personality disorder

Question 1

Topographic theory of mind

Answer 1

Conscious- Thoughts, perceptions

Pre conscious (subconscious)- memories, knowledge

Unconscious- not directly accessible to awareness. fears, unacceptable urges, desires, etc, selfish needs

Question 2

Structural theory of mind

Answer 2

ID- instincts, focused on self gratification

Ego- rational compromise

Superego- societal rules, perfection, conscience

Question 3

Defense mechanisms

Answer 3

unconscious mental processes that the ego uses to resolve conflicts

Between instinct (id), reality, important persons, conscience (supreg)

Question 4

Examples of defense mechanisms

Answer 4

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

Question 5

transference/ countertransference

Answer 5

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

Question 6

Personality

Answer 6

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

Question 7

Tempermant

Answer 7

Nature, Apparent before traditional learning occurs, 50% of personality is related to temperament

Question 8

Character

Answer 8

Nurture, what you leareded based on experiences and how you manage what you learn
Defense mechanisms

Question 9

Development

Answer 9

Negative events in early childhood (typically repeated, chronic abuse or neglect) can physiologically alter the limbic system and cause permanent effects on emotional arousal

Question 10

Psyche

Answer 10

Self awateness- the ability to learn, adapt, change

Question 11

Personality is disordered when

Answer 11

its ingrained and inflexibel, it gets in the way of relationships, functioning

Its relatively stable

It distresses people around them

Question 12

Ego syntonic vs ego dystonig

Answer 12

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

Question 13

Epidemiology of personality disorder

Answer 13

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

Question 14

Cluster A- Detached, eccentric

Answer 14

schizoid, schizotypal, paranoid

Question 15

Schizoid personality disorder

Answer 15

• 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)

Question 16

Schizotypal personality disorder

Answer 16

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,

Question 17

Paranoid personality disorder

Answer 17

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

Question 18

cluster B

Answer 18

DRAMA Drama drama

Antisocial, borderline, histrionic, narcissistic

Question 19

Antisocial

Answer 19

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

Question 20

Borderline personality disorder

Answer 20

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

Question 21

histrionic personality disorder

Answer 21

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

Question 22

NArcissitic personality

Answer 22

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

Question 23

Cluster C

Answer 23

Anxious group

OCP, avoidant, dependent

Question 24

OCPD

Answer 24

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

Question 25

Avoidant personality

Answer 25

Show extreme sensity to rejection –> may lead to socially withdrawn life

Shy have a great desire for relationships

Question 26

Dependent

Answer 26

subordiante need to always have someone, usually females

Question 27

treatment

Answer 27

Psychotherapy

Behavioral
Psychopharm (SSRI