Personality disorder Flashcards
Define personality disorder (ICD-10/DSM-5)
updated!
The REPORT criteria + 3 or more feautures of a specific personality disorder must be present
- Relationships affected
- Enduring
- Pervasive
- Onset in childhood/adolescence
- Result in distress
- Trouble in occupational/social performance
This behaviour must not be attributable to brain damage or disease, or another psychiatric disorder.
- Pervasive: occurs in all/most areas of life
- Persistent: evident in ADOLESCENCE and continues through adulthood
- Pathological: causes distress to self or others, impairs function
what are the ICD-10 catgories of personality disorder?
paranoid personality disorder F60.0
schizoid personality disorder F60.1
disocial personality disorder F60.2
emotionally unstable personality disorder F60.3
- impulsive type F60.30
- borderline type F60.31
histrionic personality disorder F60.4
anankastic personality disorder F60.5
anxious [avoidant] personality disorder F60.6
dependent personality disorder F60.7
other specific personality disorders F60.8
personality disorder, unspecified
mixed and other personality disorders F61
Summarise the epidemiology of personality disorder
Men have higher overall rates, particularly
cluster A
clubster B,C -> usually more in women
what comprises the groups/clusters for personality disorder?
Cluster A (‘odd or eccentric’): paranoid, schizoid.
Cluster B (‘dramatic, erratic, or emotional’): histrionic, emotionally unstable, and dissocial.
Cluster C (‘anxious and fearful’): anankastic, anxious (avoidant), and dependent.
Explain the aetiology of personality disorder using a bio-psycho-social approach
Bio
- Genetics;
- FHx depression, personality disorder, ETOH abuse - Childhood temperament
- early attachment and difficult temparament = possible predictors - Childhood experience
- insecure attachment
- trauma/neglect
Psycho
- Cognitive and psychoan theories
- quality of ealry relationships shapes perception of future ones - Psychological defences
- splitting, acting out, projection, fantasizing, form reactions
Neurotransmitter
1. lower serotonin levels in dissocial personality disorder = more impulsive and aggressive
What are the presenting symptoms of personality disorder ;
Paranoid personality disorder
SUSPECT
Sensitive Unforgiving Suspicious Possessive and jealous of partners Excessive self-importance Conspiracy theories Tenacious sense of rights
What are the presenting symptoms of personality disorder ;
Schizoid personalty disorder
ALL ALONE
Anhedonic Limited emotional range Little sexual interest Apparent indifference to praise/criticism Lacks close relationships One-player activities Normal social conventions ignored Excessive fantasy world
What are the presenting symptoms of personality disorder ;
histrionic personality disorder
ACTORS
Attention seeking
Concerned with own appearance
Theatrical
Open to suggestion
Racy and seductive
Shallow affect - you don’t seem to feel emotions as
deeply as average people
What are the presenting symptoms of personality disorder ;
borderline personality disorder?
For both AEIOU;
Affective instability Explosive behaviour Impulsive Outbursts of anger Unable to plan or consider consequences
- Borderline type
- Impulsive type
What are the presenting symptoms of personality disorder ;
emotionally unstable pd - borderline personality disorder?
SCARS
Self-image unclear Chronic ‘empty’ feelings Abandonment fears Relationships are intense and unstable Suicide attempts and self-harm
remember - the meek ones
What are the presenting symptoms of personality disorder ;
emotionally unstable pd - impulsve type
LOSE IT
Lacks impulse control
Outbursts or threats of violence
Sensitivity to being thwarted or criticized
Emotional instability
Inability to plan ahead
Thoughtless of consequences
What are the presenting symptoms of personality disorder ;
Dissocial personality disorder (antisocial personality disorder)?
FIGHTS
Forms but cannot maintain relationships Irresponsible Guiltless Heartless Temper easily lost Someone else’s fault
Which personality disorder? ;
Reece, the cricket club’s treasurer, had developed his
own detailed filing system. When the chairman delivered
a big box of receipts, the day before the committee
meeting, Reece was annoyed—this would take ages to
sort out! The chairman tried to help, but kept ruining
the system, and Reece sent him away, staying up all
night to do the job properly. The next day, he couldn’t
stop wondering whether he had made mistakes.
Anankastic personality disorder
DETAILED
Doubtful Excessive detail Tasks not completed Adheres to rules Inflexible Likes own way Excludes pleasure and relationships Dominated by intrusive thoughts
Identify the possible complications of personality disorder and its management
- admission may be counter-productive, fostering dependence and disempowering the patient from adopting safer coping strategies even in severe cases
Which personality disorder? ;
Hanne lived with her younger sister Rebecca. Hanne
did the housework, but needed Rebecca’s advice for
even the simplest tasks: ‘Rebecca is so clever and capable
—she makes all the important decisions! How would
I ever cope without her if she got married and left me
alone?’
Dependent personality disorder
SUFFER
Subordinate Undemanding Feels helpless when alone Fears abandonment Encourages others to make decisions Reassurance needed
