Personality disorder Flashcards
When do personality disorders normally begin
Adolescents or adulthood
What are the different domains for personality disorders
Cognition
affectivity
interpersonal function
impulse control
how many clusters are there for personality disorders
3
What personality disorders are listed in cluster A (Mad)
Abnormal thinking
psychotic symptoms
disordered self expression (eccentric)
Interpersonal relationships (reclusiveness)
Thinking problems
What personality disorder traits are in cluster B (Bad)
Dramatic
violations of social norms/ others rights
impulsivity
hyper emotional
grandiose
acting out
Emotional problems
What personality disorder traits are in cluster C (Sad)
Anxious
need for control
fear
isolation
*
Which gender is more effected by paranoid personality disorder
males
What is associated with paranoid personality disorder
Hx of childhood trauma / abuse
genetic etiology
rarely a sole dx
What is the DSM 5 criteria for paranoid personality disorder
Pervasive distrust, suspiciousness, skepticism indicated by 4+ properties
-suspicious of ‘out to get’ them
-untrustworthiness of others
-grudge holding
- perceived infidelity of partner
Not better explained by another condition
How does one present clinically with paranoid personality disorder
Significant distrust of others
no true delusions / hallucinations
defensive/hostile
feel they have been treated unfairly
grudge holding
react poorly to authority
What is the first line treatment for paranoid personality disorder
Psychotherapy (not group therapy)
What antipsychotics and benzos can be used to treat paranoid personality disorder
Olanzapine / haloperidol (for agitation)
Diazepam / clonazepam (for anxiety)
What generally causes schizoid PD and who is generally effected
Males (tend to be more severe)
h/o childhood trauma (especially neglect)
What is the DSM-5 criteria for Schizoid personality disorder
Pervasive detachment from social relationships and restricted range of emotions indicated by 4+ properties
How does Schizoid personality disorder present clinically
- Self absorbed
- Loners
- Failed intimate relationships & no interest in making them work
- Difficulty expressing emotions
- May appear depressive
What are the main signs of Schizoid personality disorder (think Sheldon)
Neither desires nor enjoys close relationships
little to no interest in sexual experiences
Few to no close friends outside of family
Emotionally cold or detached or flattened affect
What is the first line treatment of schizoid personality disorder
psychotherapy
What pharmacological options are there for schizoid personality disorder
Antipsychotics
SSRIs
BZDs
*negative symptoms
What genetic association is there with schizotypal PD
fragile X syndrome
What is the DSM 5 criteria for Schizotypal personality disorder
Pervasive social and interpersonal deficits
Discomfort with and/or reduce capacity for close relationships secondary to behavior, as indicated in 5+ properties
How does Schizotypal personality disorder present clinically
Odd thinking or speech
odd behavior and appearance
oddities make it hard to communicate with them
May claim to be superstitious, clarevoyant, have special powers
Failed interpersonal relationships
flat affect
have have frank psychotic symptoms
What is the first line treatment of Schizotypal disorder
Psychotherapy
What are the pharmacological options for schizotypal disorder
Antipsychotics
-Risperidone
-Olanzapine
Which gender is more effected by antisocial PD
Men
Which patients are at higher risk of developing antisocial PD
Low SES
Hx od ADD/ADHD
Prior hx od ODD or conduct disorder
co-morbid SUD / anxiety disorder
What are the DSM 5 criteria
Pervasive disregard for other or violation of other rights since age 15 as indicated by 3+ properties
Individual must be 18+ y/o
Evidence of conduct disorder before 15y/o
How does antisocial personality disorder present clinically
Repeated conflicts
Arrests, fines
Substance misuse / promiscuity
Repeated physical altercations
Disregard for authority
Devoid of emotions
difficulty communication from rage
Which gender is more effected by borderline personality disorder
Women
*rarely a sole diagnosis
What generally occurs with borderline personality disorder
Anxiety
SUD
Mood DO
What is the most common personality disorder
Borderline personality disorder
What is the DSM 5 criteria for borderline personality disorder
Pervasive pattern of unstable personal relationships, self-image and/or affect with impulsivity and 5+ properties
intense unstable relationships
How does borderline personality present in clinic
- Lability in various facets
- mood swings
- persistent sense of ‘crisis’ in life
- Intense unstable relationships
- self destructive behavior
- impulsivity
- separation anxiety
What is the first line treatment for borderline personality disorder
Psychotherapy
-DBT / CBT
What is histrionic personality disorder
Exaggerated, uncontrollable emotion or excitement
Which gender is more effected by histrionic personality disorder
Women
What is the DSM 5 criteria for histrionic PD
Pervasive pattern of excessive emotionality and attention seeking with 5+ properties
How does histrionic PD present clinically
- Overly dramatic
- Emotional expression seems insincere
- May make inappropriate advances
- Attention seeking behaviors
- seek reassurance / validations
- bright colored / revealing clothing
Which gender is generally effected by Narcissistic PD
Men
What are the two forms of Narcissistic PD
Grandiose -> More aggressive
Vulnerable -> overly sensitive
What is the DSM 5 criteria for Narcissistic PD
Pervasive pattern of grandiosity, need for admiration and lack of empathy, indicated by 5 properties
How does narcissistic PD present in clinic
- Overly aggressive or sensitive
- Arrogant behavior
- Resist admitting fault
- Sense of entitlement
- Picky with their social circles
-Fragile self esteem
-Have high -standards
-unable to tolerate rejection
-subject to anger / hostility / depression
What is often associated with avoidant personality disorder
h/o childhood trauma
What is the DSM 5 criteria for avoidant PD
Pervasive social inhibition, sense of inadequacy, hypersensitivity and negative disposition, indicated by 4 properties
*Unlike other CDs they desperately WANT to be in relationships and seek reassurance
How does avoidant PD present clinically
- Anxiety w/ relationships / clinician
- Overly sensitive to feedback
- Intense fear of rejection
- self defeating / self deprecating
- repeatedly seeking reassurance
- avoidance of vulnerable situations
What are pharmacological treatments for avoidant personality disorder
Beta blocker (atenolol)
SSRIs
What is the DSM 5 for dependent personality disorder
Pervasive need to be taken care of, leading to submissiveness, ‘clingy’ behavior +/- separation anxiety indicated by 5+ properties
How does dependent PD look clinically
- co-dependancy
- poor self esteem
- lack of self confidence
- constant need for approval
- Frequently seeking help
- people pleasers
- rule follower
- avoids fear / confrontation
- passive / submissive
