Personality Disorders Flashcards
1
Q
DSM 5 Description of Personality Disorders
A
- Onset in adolescence or early adulthood
- Endures over time
- Deviates from cultural standard
- Rigid and pervasive
- Social/Functional impairment
- Does not occur with: another mental illness, another medical illness, pervasive developmental disorder, effects of substance/medications
- Cluster A, B, C
- Other Specified/Unspecified: PD traits but does not meet DSM 5 criteria
2
Q
Risk for Violence with Personality Disorders
A
1) With diagnosis of substance misuse
2) Followed by Cluster B
3) TO a lesser extent schizophrenia spectrum disorders
4) Positive correlation: Paranoid, narcissistic, passive-aggressive
3
Q
Cluster A Personality Disorders
A
Paranoid, Schizoid, Schizotypal
- odd, eccentric
- loner
- emotionally distant
4
Q
Cluster B Personality Disorders
A
Borderline, Narcissistic, Antisocial, Histrionic
- Dramatic, erratic
- Egocentric
- Lack appreciation/concern for others
- Lack of empathy/ minimal functioning conscience
5
Q
Cluster C Personality Disorders
A
Avoidant, Dependent, Obsessive-compulsive
- Avoidant, anxious, and fearful
- Preoccupied with rules or reactions of others
6
Q
Paranoid Personality Disorder (Cluster A)
A
- SUSPECT (paranoid)
- Spousal infidelity suspected
- Unforgiving
- Perceives attacks of others
- Everyone viewed as friend or enemy
- Confiding in others is feared
- Threats perceived in benign events
7
Q
Differential Diagnosis: Paranoid Personality Disorder
A
- More common in families with schizophrenia
- Distinguished from delusional and schizophrenia by absence of: fixed delusions, hallucinations, thought disorder
- Distinguished from personality disorder by absence of intense relationships
- Can be a precursor to schizophrenia
8
Q
Personality Disorder Treatment
A
- Prolonged intensive psychotherapy
- Pharmacological treatment of anxiety/agitation symptoms
- Occasional use of antipsychotics to manage delusional thoughts
9
Q
Schizoid Personality Disorder: Cluster A
A
- DISTANT (social withdrawal)
- Detached or flat affect
- Indifferent to criticism or praise
- Sexual experiences of little interest
- Task performed solitarily
- Absence of close friends
- Neither desires or enjoys closeness
- Takes pleasure in few activities
- DSM 5 criteria when 4 of 7 are met
10
Q
Schizoid Personality Disorder Differential Diagnosis
A
- Male to female 2:1
- Lack of nurturing in childhood
- May be successful in isolated jobs
- Distinguished from schizotypal and schizophrenia: no delusions, hallucinations, thought disorder; Less oddity than schizotypal
11
Q
Schizoid Personality Disorder Treatment
A
- Psychotherapy
- Cautious group therapy: Defense structure
- Pharmacological intervention only for symptom control
12
Q
Schizotypal Personality Disorder
A
- ME PECULIAR (Not your typical pal)
- Magical thinking
- Experiences unusual perceptions
- Paranoid ideation
- Eccentric behavior or appearance
- Constricted or inappropriate affect
- Unusual or odd thinking and speech
- Lacks close friends
- Ideas of reference
- Anxiety in social settings
- Rule out psychotic and pervasive developmental disorders
- DSM criteria 5 of 9 characteristics
13
Q
Schizotypal Personality Disorder Treatment
A
- 10% commit suicide, periodic risk assessment
- Psychotherapy, nonjudgment focus
- Antipsychotic medications may be needed with ideas of reference, illusions
14
Q
Antisocial Personality Disorder: Cluster B
A
- CORRUPT (sociopath)
- DSM requires three or more symptoms
- Conformity to law is lacking
- Obligations ignored
- Reckless disregard for safety of self or others
- Remorse lacking
- Underhanded
- Planning insufficient (impulsive)
- Temper
- Symptoms notable before 15, may be diagnosed with conduct disorder
- Must be 18
15
Q
Antisocial Personality Disorder: Predisposing factors
A
- 75% of people who have committed crimes
- Lower socioeconomic
- Parental deprivation in first 5 years
- Males with AUD
- Five times greater with first degree male relative with ASPD
- Association with anxiety and depression
- Symptoms may decrease with aging
16
Q
Antisocial Personality Disorder: Treatment
A
- Psychotherapy
- Self-help groups
- CBT: “Moral recognition therapy”
- Valporate for rage symptoms, especially if EEG is abnormal
17
Q
