic
Major Depressive Disorder and/or an Anxiety D/O (anti-depressant meds)
What are the clinical features of Narcissistic PD?
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
What is the cause of Narcissistic PD?
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
What are treatments of Narcissistic PDs?
Focus on grandiosity, lack of empathy, unrealistic thinking
May also address co-occurring depression
Can be confused with hypomania
