Personality D/o Flashcards by Laura Gardner

When is the onset of personality d/o?

early adolescence or early adulthood

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Behavior/traits in a pt with personality d/o are considered ____ and ____

pervasive and inflexible

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Patients with personality d/o are usually (unstable/stable) over time

stable

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There are 3 clusters of personality d/o, A B and C. What are they? What are they characterized by?

A – Eccentric d/o “the weirds”
B – Dramatic D/o “the wilds”
C – Anxious d/o “the wimps”

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Personality d/o lay on a continuum ranging from no ______ to severe ______

no dysfunction to severe dysfunction

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Personality theory presents that personalities can be defined/described by a combo of 4-5 different traits:

Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness to experience

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How common is personality d/o?

very common, 9-16% US pop and 30-50% in psych outpatient pop

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What are some common comorbid conditions in a pt with personality d/o?

MDD (51%), GAD (64%), and Panic d/o (56%)

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What personality d/o are more common in males?

Antisocial personality d/o

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What personality d/o are more common in females?

Borderline personality d/o
Histrionic personality d/o
Dependent personality d/o

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What personality d/o are equal between sexes?

Schizoid, schizotypal, obsessive compulsive

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Personality d/o is more common in (younger/older) pop, and prevalence (increases/decreases) with age

younger, decreases

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Rates of unemployment, divorce, homelessness, drug abuse, and domestic violence are (lower/higher) in pts with personality d/o

higher

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The dx of antisocial personality d/o requires a minimum age of ____ y/o, and is considered ______ d/o in younger individuals

18 y/o

conduct d/o

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Personality changes later in life are more indicative of ______, such as ____ and ______

other mental illnesses, such as early schizophrenia or neurocognitive d/o

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Early traumatic experiences and failing to progress through the normal stages of sexual development are common in pts with personality d/o, but early childhood _____ and ____ is associated w/ these d/o–> particularly _______ and ______ d/o

trauma and abuse
borderline
antisocial

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______ personality d/o has a genetic component and is most likely related to/a variant of schizophrenia. Only ______ and _____ d/o have shown a clear genetic component.

schizotypal

borderline and antisocial

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There is some physiological functional differences in the brain and its anatomy in pts with personality d/o, three examples include…

Altered metabolism in the prefrontal cortex
Reduced prefrontal grey matter
Less affect-related activity in limbic regions

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Pts w/ personality d/o generally have (very little/a lot) of insight into their maladaptive behaviors

very little–often blame others for their troubles, more often do not seek help

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Usually, pts w/ personality d/o will seek help for ____, not their actual d/o

consequences of their behaviors (depression, marital/work issues, anxiety/anger)

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T/F: A dx of a personality d/o should be given ASAP to ensure early intervention

F: Do not be quick to give out these dx→ many need long term observation/interview to reach a conclusion

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Before a dx of a personality d/o is given, you should r/o other mental d/o and medical conditions that could be causing similar sx, such as…

depression, anxiety, medical illness

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A personality d/o is characterized by having certain (persistent/fluctuating) behaviors, being (flexible/inflexible), (adaptive/maladaptive) with their behaviors having a clear ______ impact on their lives

persistent, inflexible, maladaptive, negative

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As part of the interview of a pt w/ a personality d/o, the provider should focus on how the following domains have been affected in the pt’s life: (x6)

Sense of self
Interpersonal relationships

Work
Affect
Reality testing
Impulse Control

(SI, WARI)

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Is there a general tx available for pts with a personality d/o?

No, these d/o are very different No FDA approved pharmaceutical tx for any of the personality d/o Tx the sx

What is an example of a medical condition that could cause a personality change?

Frontal lobe lesion

What cluster of personality d/o is described by the following: Pervasive pattern of abnml cognition self expression or relating to others

Cluster A "the weirds"

What cluster of personality d/o is described by the following: Pervasive pattern of abnormal fears involving social relationships, separation, or need for control

Cluster C "the wimps"

What cluster of personality d/o is described by the following: Pervasive pattern of violating social norms of the rights of others, impulsivity, excessive emotionality, grandiosity, or acting out

Cluster B "the wilds"

What are the personality d/o categorized under Cluster A "the weirds" (eccentric d/o)?

