personality disorder Flashcards
Topographic theory of mind
Conscious- Thoughts, perceptions
Pre conscious (subconscious)- memories, knowledge
Unconscious- not directly accessible to awareness. fears, unacceptable urges, desires, etc, selfish needs
Structural theory of mind
ID- instincts, focused on self gratification
Ego- rational compromise
Superego- societal rules, perfection, conscience
Defense mechanisms
unconscious mental processes that the ego uses to resolve conflicts
Between instinct (id), reality, important persons, conscience (supreg)
Examples of defense mechanisms
Regression- a return to earlier patterns of adaptaptation (not uncommon in the hospital or during illness)
Denial- ignoring reality (can be adaptive dealing with serious illness or can get in the way of treatment)
Suppression- intentionally (consciously) pushing down to deal with now
Projection- attributing ones own personally unacceptable feeling to others
Reaction formation- adopting opposite attitudes to avoid personally unacceptable emotions
Sublimation- expressing a personally unacceptable feeling (rage) in a socially useful way
Splitting- Great or horrible
transference/ countertransference
Unconscious mental attributes based on one’s past upbringing and relationships (often with parents). This increases emotionally and may alter judgement and behavior of a patient toward their clinician
Or vice-versa, a clinician toward their patient- counter transference
Personality
a relatively stable and enduring set of characteristic behavioral and emotional trait
Determined by- temperament (nature), character (nurture), Development, psyche
Normaly it is flexibile and adaptable
When disordered it is maladaptive deeply ingrained, and often distressing for both the patient and significnat others
Tempermant
Nature, Apparent before traditional learning occurs, 50% of personality is related to temperament
Character
Nurture, what you leareded based on experiences and how you manage what you learn
Defense mechanisms
Development
Negative events in early childhood (typically repeated, chronic abuse or neglect) can physiologically alter the limbic system and cause permanent effects on emotional arousal
Psyche
Self awateness- the ability to learn, adapt, change
Personality is disordered when
its ingrained and inflexibel, it gets in the way of relationships, functioning
Its relatively stable
It distresses people around them
Ego syntonic vs ego dystonig
Egosyntonic- feels like me
Ego dystonic- feels off
Personality disorders are often egosyntonic rather than ego dystonic
Ego syntonic means acceptable to the ego it doesnt bother them , it bothers others, as opposed to egodystonic uncomfortable
Epidemiology of personality disorder
10-18% prevalence in the general population- your office
30-50% prevalence in psychiatric outpt populations
over 50% on inpatient psychiatric unit
of patients with Axis 1 disorders, 34% have co morbid personality disorder
Cluster A- Detached, eccentric
schizoid, schizotypal, paranoid
Schizoid personality disorder
- emotionally detached, loners, Dont want relationshipts
Prevalence- anywhere from uncommon to 7.5% of gen pop
Males» Females, Higher inciddence of of psychosis in relatives, differentiated from schizophrenia by absence of psychotic symptoms (hallucination, delusions, thought disorder)
Schizotypal personality disorder
Cognitive, perceptual and behavioral eccentricites, frequently embrace beliefs, such as telepathy, clair voyance, and magical thinking, to a degree that exceeds cultural and subcultural norms
Eccentric
3% , highly genetic,
Paranoid personality disorder
long standing suspiciousness and misturst of people with no basis for this mistrust
Read threats into non threatening situations, pathologically jealous if in a relationship
Rare, rarely seek treatment, males, differentiated from schizophrenia by absence of hallucinations or thought disorder, higher functioning, and npn bizarre paranoia
cluster B
DRAMA Drama drama
Antisocial, borderline, histrionic, narcissistic
Antisocial
repetitive unlawful acts and socially irresponsible behaviors that began prior to age 15
so unconcered with the feelings and rights of others, that they are morally bankrupt and lack a sense of remorse
deceitful, impulsive
Asocial is not the same thing, antisocial–sociopath
3% of males, high genetic
Borderline personality disorder
Frantic efforts to avoid real or imagined abandonment- interpersonal
Getting distrought if a spouse is 5 minutes late getting home from work
Placing dozens of phone calls to ones therapist before the therapist goes on vacation
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation (interpersonal, affective - you re the best after perscribing vicoden, then you become the worst
Affect instability- mood swings, can be argumentative one moment depressed the next
Empty, recurrent suicidal bahvior,
Females> males, high genetic, multiple suicide
histrionic personality disorder
Pervasive over concern with appearance and attention, exaggerated emotional response, poor frustraction intolerance that ends in outburts, and impressionistic speech that lacks detail
Peacocking
2-3, F»M
NArcissitic personality
Characterized by a heightened sense of self importance grandiose feelings and lack of empathy
Preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love
Arrogant, entitled and often envious
Require excessive admiration take advantage of other s to achieve their own ends
Cluster C
Anxious group
OCP, avoidant, dependent
OCPD
preoccupied with details and rules that the major point of an activity is lost
Display perfectionism that intereferes with task completion took hours to do notes
have inflexible, overly flexible and conscientious
M>F, oldest childrem
Defenses- rationalizing, intellectualizing, reaction formation, undoing, controlling
Not the same as OCD- ego
Avoidant personality
Show extreme sensity to rejection –> may lead to socially withdrawn life
Shy have a great desire for relationships
Dependent
subordiante need to always have someone, usually females
treatment
Psychotherapy
Behavioral
Psychopharm (SSRI
