Personality Flashcards
Paranoid
4/7
No fixed delusions
Risk factors
- sensory deficit
- new immigrant
- minority ethnicity
NOT HOMOSEXUALITY
Schizoid
4/7
Schizotypal
5/9
10-20% develop schizophrenia
10% suicide
Antisocial
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
Borderline
5/9
8-10% suicide
7.9% progress to BAD!
Heritability = 55%
Kernberg = “borderline”
Slow-wave activity on EEG
Histrionic
5/8
Narcissistic
5/9
Avoidant
4/7
CBT > Psychodynamic
More frequent in families with schizophrenia
Shared genetic liability with social phobia
Dependent
5/8
Obsessive compulse PD
4/8
Increased risk of MDD
DECREASED REM LATENCY
Abnormal dexamethasone suppression test
Main fear = of losing control
Which PDs tend not to improve with time?
OCPD
Schizotypal
Five factor model
Openness Conscientiousness (discipline, goal oriented) Extraversion (+ emotions) Agreeableness Neuroticism (- emotions, vulnerability)
Cluster A defenses?
Projection
Fantasy
Denial
Cluster B defenses?
Splitting Dissociation Denial Acting out Projective identification Primative idealization Omnipotence Devalorasation
Cluster C defenses?
Isolation of affect Passive aggressive Somatisation Intellectualization Displacement Reaction formation
What character trait increases cardiovascular risk?
HOSTILITY
2 poles of narcissism?
GRANDIOSE = KERNBERG = CONFRONT
(grandiosity hides vulnerability)
HYPERVIGILANT = KOHUT = EMPATHY
(vulnerability hides grandiosity)
What percentage of bipolar patients have BPD?
30%!
Cochrane review meds for BPD?
Impulsivity = topamax, abilify, lamictal, fluanxol, OMEGA 3
Affective instability = topamax, epical, lamictal, abilify, zyprexa, haldol
Perceptual disturbances = abilify, zyprexa
ASPD co-morbidities
ADHD (60%)
SUD (54%)
Anxiety (53%)
Female phenotype = somatization
Cloninger model of ASPD?
High novelty seeking (response to novelty)
Low harm avoidance (response to danger)
Low reward dependance (social attachment)
Low persistence
ASPD neurobiology
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
Which neurotransmitters involved in aggression?
SEROTONIN
Norepinephrine
Vasopressin
Which neurotransmitter involved in mood reactivity?
ACETYLCHOLINE
4 areas of functioning?
IDENTITY
SELF-DIRECTION
EMPATHY
INTIMACY
Genetic risk factors
Ac1 = PPD, HPD, BPD, NPD, DPD, OCPD
Ac2 = ASPD, BPD
Ac3 = schizoid, avoidance
Ac5 = OCPD
Which personality disorder has the LEAST functional impairment?
HISTRIONIC
Neurological finding in schizotypal PD?
“Jumpy” smooth pursuit eye movement
correlates with introversion and low self-esteem
At what age does temperament stabilize?
1-2 years old