Paranoid, schizoid, schizotypal

What are the personality d/o categorized under Cluster B "the wilds" (dramatic d/o)?

Antisocial, borderline, histrionic, narcissistic

What are the personality d/o categorized under Cluster C "the wimps" (anxious d/o)?

Avoidant, dependent, obsessive compulsive

What is the prevalence of paranoid personality d/o (%)?

~1-4%

Pts with paranoid personality d/o (can/cannot) have frank delusions, (often/rarely) seek tx, and have a pattern of ____ and ____ such that other's motives are interpreted as malevolent

cannot rarely distrust and suspiciousness

What is the tx for a pt with paranoid personality d/o? Is group therapy an option? What medications are options?

Mostly supportive Group therapy is NOT an option! Antipsychotic medications for mild psychotic sx, depression

What is the prevalence of schizoid personality d/o (%)?

3-5%

Patients with schizoid personality d/o have a profound defect in their ability to form ______, which they are (not okay/okay) and see (no problem/a problem) with.

personal relationships | okay with, no problem

In pts with schizoid personality d/o there is a clear pattern of detachment from social relationships and a restricted range of ______

emotional expression

Tx for pts w/ schizoid personality d/o includes

tx of whatever sx they will allow

T/F: Pts with schizoid personality d/o have some motivation for therapy

F, they lack insight/motivation for any kind of therapy, including group

What is the prevalence of schizotypal personality d/o (%)? Is it more common in males or females?

4-5%, there is no gender difference

Pts with schizotypal personality d/o show a pattern of peculiar/odd/unusual ____, ____, _____, and ____

behavior, speech, thinking, and perceptual experiences

Pts with schizotypal personality d/o have "____" beliefs, and mild _____. They also exhibit a(n) _____/_____ affect, and social _____.

magical paranoia inappropriate/constricted anxiety

Do pts with schizotypal personality d/o have delusions?

No, they have magical beliefs, delusions are "fixed beliefs"

What are three common comorbid conditions in pts with schizotypal personality d/o?

substance abuse, depression, and anxiety

Are support groups an option for tx of pts w/ schizotypal personality d/o?

Yes, if possible should utilize

What are medications that can be helpful in the tx of pts w/ schizotypal personality d/o?

2nd generation antipsychotics such as risperidone and olanzipine

What is the prevalence of antisocial d/o in males vs females (%)?

2-5% males | 0.5-1% females

Patients with antisocial d/o usually have a hx of _______

childhood behavior problems (conduct d/o)

Upon young adulthood, pts w/ antisocial d/o have problems with _______, and are thus unable to ______

age-appropriate responsibilities | keep a job

Often, pts with antisocial d/o are found to have committed _____ and _____ and have used ______

domestic abuse, criminal behavior, and have used aliases

What populations of persons is antisocial d/o most common in?

Homeless, incarcerated, psychiatric inpatient, and substance abusers

Are sx of antisocial d/o worse or better early on? Do they recede or progress as the pt ages?

worse early on in course | recede as pt ages

What medications are options for tx of pts with antisocial d/o?

Lithium and valproic acid to tx aggression | Meds for comorbid anxiety, depression, ADHD

Is CBT an option for tx of a pt with antisocial d/o?

Possibly

What is the prevalence of borderline personality d/o?

