Personality Disorder Flashcards
name the 5 structures of personality
OCEAN openness conscientiousness extraversion agreeableness neuroticism
what is personality disorder?
an enduring pattern of inner experience and behaviour tjat deviates markedly from the expectations of the individual’s culture
name the 4 areas affected by a personality disorder; how many do you need for diagnosis?
cognition affectivity (eg their emotional response) interpersonal functioning impulse control 2 (needs to cause distress)
describe the pattern of personality disorder?
inflexible, stable and of long duration
usually traced back to adolescence
what do you need to exclude before diagnosing a personality disorder?
check that its not because of a substance or other medical condition
describe the presentation of anankastic personality disorder
feelings of excessive doubt/caution obsessed with rules/schedule perfectionism pedantic, rigid, stubborn "my way or the high way" kinda person
when does a trait become a disorder?
if its pervasive and causes distress/impairment of functioning
what personality rating scale is good for wards?
PDQ-4
a dramatic and emotional (cluster B) personality is more likely to have what personality disorders?
borderline
histrionic
an odd and eccentric (cluster A) personality is more likely to have what personality disorders?
schizoid
paranoid
an anxious and fearful personality (cluster c) is more likely to have what personalty disorders?
obsessive-compulsive
avoidant
dependant
how many people have personality disorder?
10%
how does paranoid PD present?
pervasive distrust and suspiciousness of others from early adulthood with 4 or more of the following: suspects others want to hurt them doubts the loyalty of their friends reluctant to confide in others bears grudges counterattacks to attacks on them suspects infeditlity reads things in the wrong way
how does schizoid PD present?
detachment from social relationships and a restricted range of expression of emotions in interpersonal settings beginning by early adulthood: doesnt like close relationships likes being alone not interested in sex takes pleasure in few activities lacks friends indifferent to criticism cold/detached
how does antisocial PD present?
disregard for and violation of the rights of others since age 15: failure to conform to behavioural norms deceitfulnesss eg lying impulsivity to plan ahead irritability/aggressiveness reckless disregard for safety of them/others consistent irresponsibility lack of remorse
how does borderline PD present?
instability of relationships, self image, affects and marked impulsivity: frantic efforts to avoid abandonment unstable and intense relationships identity disturbance impulsivity eg spending/sex recurrent suicidal behaviour/threats affective instability eg anxiety/irritability feeling empty inappropriate intense anger stress-related paranoid ideation
how does histrionic PD present?
excessive emotionality and attention seeking (drama queen):
- uncomfortable when theyre not the centre of attention
- inappropriately sexual to get what they want
- shallow with emotions
- physical appearance to draw to self
- impressionistic style of speech
how does avoidant PD present?
social inhibition, feelings of inadequcy, hypersensitivity to negative evaluation: avoids activities from fear is unwilling to get involved with people shows restraint within intimate relationships preoccupied with being criticised scared in social situations view self as socially inept/inferior reluctant to take risks
how does dependent PD present?
excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation (INDECISIVE AF):
cant make decisions without input from others
needs others to take responsibility for them
cant express disagreement with others
cant initiate things on their own
feel uncomfortable about caring for themself
seeks relationships
how do OCD and OCPD differ?
compulsions are unwanted and cause destress where as OCPD gives a sense of reassurance
how does OCPD present?
preoccupation with orderliness, perfectionism, mental/social control at the expense of flexibility, openness and efficiency:
loves lists, rules, order, organisation
perfectionism that interferes with task completion
excessively devoted to work
overconscuous and inflexible about values
stubborn!!!
money is hoarded for future catastrophes
Tx of PD?
treat the comorbidities eg depression etc
Tx of avoidant PD?
social skills training
some evidence for antidepressants
Tx of borderline PD?
dialectical behavioural therapy
mentalisation is often used but lacks evidence
what medication is known to be effective for borderline PD?
olanzapine
antidepressants
