Personality Disorder

Question 1

What is personality?

Answer 1

According to PCPsych: Collection of characteristic or traits that you collect as you grow that makes each of us individual. They dictate how we think and feel about things and are usually shaped by our late teens or early twenties

Question 2

What things help to shape personality?

Answer 2

Neurophysiology
Genetics
Environment / Childhood experiences (trauma, violence and attachment issue)

Question 3

How does ICD-10 define personality disorder?

Answer 3

Abnormal, persistent or extreme variation away from the normal range of one or more personality traits that are causing the individual/society to suffer
It does NOT result from organic damage to the brain OR another mental health disorder
Person must be OVER AGE 18

Question 4

What are some sub-types of personality disorder according to the ICD-10?

Answer 4

Paranoid 
Schizoid 
Dissocial
Emotionally unstable 
Histrionic 
Anankastic 
Anxious 
Dependent

Question 5

What features are seen in paranoid personality disorder?

Answer 5

Someone who is suspicious, sensitive, mistrustful, jealous, resentful and bears grudged

Again this should be in the absence of other mental health conditions - however, someone is massively more likely to get other mental health morbidities with paranoid PD

Question 6

What are some features of someone with schizoid PD?

Answer 6

These people often prefer being alone and do not life, or get enjoyment from relationships with others, they also commonly have low libido
They are also classically indifferent to friends and family and are indifferent to praise or criticism

Question 7

What are some features of dissocial or antisocial PD?

Answer 7

More common in men, multiple contacts with law - failure to keep to social norms (laws)
Deception (repeated lying)
Impulsivity
Aggression and irritation
Reckless regard for safety of self or others
Irresponsibility - inability to keep job
Lack of remorse

Question 8

What are some features of emotionally unstable personality disorder?

Answer 8

Unstable personal relationships that alternate between idealisation and devaluement
Taking steps to avoid abandonment
Unstable self image
Impulsivity in dangerous way (sex, spending)
Chronic feelings of emptiness
Difficulty controlling thoughts
Quasi-psychotic thoughts

Question 9

What are some features of histrionic PD?

Answer 9

Inappropriate sexual seductiveness 
Need to be the centre of attention
Suggestibility 
Impressionistic speech lacking detail
Relationships considered more intimate than they are in reality
Dramatisation

Question 10

What is the first line treatment for personality disorders?

Answer 10

Psychological therapies: DIALECTICAL BEHAVIOURAL THERAPY
Helps people to identify their triggers and reactive states, address them and deal with them
GROUP AND ONE-ON-ONE
DICE APPROACH
- Distress Tolerance
- Interpersonal effectiveness (help with relationships)
- Cognitive mindfulness
- Emotional regulation