Personality Disirders And Disruptive Behavioral Disorders

Question 1

What are the cluster A personality disorders?

Answer 1

Odd-eccentric

Paranoid
Schizoid
Schizotypal

Question 2

What are the cluster B personality disorders?

Answer 2

Dramatic/emotional/erratic

Histrionic
Borderline
Narcissistic
Antisocial

Question 3

What are the personality disorders of Cluster C disorders ?

Answer 3

Anxious/ fearful

Dependent
Obsessive-Compulsive

Question 4

What are personality disorders?

Answer 4

Pattern of perceiving, relating, and thinking about the environment and oneself that is:
– Chronic and pervasive
– Culturally deviant
– Maladaptive or distressful

Onset & Course: In childhood-adolescence with behaviors solidifying with age (typically not diagnosed until adult)

Question 5

Describe the treatment and prognosis of personality disorders

Answer 5

Cognitive-behavioral psychotherapy is typically used as the primary form of treatment

• Medications could be used as adjunctive treatment

• In general, treatment is difficult due to:
– Patient disinterest in treatment
– The inherent difficulty in unlearning entrenched behaviors

Question 6

What are the symptoms of paranoid personality disorder (PPD)?

Answer 6

Suspicion that others are being exploitative or deceptive

• Unjustified doubts about loyalty/trustworthiness
• Reluctance to confide
• Reads hidden threatening meanings into remarks
• Reacts angrily to perceived insults

Theme: Distrust and Suspiciousness

Question 7

What is the major differential diagnosis of Paranoid Personality disorder?

Answer 7

Major Differential

➢ Delusional Disorder (DD), Persecutory Type
– Degree of certainty: In DD, the paranoid thought is believed with certainty; In PPD, the paranoid thought is merely suspected

– Onset & pervasiveness: In DD, the onset is sudden and typically in middle age with a focus on a single paranoid theme; In PPD, symptom onset is gradual and typically in childhood with pervasive paranoia

Question 8

What are the symptoms of Schizoid personality disorder?

Answer 8

Example Symptoms

• Lacks desire for close relationships/intimacy
• Lacks close friends
• Prefers solitary activities
• Derives pleasure in few activities
• Indifference to praise/criticism
• Emotional coldness, detachment or flat affect

Theme: Interpersonal Detachment

Question 9

What are the symptoms of the Schizotypal personality disorder?

Answer 9

Question 10

What Schizotypal behaviors are on the schizophrenia spectrum?

Answer 10

Question 11

What are the symptoms of histrionic personality disorder ?

Answer 11

. Histrionic Personality Disorder

Example Symptoms
• Needs to be center of attention
• Exaggerated emotional expression
• Shallow and rapidly shifting emotions
• Uses physical appearance for attention
• Inappropriately provocative behavior
• Impressionistic speech but lacks detail
• Considers relationships intimate

Theme: Excessive Emotionality

Question 12

Describe Borderline Personality Disorder

Answer 12

Question 13

Describe the treatment of Border line Personality disorder

Answer 13

Question 14

What are the symptoms of Narcissistic personality disorder?

Answer 14

Question 15

What are the major differentials of Narcissistic personality disorders?

Answer 15

Major Differentials
➢ Delusional Disorder (DD), Grandiose Type
– In DD, the person has a grandiose delusion;
In NPD, the person has general arrogance

 – In DD, the onset is abrupt and often in middle age; In NPD, the onset is gradual and usually in childhood 

➢ Bipolar I (BPI) Disorder
– BPI involves a mood disturbance with more symptoms than grandiosity (e.g., flight of ideas)

Question 16

What are the symptoms of Antisocial personality disorders ?

Answer 16

• Repeated unlawful acts
  • Deceitfulness
  • Irritability and aggressiveness
  • Reckless disregard for safety of self or others
  • Irresponsibility (employment or financial)
  • Lack of remorse

Theme: Pervasive disregard for other’s rights

Question 17

What are the requirements and associated features of ASPD?

Answer 17

➢ Requirements

– Person must be at least 18 for ASPD diagnosis
– There must be evidence of Conduct Disorder with onset
before age 15 (not necessarily diagnosed but a history of Conduct Disorder symptoms)

➢ Associated Features

– ASPD is associated with lack of physiological reactivity
to stressors (amygdala dysfunction?)
– “Psychopath” (sociopath) is often used synonymously with ASPD, but psychopaths are only a research subset of ASPD