In pts with borderline personality d/o, pts have a pervasive pattern of mood _____, ___/___ interpersonal relationships, and chronic "______"

instability unstable/intense "emptiness"

____% of pts with borderline personality d/o will perform self-harm/mutilation, and there is a ____% suicide rate

75% | ~10%

Pts with borderline personality d/o fear _____

abandonment

Pts with borderline personality d/o have marked _____

impulsivity

______ has shown the most benefit in tx of borderline personality d/o

Therapy

The 20 week STEPPS program has shown benefit for tx of pts with borderline personality d/o. What does STEPPS stand for?

``` Systems Training for Emotional Predictability and Problem Solving ```

What are medications that can be used in the tx of a pt with borderline personality d/o?

SSRIs for comorbid depression and antipsychotics for perceptual disturbances, anger, and agitation (risperidone, valproic acid)

What is the prevalence of histrionic personality d/o?

In pts with histrionic personality d/o, there is a pattern of excessive _____ and ______ behavior

emotionality and attention-seeking behavior

In pts with histrionic personality d/o, there is an excessive concern w/ _____ and wanting to be _______

appearance, center of attention

Often, pts with histrionic personality d/o are initially ____ and _____, but then ____ and _____

charming and gregarious | demanding and vain

Do patients with histrionic personality d/o seek medical attention rarely or often?

Often!

What is believed to be the cause of histrionic personality d/o?

unknown, but there is shown linkage to somatic sx and antisocial d/o

What is the best option for tx of a pt with histrionic personality d/o?

Therapy, if agreeable

Is group therapy useful for pts with histrionic personality d/o?

Yes, when tackling provocative or attention seeking behaviors

What is the prevalence of narcissistic d/o?

Narcissistic d/o is characterized by _____, a lack of ____, and hypersensitivity to _____

grandiosity empathy evaluation by others

Pts with narcissistic d/o inflate their _____, and exploit/manipulate those around them for ____

accomplishments | personal gain

Pts with narcissistic d/o have an exaggerated sense of _____

entitlement

Pts with narcissistic d/o may initially be very _____ and _____ to be around, but ultimately very difficult, haughty and temperamental

charming and exciting

What is the mainstay of therapy for a pt with narcissistic d/o?

Therapy (CBT, psychodynamic, interpersonal therapies)

Pts with narcissistic d/o usually seek tx for other sx such as ____ and ____, usually in combination with not receiving something they feel they deserved (_____, _____)

depression and anger | Job, promotion

Pts with avoidant personality d/o usually are described as ____, _____, and _____

inhibited, introverted, and anxious

Patients with avoidant personality d/o have a (low/high) self esteem, are hypersensitive to ____, and are socially awkward

low, rejection

What is the mainstay of tx for pts with avoidant personality d/o?

Therapy

Is group therapy beneficial for pts with avoidant personality d/o?

Yes

What are medication options for pts with avoidant personality d/o?

BZD, SSRIs

What is the prevalence of dependent personality d/o

0.5%

Pts with dependent personality d/o rely on others/someone excessively for ______

emotional support | They exhibit submissive/clinging behavior related to excessive need to be taken care of

What do some believe dependent personality d/o to be due to?

Disruption of early attachments or from over-protectiveness/parental authoritarianism in childhood

Pts with dependent personality d/o commonly have _____ and _____

other personality d/o and other chronic medical conditions

What is the best option for tx of pts with dependent personality d/o?

Therapy (CBT) | Focused assertiveness training, social skills training, tx comorbid conditions

What prevalence does obsessive compulsive personality d/o have?

1-2%

T/F: Obsessive compulsive personality d/o and obsessive compulsive d/o are different

True

Obsessive compulsive personality d/o is characterized by _____ and _____

Perfectionism and over-conscientiousness

Pts with obsessive compulsive personality d/o are preoccupied with ____, ____, and ____.

orderliness, perfectionism, and control

What is the best option for therapy in a pt with obsessive compulsive personality d/o?

CBT

Obsessive compulsive personality d/o is more common in patients with (low/high) level of education and SES

high

What are two common comorbidities in pts with obsessive compulsive personality d/o?

mood and anxiety d/o

Does obsessive compulsive personality d/o lead to OCD?

______ (medication) have been shown to be helpful w/ ritualistic tendencies and a decreased need for perfectionism in pts with obsessive compulsive personality d/o

SSRIs