Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatric Principles > Exam 2 Personality disorders > Flashcards

Exam 2 Personality disorders Flashcards

1
Q

define personality

A

person’s unique emotional and behavioral traits used to RESPOND to the environment and INTERPERSONAL relationships, which are APPARENT in ordinary life and are usually STABLE and PREDICTABLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does personality influence neural processing

A

sensation –> perception* –> cognition* –> behavior* or emotions*

*personality influences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

General description of PDs

A

A. subjective experiences and behaviors that

  1. Deviate from cultural standards
  2. Traits are pervasive, inflexible, maladaptive
  3. Have onset in late adolescence or early adulthood
  4. Are stable from late adolescence through time
  5. Can lead to unhappiness and impairment

B. Characteristics

  1. Deny they have problems
  2. Sx are alloplastic; attempt to alter the external environment (not themselves)
  3. Ego-syntonic: believe behaviors are normal to suit their self0image
  4. Do not feel anxious about their maladaptive behavior
  5. Disinterested in tx: refuse psych tx
  6. Impervious to recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the different clusters of PDs

A 
Cluster A (odd/eccentric)
Cluster B (dramatic/emotional)
Cluster C (anxious/fearful)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is included under Cluster A of PDs

A

“Odd/eccentric” - acts peculiar or avoids social relationships

  1. Paranoid
  2. Schizoid
  3. Schizotypal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is included under cluster B (dramatic/emotional)

A

“dramatic/emotional”

  1. Antisocial
  2. Borderline
  3. Histrionic
  4. Narcissistic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is included under Cluster C (anxious, fearful)

A

“anxious, fearful”

  1. Avoidant
  2. Dependent
  3. Obsessive compulsive (PD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Etiology of PDs

A
  1. Developmental hx may reveal individual difficulties - family problems/abuse/incest
  2. Biological determinants may be evident (genetics) - perinatal injury, encephalitis, head trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DSM dx of Paranoid Personality disorder

suspicious, mistrusting, 4/7

A

A pervasive distrust and suspiciousness of others present w/o justification, Begins by early adulthood at least 4 of the following:

  1. Suspicious others are exploiting, harming or deceiving
  2. Doubts loyalty or trust-worthiness of others
  3. Fears that info given to others will be used maliciously against them
  4. Mistrust other “out to get them”
  5. Bears grudges
  6. Perceives attacks that are not apparent to others and is quick to react angrily or to counterattack
  7. Repeatedly questions the fidelity of the spouse or sexual partner
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DSM criteria of Schizoid personality disorder

Schizoid, devoid 4/7

A

Pervasive pattern of social detachment with a restricted affect, beginning by early adulthood and indicated by at least FOUR of the following:

  1. Neither desires nor enjoys close relationships
  2. Chooses solitary activities
  3. Little interest in having sexual experiences
  4. Takes pleasure in few, if any, activities
  5. No close friends or confidants except first degree relatives
  6. Indifferent to the praise or criticism of others
  7. Emotional detachment (restricted range of emotions( cold and aloof
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

DSM dx cx Schizotypal PD

*no close relationships, eccentric, 5/9

A

pervasive pattern of interpersonal deficits marked by discomfort and REDUCED CAPACITY FOR CLOSE RELATIONSHIPS as well as perceptual distortions and ECCENTRICITIES of behavior, beginning in early adulthood. at least FIVE of the following:

  1. Ideas of REFERENCE
  2. NO close relationships outside first degree relatives
  3. Behavior or appearance is odd, eccentric or peculiar
  4. Odd thinking and speech
  5. Suspiciousness or paranoid ideations
  6. Inappropriate or constricted affect
  7. Excessive social anxiety that does not diminish with familiarity
  8. Odd beliefs or magical thinking
  9. Unusual perceptions/body illusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cluster B of PDs includes

A

“emotional, inconsistent, dramatic”

  • Antisocial “man slaughterers 3/8”
  • Borderline “unstable clingy, paranoids 5/9”
  • Histrionic “drama queen 5/8”
  • Narcissistic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dx criteria for antisocial personality do

disregard, deadly 3/8

A

A. Pt displays disregard for, and violation of the rights of others and is indicated by at least THREE:

  1. disregard for social norms with respect to lawful behaviors
  2. Deceitfulness: repeated lying, conning others for personal profit or pleasure
  3. Impulsivity or failure to plan ahead
  4. Irritability and aggressiveness
  5. Reckless disregard for the safety of self or others
  6. Irresponsibility in employment or finances
  7. Lack of remorse/guilt/shame
  8. Lack of empathy

