Personality

Question 1

Paranoid

Answer 1

4/7
No fixed delusions

Risk factors

• sensory deficit
• new immigrant
• minority ethnicity

NOT HOMOSEXUALITY

Question 2

Schizoid

Answer 2

4/7

Question 3

Schizotypal

Answer 3

5/9
10-20% develop schizophrenia
10% suicide

Question 4

Antisocial

Answer 4

3/7
Must be over 18 years old
Must have had evidence of CD before 15 years old
5% suicide

LOW MAO-A activity
Slow-wave activity on EEG

RR 9 for men and 3 for women increased risk death by violence

Question 5

Borderline

Answer 5

5/9
8-10% suicide

7.9% progress to BAD!
Heritability = 55%

Kernberg = “borderline”

Slow-wave activity on EEG

Question 6

Histrionic

Answer 6

5/8

Question 7

Narcissistic

Answer 7

5/9

Question 8

Avoidant

Answer 8

4/7

CBT > Psychodynamic

More frequent in families with schizophrenia

Shared genetic liability with social phobia

Question 9

Dependent

Answer 9

5/8

Question 10

Obsessive compulse PD

Answer 10

4/8

Increased risk of MDD
DECREASED REM LATENCY
Abnormal dexamethasone suppression test

Main fear = of losing control

Question 11

Which PDs tend not to improve with time?

Answer 11

OCPD

Schizotypal

Question 12

Five factor model

Answer 12

Openness
Conscientiousness (discipline, goal oriented)
Extraversion (+ emotions)
Agreeableness 
Neuroticism (- emotions, vulnerability)

Question 13

Cluster A defenses?

Answer 13

Projection
Fantasy
Denial

Question 14

Cluster B defenses?

Answer 14

Splitting
Dissociation
Denial
Acting out
Projective identification
Primative idealization
Omnipotence
Devalorasation

Question 15

Cluster C defenses?

Answer 15

Isolation of affect
Passive aggressive
Somatisation
Intellectualization
Displacement
Reaction formation

Question 16

What character trait increases cardiovascular risk?

Answer 16

HOSTILITY

Question 17

2 poles of narcissism?

Answer 17

GRANDIOSE = KERNBERG = CONFRONT
(grandiosity hides vulnerability)

HYPERVIGILANT = KOHUT = EMPATHY
(vulnerability hides grandiosity)

Question 18

What percentage of bipolar patients have BPD?

Answer 18

30%!

Question 19

Cochrane review meds for BPD?

Answer 19

Impulsivity = topamax, abilify, lamictal, fluanxol, OMEGA 3
Affective instability = topamax, epical, lamictal, abilify, zyprexa, haldol
Perceptual disturbances = abilify, zyprexa

Question 20

ASPD co-morbidities

Answer 20

ADHD (60%)
SUD (54%)
Anxiety (53%)

Female phenotype = somatization

Question 21

Cloninger model of ASPD?

Answer 21

High novelty seeking (response to novelty)
Low harm avoidance (response to danger)
Low reward dependance (social attachment)
Low persistence

Question 22

ASPD neurobiology

Answer 22

5x increased risk if 1st degree relative

Low 5-HIAA in CSF
DECREASED GREY MATTER
DECREASED PREFRONTAL ACTIVITY
LOW CORTISOL
HIGH TESTOSTERONE

EEG ABNORMALITIES
SOFT NEUROLOGICAL SIGNS

Question 23

Which neurotransmitters involved in aggression?

Answer 23

SEROTONIN
Norepinephrine
Vasopressin

Question 24

Which neurotransmitter involved in mood reactivity?

Answer 24

ACETYLCHOLINE

Question 25

4 areas of functioning?

Answer 25

IDENTITY
SELF-DIRECTION
EMPATHY
INTIMACY

Question 26

Genetic risk factors

Answer 26

Ac1 = PPD, HPD, BPD, NPD, DPD, OCPD

Ac2 = ASPD, BPD

Ac3 = schizoid, avoidance

Ac5 = OCPD

Question 27

Which personality disorder has the LEAST functional impairment?

Answer 27

HISTRIONIC

Question 28

Neurological finding in schizotypal PD?

Answer 28

“Jumpy” smooth pursuit eye movement

correlates with introversion and low self-esteem

Question 29

At what age does temperament stabilize?

Answer 29

1-2 years old