Borderline Personality Disorder: Cluster B
A
- I DESPAIRR (borders both neurosis and psychosis)
- Identity disturbance
- Disordered unstable affect with marked mood reactivity
- Emptiness feelings
- Suicidal behaviors
- Paranoid ideation under duress
- Abandonment sense
- Impulsivity
- Rage
- Relationship instability
- DSM criteria: 5 or more symptoms
- Females 75%
- HX childhood abuse/sexual abuse
18
Q
Borderline Personality Disorder: Treatment
A
- Psychotherapy
- Individual and Group therapy (not usually)
- Behavioral therapy and social skills training
- Limit setting
- Olanzapine: mood stabilization
- SSRI: depression
- MAOI: impulsive behaviors
19
Q
Histrionic Personality Disorder: Cluster B
A
- PRAISE ME (dramatic)
- Provocative: Relationships overvalued
- Attention seeking and uncomfortable when not
- Influenced easily
- Style of speech exaggerated
- Emotions shallow and rapid shifting
- Made-up in ways to draw attention
- Emotions exaggerated
- Begins in early adulthood
- Females more than males
- Substance use and somatization disorders common
- DSM criteria: 5 or more
20
Q
Histrionic Personality Disorder: Differential
A
- Self-destructiveness and identity disturbance differentiate BPD from HPD
- Narcissistic PD is more grandiose, arrogant, and lacking in empathy compared to HPD; Narcissistic PD craves recognition for superiority, whereas HPD settles for recognition of weakness or fragility
- Individuals with ASPD manipulate for power, profit or personal gratification; HPD manipulate for nurturing
21
Q
Histrionic Personality Disorder: Treatment
A
- Psychotherapy with focus on identification of emotions/insight
22
Q
Narcissistic Personality Disorder: Cluster B
A
*SPEECIAL (Grandiosity)
- Special, believes in own uniqueness
- Preoccupied by fantasies
- Envious
- Entitlement
- Excessive admiration required
- Conceited
- Interpersonal exploitation
- Arrogant
- Lacks empathy
DSM criteria 5 or more symptoms
23
Q
Narcissistic Personality Disorder: Differential
A
- 50-75% male
- Associate with anorexia and SUD
- BPD, HPD, and ASPD all have narcissistic traits; distinguishing feature of NPD is grandiosity
24
Q
Avoidant Personality Disorder: Cluster C
A
- CRINGES (inferiority complex/nervous)
- Certainly of being liked criteria for involvement
- Rejection sensitive and preoccupied
- Intimate relationships avoided
- New relationships avoided
- Gets around occupational work that involves interpersonal contact
- Embarrassment potential prevents new activities
- Self-view is on of inferiority, ineptness
- DSM criteria 4 characteristics
25
Avoidant Personality Disorder: Differential
* Males = Females
* DIffer from schizoid because they desire social contact
* DIffer from dependent with focus on avoidance of humiliation not being cared for
* Differ from paranoid personality, avoid s interactions our of perceptions of inadequacy not malice.
* Strong overlap with anxiety disorder
*
26
Avoidant Personality Disorder: Treatment
* Psychotherapy: insight-oriented, behavior modification, assertivenes training, Group/family therapy
* Treat anxiety with SSRIs
27
Dependent Personality Disorder: Cluster C
* RELIANCE (needy)
* Reassurance required for decisions
* Expressing any disagreement is difficult
* Life responsibilities assumed by others
* Initiating projects difficult
* Alone not tolerated
* Nurturance needs excessive
* Companionship needed urgently at all times
* Exaggerated fears of being left to care for others
28
Dependent Personality Disorder: Treatment
* Similar to Avoidant
* Psychotherapy: insight-oriented, behavior modification, assertiveness training, group/family therapy
* Treat anxiety with SSRIs
29
Obsessive-compulsive Personality Disorder: Cluster C
* LAW FIRMS (perfectionism)
* Loses the point of activities
* Ability to finish anything compromised by desire for perfection
* Worthless objects overvalued and cherished
* Friendships excluded as work focus of life
* Inflexible and overly conscientious
* Reluctant to delegate
* Miserly
* Stubborn
30
Obsessive-compulsive Personality Disorder: Differential
* OCPD pre-occupations and ego-syntonic; OCD obsessions/compulsions are ego-dystonic
31
Obsessive-compulsive Personality Disorder: Treatment
* Behavioral therapy
* Cognitive therapy
* SSRIs for anxiety
