Definitions 3 (and PDs)

Question 1

Ideas of reference vs. delusion of reference

- A condition causing ideas of reference

Answer 1

Misinterpretation of events in the outside world as having direct personal reference to the patient (in delusion of reference, this has an effect on the patient’s behaviour)
- Schizotypal PD

Question 2

Delusion of control

- AKA…?

Answer 2

External forces/agent controlling actions

passivity phenomena

Question 3

Erotomanic delusions

- Example in modern history?

Answer 3

Belief that a person (usually of higher status and unattainable) is in love with the patient
- John Hinckley Jr

Question 4

Grandiose delusions

Answer 4

Inflated sense of self-worth, power or wealth

Question 5

Somatic delusion

Answer 5

Patient has a physical defect

Question 6

Persecutory delusion

Answer 6

Others are trying to cause them harm

Question 7

Insight

- give the 3 stages

Answer 7

Awareness of one’s own illness or situation:

• awareness of abnormal experience
• result of a disease process
• open to intervention

Question 8

Thought form/process

• Example in psychotic depression
• Example in manic episode

Answer 8

Thought process in the MSE refers to the quantity, tempo (rate of flow) and form (or logical coherence) of thought

• psychotic depression: slow, latency, poverty of speech
• manic: flight of ideas, loosening associations, tangentiality, circumstantiality

Question 9

Formal thought disorder

• What is it?
• How is it diagnosed?
• Give 4 examples

Answer 9

Refers to disorganized thinking as evidenced by disorganized speech.
- Specific thought disorders include derailment, poverty of speech, tangentiality, illogicality, perseveration, and thought blocking.

Question 10

The 5 Ps of formulation

Answer 10

Predisposing, precipitating, presenting, perpetuating and protective factors

Question 11

Personality disorder
3 criteria (what, effect, onset)

Answer 11

• A severe disturbance in the character and behavioural tendencies of the individual, usually involving several areas of the personality
• Associated with considerable personal and social disruption
• Onset in adolescence or early adulthood

Question 12

Give the 4 defining features of personality disorders

ICE-T

Answer 12

Interpersonal difficulties.
Control of impulses poor
Emotional responses problematic
Thinking patterns distorted

Question 13

Schizoid PD

- Remains of the day

Answer 13

Characterised by withdrawal from affectional, social and other contacts. This type of person is isolated and has a limited capacity to experience pleasure and express feelings.

Question 14

Paranoid PD

- Conspiracy theory

Answer 14

Pervasive distrust and suspicion

Question 15

Schizotypal PD

- Taxi driver

Answer 15

They may be eccentric and have odd beliefs, for instance, they may believe they can read other people’s thoughts, or that that their own thoughts have been stolen from their heads.
These odd or superstitious beliefs and fantasies are inconsistent with cultural norms

Question 16

Borderline (UEPD)

Answer 16

Impulsive and unpredictable.
- They may act without appreciating the consequences. Outbursts of emotion and quarrelsome behaviour may be exhibited. Relationships tend to be unstable and there may be suicidal gestures and attempts.

Question 17

Histrionic PD

- Regina George (drama queens)

Answer 17

shallow and labile affectivity and theatricality. There is lack of consideration for others and a tendency for egocentricity. People with this type of personality often crave excitement and attention.

Question 18

Anankastic PD

- Medical student/ OCD

Answer 18

characterised by feelings of doubt, perfectionism and excessive conscientiousness. There is a compulsion to check and a preoccupation with details. This personality type tends to be stubborn, cautious and rigid. Insistent and unwelcome thoughts may intrude or impulses that do not attain the severity of an obsessive-compulsive disorder.

Question 19

Anxious/avoidant PD

Answer 19

characterised by feelings of tension and apprehension, insecurity and inferiority. People with this type yearn to be liked and accepted, are sensitive to rejection. There is a tendency to exaggerate potential dangers and risks, leading to an avoidance of everyday activities

Question 20

Dependent PD

Answer 20

characterised by a reliance on others to take decisions and a fear of abandonment. There is an excessive reliance on authority figures and difficulty in acting independently. This can affect the capacity to deal with the intellectual and emotional demands of daily life

Question 21

Antisocial PD

• 2 varieties
• Features in people < 18 years - diagnosis?

Answer 21

a tendency to act outside social norms, a disregard for the feelings of others and an inability to modify behaviour in response to adverse events (e.g., punishment). A low threshold for violence and a tendency to blame others may be features
If under 18 years - conduct disorder

Question 22

Narcissistic PD (Trump)
- Mnemonic: SPE(3)CIAL

Answer 22

Special (believes he or she is special and unique)
Preoccupied with fantasies (of unlimited success, power, brilliance, beauty or ideal love)
Entitled, envious of others (or believes others are envious of them), and excess admiration required
Conceited (grandiose sense of self importance)
Interpersonal exploitation
Arrogant
Lacks empathy

Question 23

Give 4 key features of antisocial PD

Mnemonic: CORRUPT

Answer 23

Conformity to law lacking
Obligations ignored
Reckless disregard for safety of self or others
Remorse lacking
Underhanded (deceitful, lies, cons others)
Planning insufficient (impulsive)
Temper (irritable and aggressive)

Question 24

Give a tool for PD diagnosis

Answer 24

Diagnostic Interview for Personality Disorders (DIPD)

Question 25

Give a tool for PD diagnosis

Answer 25

Minnesota Multiphasic Personality Inventory (MMPI)

Diagnostic Interview for Personality Disorders (DIPD)

Question 26

Features of EUPD (borderline PD)

Mnemonic: AM SUICIDE

Answer 26

Abandonment (fear)
Mood instability (marked reactivity of mood)
Suicidal (or self-mutilating) behaviour
Unstable and intense relationships
Impulsivity (in two potentially self-damaging areas)
Control of anger
Identity disturbance
Dissociative (or paranoid) symptoms that are transient
and stress-related
Emptiness (chronic feelings of)

Question 27

Attachment theory:

a) What is it?
b) What psychiatric diseases can it explain well?

Answer 27

a) The need to develop an attachment to a caregiver in the formative stages of life. If this is lacking, leads to social and emotional maldevelopment.
b) Conduct disorders, Borderline Personality Disorders (“Come close, No! Go away!”)