Disregard lawful behavior, Deceitful, impulsive, irritable, reckless, irresponsible, unremorseful, apathetic

DDIIRIUA (at least 3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antisocial personality d/o background

A

hx of sx of conduct disorder before age 15 ie

  1. Aggression against people and animals
  2. Destruction of property
  3. Deceitfulness
  4. Serious violation or rules

predisposing: ADHD, oppositional defiant disorder, conduct disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does dysfunction of paralimbic structures relate to antisocial personality d/o (prefrontal cortex, anterior cingulate, amygdala, insular damage)

A

Prefrontal cortex damage = impulsive, lacks insight, recidivism

Anterior cingulate damage = lack of empathy and affect

amygdala damage = fearlessness; misperceptions of threat

Insular damage = can’t recognize violation of social norms; high disgust threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DSM dx of Borderline Personality disorder (unstable/clingy/paranoid 5/9)

A

A pervasive pattern of UNSTABLE INTERPERSONAL RELATIONSHIPS, unstable SELF IMAGE, and poor IMPULSE CONTROL beginning by early adulthood. at least FIVE:

  1. Frantic efforts to avoid real or imagined ABANDONMENT
  2. Unstable and intense interpersonal relationships
  3. Identity disturbance: unstable self image or sense of self
  4. Impulsivity in at least TWO areas that are potentially self damaging (spending, promiscuity, substance abuse, reckless driving, binge eating)
  5. Recurrent suicidal behavior, gestures or threats or self-mutilating behavior
  6. Affect instability (sudden intense dysphoria, irritability or anxiety of short duration)
  7. Chronic feelings of emptiness
  8. Intense anger or difficulty controlling anger
  9. Transient stress related paranoid ideation, dissociative sx or brief psychotic episodes

fear abandonment, unstable relationships, identity disturbance, self-damaging impulsivity, suicidal, affect instability, empty, anger, brief psychosis/ideation
*BORDERline = unstable

17
Q

Characteristics of attention and emotional imbalances

A

better name = “emotional dysregulation disorder”
- no emotional skin
-worship then detest partners
DEPAKOTE (VALPROATE) may help alleviate emotional and interpersonal volatility
-hypersensitivity to facial expressions
- difficulty distancing from emotionally charged situations due to: less emotional regulation by anterior cingulate cortex and difficulty turning attention away due to dysfunction in intraparietal sulcus

18
Q

DSM dx Histrionic Personality Disorder

*drama queen, 5/8

A

Pervasive Pattern of excessive EMOTIONALITY and ATTENTION SEEKING beginning early adult. FIVE or more:

  1. Not comfortable unless center of attention
  2. Sexually seductive or provocative
  3. Rapid shifting and shallow expression of emotions
  4. Uses physical appearance to attract attention
  5. Style of speech excessively impressionistic, lacking detail
  6. Dramatic and exaggerated expression of emotion
  7. Suggestible, easily influenced by others
  8. Considers relationships more intimate than they are
19
Q

DSM dx Narcissistic Personality d/o

*Voldemort 5/9

A

Pervasive pattern of GRANDIOSITY (in fantasy or behavior), NEED for ADMIRATION, LACK EMPATHY, beginning early adulthood; FIVE of the following:

  1. Grandiose sense of self importance
  2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty or ideal love
  3. Associates only with others who are perceived as unique or exceptional
  4. Needs excessive admiration
  5. Has a sense of entitlement
  6. Takes advantage of others to achieve his/her own ends
  7. Lacks empathy - unwilling to recognize or identify with feelings or needs of others
  8. Envious of others, believe others envious of them
  9. Shows arrogant, haughty behaviors or attitudes
20
Q

Cluster C personality d/o include

A

“Fearful and anxious”

a) avoidant PD
b) Dependent PD
c) Obsessive Compulsive PD

21
Q

DSM dx Avoidant PD

*no relationship bc fear rejection, 4/7

A

Pervasive pattern of SOCIAL INHIBITION, feelings of INADEQUACY, and HYPERSENSITIVITY beginning by early adulthood. At least FOUR

  1. Avoids occupations with sig interpersonal contact due to fear of criticism, disapproval or rejection
  2. Restrained in intimate relationships due to fear of being shamed or ridiculed
  3. Preoccupied with being criticized or rejected in social situations
  4. Inhibited in new interpersonal situations due to feelings of inadequacy
  5. Pt views himself as socially inept, unappealing or inferior to others
  6. Reluctant towards personal risks or new activities - fear of embarrassment
  7. Unwilling to get involved with people unless certain of being liked

