Kap 12 Personality Disorders

Question 1

What is a Personality disorder?

Answer 1

An extreme deviation of the spectrum of personality traits, which violate social norms and expectations.

They usually present with social issues and are inflexible and cannot adapt well to different situations or people.

They are usually missing insight into their problems and personality.

Question 2

What are the cluster A personality disorders?

Why are the clustered together?

Answer 2

Schizoid personality disorder
Schizotypal personality disorder
Paranoid personality disorder

They are clustered together because of their closeness to Schizophrenia and shared (genetic&environmental) risk factors.

Question 3

What are the cluster B personality disorders?

Answer 3

Narcissistic personality disorder
Antisocial personality disorder
Histrionic personality disorder
Borderline personality disorder

Question 4

What are the cluster C personality disorders?

Answer 4

Dependent personality disorder
Obsessive compulsive personality disorder
Avoidant personality disorder

Question 5

Why is the clustering system widely used?

Answer 5

Because it comes from the DSM system and is used widely in research

Question 6

In the context of personality disorders, what effects do Cluster A and B have on the person in comparison to Cluster C?

Answer 6

Cluster A and B have a bigger (negative) impact on social functioning and work
While cluster C has bigger impacts on subjective symptoms (Anxiety, Depression)

Question 7

What are possible causes of Personality disorders?

Answer 7

Around 50% genetic (hereditary)

Abuse and Trauma have an influence.

Question 8

What measure is usually used for testing for personality disorders?

Answer 8

The SCID-II
(Structured Clinical Interview for DSM, Axis II)

Question 9

What is needed for diagnosing someone with a personality disorder?

Answer 9

Issues for at least 2 years

Problems with themselves or interpersonal functioning

Rigid maladaptive patterns of cognition, emotional experience, expression and behaviour

Problems in social, occupational, educational, or family functioning

These issues are not caused by other conditions such as diagnoses or drugs

Question 10

What is the Prevalence of personality disorders in the general population?

Answer 10

10%

Question 11

What is the prevalence of personality disorders in the clinical population?

Answer 11

50%

Question 12

Which personality disorders are more common with women?

Answer 12

Dependent PD
Histrionic PD
Borderline PD

Question 13

Which personality disorders are more common with men?

Answer 13

Antisocial PD

Question 14

Which medications are used to treat which personality disorder?

Answer 14

Antipsychotics for Schizotypal PD

Mood Stabilizers for Borderline PD

Antidepressiva for depressive comorbidity

Question 15

What should be taken into consideration when treating someone with a personality disorder in talk therapy?

Answer 15

The personality disorder has an effect on the relation between the patient and the therapist. This can lead them to end the treatment earlier.

It can become difficult for the patient to change, because they are lacking insight into their issue

One should help the patient understand how their personality contributes to their issues.

Question 16

What are typical characteristics of Paranoid personality disorder?

Answer 16

They are paranoid. ;)

They have a suspicion against others, that they want to hurt/exploit them.

Low insight into their paranoia.

They look for hidden signs everywhere.

Schizophrenia often runs in the family.

Question 17

Compared to Paranoid personality disorder, what are the differences to other conditions?

Answer 17

Social anxiety: Afraid of negative evaluation

Avoidant PD: Here they feel unworthy

Schizotypal PD: Social problems

Question 18

What are typical characteristics of Schizoid personality disorder?

Answer 18

The night-janitor

Low interest in social relations or the world in general

Interest in themselves and fantasies

No care for their social standing (criticism and praise)

No enjoying of life and little emotionality.

They can have short episodes of psychosis but just very short (minutes)

Question 19

What are typical characteristics of Schizotypal personality disorder?

Answer 19

Lonelyness and akwardness in social situations.

Strange thinking patterns (magical)

Vague and complicated speech

Question 20

Which other psychological disorder is Schizotypal personality disorder connected with?

Answer 20

Schizophrenia!

With schizophrenia in the family the risk is increased.

People with Schizotypal PD have a 30% chance of developing Schizophrenia.

Schizotypal personality disorder can be treated with antipsychotics

Question 21

What is different with Schizotypal disorder in the ICD-11 compared to other personality disorders?

Answer 21

It is sorted under the Psychotic disorders and not under personality disorders

Question 22

What is the difference between Schizoid personality disorder and other diagnoses?

Answer 22

Autism:
Autistic people are more rigid in their interests and behaviour.
They do not understand emotions as well. Schizoid people do understand them but do not express them.

Avoidant PD:
They have a desire for being with people but think that they are flawed

Paranoid/Schizotypal PD:
Their psychosis is usually much longer.

Question 23

What are typical characteristics of Borderline personality disorder?

Answer 23

A feeling of emptiness

Unstable emotions, relationships and self image

Fear of abandonment