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Brain And Behavior Exam 4 > Lec 79 Personality Disorders > Flashcards

Lec 79 Personality Disorders Flashcards

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1
Q

Is there FDA approved treatment for personality disorders?

A

nope! just do psychotherapy

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2
Q

What is the core feature of all personality disorders?

A

difficulty in interpersonal functioning

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3
Q

What is the DSM-5 definition of personality disorder?

A
  • enduring pattern of inner experience and behavior that deviates from expectations of one’s culture. pattern manifests in 2 or more of the following: cognition, affectivity, interpersonal functioning, impulse control
  • inflexible and pervasive pattern
  • leads to clinically significant distress or impairment
  • stable pattern of long duration, onset traced back at least to adolescence or early adulthood

person is not usually aware of the problem

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4
Q

What is development and course of personality disorder?

A
  • person is not usually aware of the problem
  • evident during adolescence or early adult life
  • relatively stable over time
  • hard to diagnose under age 18
  • may be exacerbated by loss of significant support or previously stabilizing social situations
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5
Q

Is personality disorder dimensional or categorical?

A

currently in DSM 5 = categorical = not on a continuum with normal personality

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6
Q

What is difference axis 1 vs axis 2 disorders DSM4?

A

axis 1 = symptoms, episodic, pt suffers most, biologic, genetic, treat with meds
axis 2 = traits, stable, those around pt suffer most, psychological, development, treat with therapy

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7
Q

What are the 3 clusters of personality disorders?

A

cluster A = odd or eccentric [weird]
cluster B = dramatic, emotional, erratic [wild]
cluster C = anxious/fearful [worried]

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8
Q

What are the cluster A personality disorders? 3 types?

A

odd/eccentric, inability to develop meaningful social relationships, no psychosis, genetic association with schizophrenia
= Accusatory, Aloof, Awkward

3 types: paranoid, schizoid, schizotypal

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9
Q

WHat are the 3 personality clusters and their major characteristics [ABCs]?

A

cluster A = weird [accusatory, aloof, awkward]
cluster B = wild [bad to the bone]
cluster C = worried [cowardly, compulsive, clingy]

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10
Q

What is paranoid personality disorder?

A
  • cluster A
  • irrational suspicions and mistrust of others
  • projection is major defense mech
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11
Q

What is schizoid personality disorder?

A
  • cluster A
  • voluntary social withdrawal, limited emotional expression,, content with social isolation
  • schizoiD = Distant
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12
Q

What is schizotypal personality disorder?

A
  • cluster A
  • commonly co-occurs with paranoid PD = high rate of aggression often leading to criminal violence
  • classic schizotypal: eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness, difficulty with working memory, lack of close friends, emotionally reserved
  • schizoTypal = magical Thinking

don’t look obviously mentally ill, could be misdiagnosed as depression, ADHD

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13
Q

What are characteristics of cluster B personality disorders? 4 types?

A

dramatic, emotional, erratic
- genetic association with mood disorders and substance abuse

  • antisocial, borderlines, histrionic, narcissistic
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14
Q

What are characteristics of cluster C personality disorders? 3 types?

A

anxious or fearful; genetic association with anxiety disorders

avoidant, obsessive compulsive, dependent

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15
Q

Match the personality disorder cluster and which diseases it has genetic association with:

  1. cluster A
  2. cluster B
  3. cluster C

A. mood disorders/substance abuse
B. anxiety disorders
C. schizophrenia

A

cluster A = schizophrenia
cluster B = mood disorders/substance abuse
cluster C = anxiety disorders

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16
Q

What is antisocial personality disorder?

A
  • cluster B
  • disregard for violation of rights of others
  • criminality, impulsivity
  • males > females; > 18yo and have conduct disorder before age 15
  • if under age 18 its conduct disorder not personality disorder
17
Q

What is borderline personality disorder?

A
  • cluster B
  • emotional instability [esp anger], hypersensitivity to interperonsal interactions esp. rejection, self-injury [to relieve pain], dissociatve symptoms, impulsivity esp aggression, intense unstable mood and interpersonal relationships, extreme “black and white” thinking, boredom, sense of emptiness
  • female > male
  • high suicide rate [distinct from self-injury]
  • onset = adolescence but symptoms evident in child
  • childhood trauma increases risk
18
Q

What is histrionic personality disorder?

A
  • cluster B
  • pervasive attention-seeking, sexually provocative, overly concerned with appearance, excessive emotionality and excitablity
19
Q

What is narcissistic personality disorder?

A
  • cluster B
  • grandiosity, sense of entitlement, lacks empathy and requires excessive admiration, often demands the “best” and reacts to criticism with rage
20
Q

What is avoidant personality disorder?

A
  • cluster C
  • hypersensitive to rejection, socially inhibited, avoidance of social interactions, timid, feelings of inadequacy, desires relationships with others
  • closely tied to social anxiety disorder
  • pt desires affection/acceptance/relationships
21
Q

What is obsessive-compulsive personality disorder?

A
  • cluster C
  • preoccupation with order, perfectionism, control
  • rigid conformity to rules
  • behavior consistent with one’s own beliefs and attitudes [vs OCD has intuition]
22
Q

What is dependent personality disorder?

A
  • cluster C
  • psychological dependence on others
  • submissive and clinging
  • excessive need to be taken care of
  • low self-confidence
23
Q

What 3 personality disorders most seen in clinic?

A
  • schizotypal
  • borderline
  • avoidant
24
Q

Which personality disorders more seen in men?

A
  • antisocial personality disorder
25
Q

Which personality disorders more seen in women?

A
  • dependent
  • histrionic
  • borderline
26
Q

What is neurobiology of schizotypal personality disorder? treat?

A

eye tracking abnormalities, temporal lobe volume loss, reduced striatal DA

treat = social skills training, low dose antipsychotics

27
Q

What are neuro models of borderline personality disorder?

A
  • amygdala-OFC disconnection –> emotional dysregulation = made worse by benzos/alc
  • fialure in habituation to negative emotional stimuli –> reviewing painful memories worsens symptoms + increases self-injury
  • social cognition dysfunction –> decreased activity in insula during social interaction, difficult identifying feels in self and others = lack of gut feeling that there is a problem with a relationship
28
Q

What is course of borderline personality disorder?

A
  • impairment and suicide risk decrease with age + relationships stabilize
  • if therapy –> benefit w/in 1 yr
  • after 10 yrs up to 50% no longer have pattern of behavior that meets full criteria for borderline personality disorder
  • 10% commit suicide
29
Q

What is neurobiology of avoidant PD?

A

inhibited temperament evident prenatally + infancy predicts

high amygdala activity similar to BPD

30
Q

What is treatment for avoidant PD?

A

psychoanalytic psychotherapy, social skills training, antidepressant

Brain And Behavior Exam 4 (24 decks)

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