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Block 33 Mental Health > CT 8 - Personality Disorders > Flashcards

CT 8 - Personality Disorders Flashcards

1
Q

What is personality

A

Collection of traits that we have developed as we have grown up which make us an individual. Includes how we think, feel and behave

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2
Q

How does personality develop

A

Nature - inherited tendencies

Nurture - influenced by the environment you are raised in

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3
Q

Which kind of mental health conditions have some sort of genetic influence

A

Cluster B

Schizotypal

Schizophrenia
Borderline personality disorder
Affective disorders

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4
Q

Most personality disorders have a link to an individuals childhood

A

Starts from intrauterine period all the way to adulthood. Any adversities, neglect, abuse etc can impact on the devlopement of the child and increases risk of personality disorder in adulthood

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5
Q

What physiological things might contribute to personality disorder

A

Low levels of 5HT /serotonin

Or imaging of amygdala might show decreased activity in those with psychopathy/apathy -lack of neuronal connections

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6
Q

What is the psychodynamic theory of how personality is developed

A

Freud:

Mind can be split into 3:
- Id - primitive part of the mind which focuses on pleasure, desires and needs.
- ego - rational part of the mind which mediates between a balance between ID and superego and finds ways to satisfy needs in a manner which is socially acceptable
- superego - moral component to the mind which judges actions and strives to be perfect according to societies standards

Levels of consciousness:
- conscious,
- preconscious
- unconscious* (largest and most influential part with repressed memories + desires )

Oral stage 0-1
Anal stage 1-3
Phallic stage 3-6 focus shifts to genitals
Latency 6- puberty (sexual impulses are repressed + social skills develop)
Genital stage puberty onwards (maturation of sexual interests and mature relationships occur)

Ego employs defence mechanisms to manage conflicts like repression, denial, projection etc

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7
Q

Which region in the brain specialises in threat detection, fear conditioning and harm avoidance

A

Amygdala

Living in an unfriendly environment in childhood sensitises the amygdala + lowers the threshold for triggering defensive reactions later on life

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8
Q

Where is the reward centre of the brain

A

Nucleus accumbens/ located in the basal forebrain

Messages are sent to this area in the brain + dopamine is the primary NT

Density of receptors for dopamine and oxytocin in the nucleus depends on how well the person was parented

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9
Q

What kind of PDs are more common in males

A

Emotionally unstable borderline personality
Antisocial
Schizotypal

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10
Q

What kind of PDs are more prevalent in women

A

Borderline
Histrionic
Dependent

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11
Q

What % of the general population have PD

A

5-10%

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12
Q

What are specific personality disorders:

A

Severe disturbances in the personality and behavioural tendencies of the individual not directly resulting from disease, damage or insult to brain or from another psychiatric disorder

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13
Q

What is emotionally unstable PD:

A

Marked tendency to act impulsively and mood instability. Have anger outbursts which may be easily precipitated when impulsive acts are criticised by others

Two types of this disorder exist:

  • impulsive type
  • borderline type ( overdoses and self harm, chronic feelings of emptiness, unstable +intense relationships uncertainty about self-image and sexuality), do a lot to avoid abandonment, polarised thinking (all or nothing, good or bad etc black or white)
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14
Q

What is dissocial PD

A

Irresponsible + callous unconcern for others
Don’t care about social norms + rules
Can’t MAINTAIN relationships
Very low tolerance to frustration
Can’t feel guilt
Blame others or offer rationalisations for behaviour

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15
Q

Dissocial PD: CORRUPT and FIGHTS

A

Cannot conform to law
Obligations ignored
Reckless
Remorseless
Underhanded (deceitful)
Planning insufficient (impulsive)
Temper

Forms relationships but can’t maintain
Irresponsible
Guiltless
Heartless
Temper easily lost
Someone else’s fault

  • note this is not conduct disorder as that is diagnosed in childhood or adolescence. Dissocial PD diagnosed in >18yrs
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16
Q

Paranoid PD : suspect

A

Suspicious
Unforgiving
Sensitive about setbacks
Possessive
Excessive self importance
Conspiracy theories
Tenacious sense of rights

  • not delisonal disorder
    Not schizophrenia
17
Q

Schizotypal PD: ME PECULIAR

A

Magical thinking
Experiences unusual perceptions
Paranoid ideation
Eccentric behaviour or appearance
Constricted or innapriate affect
Unusual thinking or speech
Lacks close friends
Ideas of reference
Anxiety in social situations
Rule out psychotic

18
Q

Schizoid PD: DISTANT

A

Detached - flattened affect
Indifferent to criticism or praise
Sexual experience of little interest
Tasks done alone
Absence of close friends
No desire for enjoyment
Takes pleasure in few activities

Not - Asperger’s or schizophrenia

19
Q

Avoidant personality disorder : CRINGES

A

Criticism and fear of social rejection
Restraint in relationships due to fear of shame
Inhibited in new relationships
Needs to be sure of being liked before engaging
Gets around occupational activities with little need for interpersonal contact
Embarrassment prevents doing new things
Self view as unappealing or inferior

20
Q

Depedent PD : reliance

A

Reassurance needed
Expressing disagreement is difficult
Life responsibilities assumed by others
Initiating projects difficult
Alone
Nurturance (goes to excessive lengths to get)
Companionship sought uregcntly as soon as one ends
Exaggerated fear of being left on own

21
Q

Narcissistic PD: GRANDIOSE

A

Grandiose
Require attention
Arrogant
Need to be special
Dream of success and power
Interpersonally exploitative
Others disregarded
Sense of entitlement
Envious

SPECIAL :

Superiority
Preoccupied with fantasies
Entitled
Criticism sensitive
Interpersonal exploitation
Arrogant
Lack empathy

22
Q

Histrionic PD:

A

Care about their appearance a lot, seek attention, shallow, theatrical, seductive behaviour

PRAISE:
Provocative/seductive
Racked with concern over appearance
Attention
Impressionable/easily influenced
Shallow and labile affect
Exaggerated expressions of emotion

23
Q

What is dialectical behavioural therapy

A

Based on CBT but adapted to help people who experience emotions very intensely

Occurs as group therapy where therapists teach skills like

1) mindfulness (help patient to focus on present rather than worries)

2) distress tolerance (teaching to deal with distress in other ways than self harm)

3) interpersonal effectiveness (teaching how to ask for things or how to say no)

4) emotion regulation (awareness and control over emotions)

24
Q

what is cognitive analytic therapy

A

CAT - Looks at the way a person thinks, feels and acts and the events and relationships that underlie these experiences (eg from childhood)

CBT focuses on the practical effects of a problem rather than its meaning and the reasons behind it

25
Q

What % of Schizotypal Disorder progresses to schizophrenia

A

50%

26
Q

What % of BPD die of suicide

A

10%

27
Q

What % of suicides show evidence of a PD

A

30-60%

28
Q

What is PD

A

Inflexible + enduring behavioural patterns which deviate from society’s norms
Stable over time
Pervasive
Cause great distress and inability to get along with others

29
Q

Cluster A:

A

Odd or eccentric behaviours

Paranoid
Schizoid
Schizotypal

  • add more notes
30
Q

Cluster B:

A

Dramatic, emotional or erratic behaviour

Antisocial
Borderline
Histrionic
Narcissistic

31
Q

Cluster C

A

Anxious or fearful behaviours

Avoidant
Dependent
Obsessive compulsive

32
Q

Tools that assess PD:

A

ICD-10
IPDE, SCID-II** (self reported questionnaires.)

33
Q

What’s BCA

A

Behavioural chain analysis (not a therapy itself)

Looks at promoting factors and vulnerabilities that led the patient to self harm for example with the patient and finding ways to exit chain and not progress towards the behaviour in the future again

34
Q

Borderline personality disorder symptoms

A

Poor self image + social anxiety
Mood instability
Impulsive
Self harm
Unstable + stormy relationships

Transient quasi-psychotic episodes +or dissociation under stress

35
Q

What are hypnogogic hallucinations

A

**

36
Q

Pseudohallucinations are quite common in which disorder

A

Borderline PD

Hallucinations are not from external sources and are actually voices/thoughts within your head
Perhaps occurs due to repressed memories from childhood which resurface as voices. Patient not able to recognise that it might be a memory rather than an actual voice

Block 33 Mental Health (5 decks)

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