Personality Disorders

Question 1

BPD criteria

Answer 1

A pervasive pattern of instability of personal relationships, self-image and affect and marked impulsivity beginning by early adulthood and present in a variety of contexts as indicated by 5 or more of the following:

1. frantic efforts to avoid real/imagined abandonment
2. pattern of unstable, intense interpersonal relationships characterized by alternating between extremes of idealization/devaluation
3. unstable sense of self/self-image
4. impulsivity in 2 or more areas that are potentially self-damaging
5. recurrent suicidal behaviour, gestures or threats or self-mutilating
6. affective instability due to a marked reactivity of mood (usually only a few hours and rarely a few days)
7. chronic feelings of emptiness
8. inappropriate, intense anger or difficulty controlling it
9. transient, stress-related paranoid ideation or severe dissociative symptoms

Question 2

Management of BPD

Answer 2

Biological: symptomatic only like SSRIs and AP 
Psychological: 
- DBT
- psychoeducation 
- mentalisation 
- family therapy 
Crisis management
- monitor suicide risk 
- DSH 
- safety plan 
Social
- as usual

Question 3

Antisocial personality disorder

Answer 3

Pervasive pattern of disregard for and violation of the rights of others, occurring since the age of 15 and as indicated by 3 or more of:
1. Failure to conform to social norms with respect to lawful behaviors
2. Deceitfulness: repeated lying, use of aliases or conning others for profit or pleasure
3. Impulsivity/failure to plan ahead
4. Irritability and aggressiveness: repeated physical fights/assaults
5. Reckless disregard for the safety of self and others
6. Consistent irresponsibility: repeated failure to sustain consistent work behavior/honor financial obligations
7. Lack of remorse: indifferent to/rationalizing having hurt or mistreated or stolen from others
B. at least 18
C. Evidence of conduct disorder with onset before 15 years old
D. Symptoms not exclusively during course of schizophrenia/bipolar

Question 4

Management of ASPD

Answer 4

Pharmacological:
- antipsychotics 
- lithium 
Psychological:
 -psychoeducation 
- relaxation techniques 
- anger management 
- motivational interviewing 
- family therapy

Question 5

OCPD Criteria

Answer 5

Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts as indicated by 4 or more of:

1. preoccupied with details, values, lists, order, organization or schedules to the extent that the major point of the activity is lost
2. shows perfectionism that interferes with task completion
3. is excessively devoted to work and productivity to the exclusion of leisure and friends
4. is over conscientious, scrupulous and inflexible about matters of morality, ethics or values
5. unable to discard worn-out or worthless objects even when they have no sentimental value
6. reluctant to delegate tasks or work to others unless they submit to exactly their way of doing things
7. adopts a miserly spending style towards both self and others
8. shows rigidity and stubbornness

Question 6

Paranoid Personality Disorder characteristics

Answer 6

• pervasive sense of distrust and suspiciousness of others