L21 - Personality Disorders

Question 1

What is the DSM-5 criteria for Personality Disorder?

Answer 1

• Enduring pattern of inner experience and behaviour that deviates from individual’s culture.
• In ≥2 areas (cognition, affect, interpersonal functioning, impulse control).
• Onset in early-mid childhood.

Question 2

What are the 3 core features of Personality Disorders according to Millon (1981)?

Answer 2

1. Functional Inflexibility:
   - failure to adapt to situations; rigid response.
2. Self-defeating:
   - behavioural responses are damaging.
3. Unstable in response to stress:
   - emotional, behavioural, & cognitive instability.

Question 3

What are the 3 clusters of PDs in DSM-5?

Answer 3

Cluster A (odd/eccentric):
- Paranoid
- Schizoid
- Schizotypal
Cluster B (dramatic/emotional/erratic) :
- Antisocial
- Borderline
- Narcissistic
- Histrionic
Cluster C (anxious/fearful):
- Avoidant
- Dependant 
- Obsessive-compulsive

Question 4

What are some benefits and disadvantages of the categorical approach to classifying PDs as in the DSM?

Answer 4

Benefits:
- Clarity and ease of communicating information.
Disadvantages:
- Difficult to distinguish the threshold between normal and disordered.

Question 5

Cluster A:

How is Paranoid PD characterised?

Answer 5

• Distrust, suspicion, prolonged grudges.
• Believe people are out to exploit them.
• Hostile, aggressive, angry, jealous.
• Sensitive to criticism/threat.

Question 6

Cluster A:

How is Schizoid PD characterised?

Answer 6

• Detachment, aloof.
• Withdrawn, isolated.
• Anhedonia.
• Comorbid with Schizotypal and Avoidant PDs.

Question 7

Cluster A:

How is Schizotypal PD characterised?

Answer 7

• Behavioural eccentricities.
• Extreme superstition.
• Perception distortions (not to Schizophrenia level).

Question 8

Cluster B:

How is Antisocial PD characterised?

Answer 8

• Reckless disregard for others.
• Victimising and blaming others.
• Shallow and manipulative.
• Self-centred.
• Lack empathy.
• Criminal behaviours may or may not be present.

Question 9

Cluster B:

How is Borderline PD characterised?

Answer 9

• Emotional instability/affective dis-regulation.
• Impulse control issues.
• Self-harm, promiscuity.
• Unstable self-concept/

Question 10

Cluster B:

How is Histrionic PD characterised?

Answer 10

• Attention seeking.
• Excessive emotionality.
• Flirtatious, seductive, dramatic.
• Denial of anger and hostility.
• Manipulative, low frustration tolerance.

Question 11

Cluster B:

How is Narcissistic PD characterised?

Answer 11

• Over-inflated ego.
• Compensatory reactions (self-righteousness, contempt, vanity).
• Sense of entitlement.
• Focus on self without regard for others.

Question 12

Cluster C:

How is Avoidant PD characterised?

Answer 12

• Discomfort in social situations.
• Low self-esteem.
• Hypersensitive to criticism.
• Believe that they are unappealing and inferior to others.

Question 13

Cluster C:

How is Dependent PD characterised?

Answer 13

• Need for constant approval.
• Feel they need to be taken care of.
• Helplessness/incompetent.
• Fear abandonment.

Question 14

Cluster C:

How is Obsessive Compulsive PD characterised?

Answer 14

• Perfectionism.
• Rigidity and stubbornness.
• Occupied with rules, minor details.