*they do desire to have attachments with others

22
Q

DSM dx Dependent Personality disorder

*always need confirmation 5/9

A

Pervasive and excessive need to be cared for - subemissive, behavior and fears of separation. At least FIVE:

  1. Unable to make their own decisions
  2. Need to be taken care of and others assume responsibility for them
  3. Difficulty expressing disagreement with others
  4. Difficulty initiating projects - pessimistic about abilities
  5. Goes to excessive lengths to be dependent on others regardless of cost to self
  6. helpless when alone. Fears being unable to care for himself/herself
  7. Urgently seeks another relationship when one ends
  8. Preoccupied with fears of being left to take care of themselves
23
Q

OCPD DSM dx

A

Preoccupation with ORDERliness, PERFECTIONISM and CONTROL, at the expense of flexibility, openness and efficiency beginning by early adulthood. At least FOUR:

  1. Preoccupied with details, rules, lists, organization or schedules
  2. Perfectionism interferes with task completion
  3. Excessively devoted to work and productivity to the exclusion of leisure activities and friendships
  4. Over conscientious, scrupulous and inflexible about morality, ethics or values (not accounted for by cultural or religion)
  5. Unable to discard worn out or worthless objects even if they have no sentimental value
  6. Reluctant to delegate tasks to others
  7. Miserly spending toward self and others
  8. Rigid and stubborn
24
Q

In response to medical illness, any aberrant sx will..

A

become more exaggerated

25
Q

If these clusters (A, B, C) have a medical illness, how do they typically respond ? how should we handle this?

A

A: more withdrawn or suspicious: take time to est trust

B: more emotional and seductive: set limits on inappropriate behavior; use close ended questions

C: increased anxiety, fear and more controlling, angry, needy: Do not take the manifestations of their illness personally

26
Q

Objectives of Personality disorders tx

A
  1. Facilitate the pt highest level and most flexible degree of adaptive INTERPERSONAL FUNCTIONING
  2. ensure pt connects to therapist, clinic, group or institution
27
Q

Target and Requirements for Psychotherapy in PD tx

A

Target: personality structure

Requirements:

  1. Pt motivation to change
  2. Pt capacity for insight
  3. pt capacity to engage in therapeutic relationship
28
Q

Types of Psychotherapy tx for personality disorders

A

Supportive

Interpersonal

CBT

DBT (dialectical Behavioral therapy)

  1. Core mindfulness
  2. Emotional regulation
  3. Interpersonal effectiveness
  4. Distress Tolerance
29
Q

Psychopharmacologic tx for personality disorders is/includes//

A

SX MGMT

a) cognitive distortions - paranoia- pscyhotic sx:
1. low dose antipsychotics

b) Spectrum of irritability, impulsivity, rage and violence
1. Mood stabilizers
2. SSRI’s
3. Antipsychotics

c) Emotional/affect instability
1. Mood stabilizers

d) Persistent anxiety
1. Antianxiety meds (Buspar first?)
2. B blockers
3. SSRI’s (take 4-6 wk)

e) Dysphoria and Depression
1. Antidepressants
2. Lithium

f) Acute Insomnia
1. Low dose Trazodone (priaprism risk)
2. Sedating TCA

g) Pervasive Attention difficulties
1. Stimulants
2. Buproprion (wellbutrin) *seizure risk

h) Severe OCD sx
1. Clomipramine (anafranil) or SSRI’s

30
Q

Tx cognitive distortions/paranoia/psychotic sx in PD

A

a) cognitive distortions - paranoia- psychotic sx:

1. low dose antipsychotics

31
Q

Tx of OCD sx

A

Clomipramine (anafranil) or SSRI’s

32
Q

Tx of pervasive attention difficulties in PD

A
  1. stimulants

2. Buproprion (wellbutrin)

33
Q

Tx of insomnia in PD

A
  1. Low dose Trazodone (priaprism risk)

2. Sedating TCA

34
Q

Tx of spectrum of irritability/impulsivity/rage

A

Spectrum of irritability, impulsivity, rage and violence

  1. Mood stabilizers
  2. SSRI’s
  3. Antipsychotics
35
Q

Tx of emotional/affect instability in PD

A

Mood stabilizers

36
Q

Tx of persistent anxiety in PD

A
  1. Antianxiety meds (Buspar first?)
  2. B blockers
  3. SSRI’s (take 4-6 wk)
37
Q

Tx of

Dysphoria and Depression

A
  1. Antidepressants

2. Lithium

Psychiatric Principles (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions