Personality and Impulse control disorders

Question 1

enduring pattern of inner experience and behaviour that deviates markedly from the expecations of the individual’s culture, is pervasive and inflexible, has its onset in adolsence or early childhood, is stable over time, and leads to clinically significant distress or impairment in social, occupations, or other important areas of functining

Answer 1

personality disorder

Question 2

1. what is the prevalence of personality disorders in the general population?
2. when do they start? with signs in? when are patterns established
3. what are late-onset personality changes suggestive of?

Answer 2

1. 10-20% of the general population
2. often start in late adolescence, often with signs in childhood; established patterns in early adulthood
3. late onset changes suggestive of other undiagnsoed “other problem” (dementia, substance abuse, medical illness, neurological problem)

Question 3

the following 5 traits below are examples of what?

1. emotional stability - neuroticism
2. agreeableeness- antagonism
3. extraversion - introversion
4. conscientiousness -constraint
5. openness to experience - eccentric

Answer 3

lasting trait dimensions that cut across cultures

Question 4

emotional stablitiy

agreeableness

extraversion

conscientiousness

and openness to experience are all traits that predict what? (H+D JARD)?

Answer 4

H-ealth and Mortality

Job performance

Academic success

Relationships (capacity for lasting relationships)

Drug abuse and criminality

Question 5

according to Frued, what does fixation at an early age prevent?

Answer 5

fixation at early stage prevents healthy personality development

Question 6

according to Ericskon, what needs to be mastered at certain stages of development?

Answer 6

certain taskts

Question 7

what are ppl born in chaos deficient in?

Answer 7

basic trust (Erickson)

Question 8

extended early emotional trauma and abuse have been shown to adversely____1___ skills, as well as ____2__ development.

Traumatized pts are overrepresentd in the medical population

Answer 8

1. coping
2. brain

Question 9

what are defense mechanisms?

what happens to early trauma?

Answer 9

cognitive strategies to help deal with stressful information.

early trauma = often “repressed” ie not accessible to conscious memory

Question 10

inocming information that is threatening or contradictory to stored memory is refuted

Answer 10

denial

Question 11

perceptions of events that are threatening or contradictory to past experiences are neither recognized nor retrievable from memory

Answer 11

repression

Question 12

an event or memory ir re-conceptualized in sufficiently abstract terms to “distance” it from its original referent and associated conditioned emotional responses

Answer 12

intellectualization

Question 13

an idea, feeling, or behavior inconsistent with one’s self-concept is attributed to another person

Answer 13

projection

Question 14

stress is responded to using cognitive processes from earlier developmental stages associated with periods of less stressful coping

Answer 14

regression

Question 15

what are 5 common defense mechanisms?

Answer 15

denial

repression

intellectualization

projection

regression

Question 16

what are the three personality clusters? (WWW)

Answer 16

weird

wild

worried

Question 17

cluster A = weird = odd and eccentric

what are the three disorders here(PSS)?

Answer 17

paranoid personality

schizoid personality

schizotypal personality

note: biological relatives of ppl w/schizophrenai are often cluster A

Question 18

which disorder described?

always look for wrong-doings and hidden malicious meaning

rigid, defensive, and self-rightenous

preoccupied w/doubts of others’ motives

suspicious of partner’s fidelity

very unforgiving of mistakes

often-uses the defense mechanism of “projection” (blaming)

Answer 18

paranoid personality

Question 19

which disorder?

solitary loner

_does NOT WANT or seek close relationships _

chooses solitary jobs and night shifts

takes pleasure in few, if any, activities

emotionally cold, detached,

(may be the premorbid pahse of schizoprhenia)

Answer 19

schizoid personality

Question 20

what is the key feature of schizoid personality disorder?

Answer 20

they do not want relationships or seek close relationships

Question 21

what is the difference btw schizoid personality and social phobia?

Answer 21

schizoid personality: **DOES NOT desire social relationships **

Social phobia= social anxiety =

-desires friends

• afraid of embarrassment
• avoids social contacts b/c of anxiety

Question 22

what is described below:

cognitive and perceptual distortions and eccentricities(not while on drugs); odd appearance; odd speech(vague, methaphorial, over-elaborate); no close friends or associates

suspicous

magical thinking

**OFTEN ODD enough that psychosis is suspected, but pt. is not psychotic (ie still in touch w/reality) **

Answer 22

schizotypal personality

Question 23

which disoder defiend by: odd enouth that psychosis is suspected, but pt is not psychotic (ie still in touch with reality)

Answer 23

schizotypal personality

Question 24

impulsive, erratic, mood swings

life long pattern of instability

high on “extraversion” dimension

short attention span

intense, stormy relationships

multiple marriages and divorces

freqeuntly display somatization

common defense mechanisms are denial, projection, and somatization

Answer 24

Cluster B

Question 25

which cluster of diseases can often get mistaken with bipolar disease b/c it can co-exist with bipolar disorder? what is diff about these patients tx?

Answer 25

CLUSTER B patient will not improve with medication, unless personality problems are also addressed in psychotherapy.

Question 26

Antisocial personality disorder: technical term means the pt \_\_\_\_\_\_\_. Has nothing to do with being not sociable, as in social parlance. At which age are these pts diagnosed and at which age is the onset of disease?

Answer 26

1. defies social rules 2. MUST be 18+ for dx; onset or evidence of conduct disorder w/onset B4 age 15.

Question 27

which disorder described? which cluster? life long pattern never at fault, no guilt or remorse social class diff (white collar crimes in middle class population) attracted to otehr Cluster B partners multiple marriages-superficial charmers

Answer 27

Antisocial personality disorder = No conscience (moral imbecile)

Question 28

what is described by the following? which cluster? MC in women multiple somatic complaints highly suggestible, naive sexually seductive, often unaware emotinionally labile imprecise and global in verbal descriptions FMx of antisocial and alcohol

Answer 28

Histrionic Cluster B

Question 29

which personality disoder? which cluster? 1. grandiose sense of self-importance and entitlemen, **_overlap w/antisocial _** 2. preoccupied w/self (Narcissus myth) 3. may be arrogant, devalues others 4. demanding of special tx 5. may become suicidal when rejected

Answer 29

Narcissitic

Question 30

characterizes which disorder: unstable moods, mood swings stormy relationships, poor choices often confused w/bipolar disorder splitting

Answer 30

borderline personality = a cluster B disorder

Question 31

what is splitting?

Answer 31

all or none-thinking - no shades of gray

Question 32

features of what described below: substance abuse or mis-use hx of several physical, emotional, or sexual abuse, alcoholic or mentally ill pt self-injurious behavior, especially wrist-slawhing, self-stabbing, piercing, cutting to see blood - suicidal gestures and attempts - chronic feelig of emptiness, relived by pain (endorphins?), and by seeking relationships

Answer 32

borderline features

Question 33

example of what type of behaviors: pt has acute emotional stress seems to require "special tx" causes agreat deal strike and confusion in social environment "splitting" rapid shifts in mood and manner **_BOUNDARY ISSUES_**

Answer 33

examples of borderline behavior

Question 34

describes what defense mechanism: seeing the world only black and white, all good or bad playing ppl against each other causes discord and stress in environment despair and agitation

Answer 34

splitting

Question 35

describe cluster C people

Answer 35

Anxious, fearful ppl

Question 36

what are the three cluster C disorders?

Answer 36

Obsessive compulsive dependent avoidant

Question 37

describes which disorder: rigid, orderly, miserly, anal excessive devotion to work, humorless hoards, things, can't throw anything away preoccupied with details and rules schedules everything gets upset when things don't work out according to plan

Answer 37

Obsessive-compulsive personality

Question 38

describes which personality: excessive need to be cared for urgently seeks attachement cannot be alone cannot make independent decisions clinging insecure

Answer 38

dependent personality

Question 39

describes which personality disorder: closely linked to anxiety disorders cannot take risks avoids conflict and responsbillity procrastinates passive-agressive behavior goest to great lengths to avoid being judged

Answer 39

avoidant

Question 40

what are three most important aspects in the tx of personality disorders:

Answer 40

1. understand the pts story, especially hx of trauma and abuse 2. find and support the patient's strengths 3. MAINTAIN good, firm boundaries

Question 41

what are the three, disruptive, impulse-control and conduct disorders (aka externalizing disoders) AKA KIP

Answer 41

Kleptomania (stealing) Intermittent explosive disorder Pyromania (fire-setting)

Question 42

t/f DSM-5 now considers gambling as an "addictive disorder"

Answer 42

TRUE

Question 43

what is trichotillomania?

Answer 43

compulsive hair pulling. now listed under Obessive-compulsive in DSM-5

Question 44

What is excoriation disorder?

Answer 44

skin-picking

Question 45

tx of personality disorders: psychological issues, including dysfunctional defense mechansisms, play a major part in any and all of these disoders. these pts do best w/supportive and caring approach that includes firm limits and boundaries. more complex issues needed to be addressed in psychotherapy. meds may be helpful, but are not to be seen as the only (or even primary) tx.