Personality disorders

Question 1

What is a personality disorder?

Answer 1

• An enduring pattern of inner experience and behavior that
  1. deviates markedly from the expectations of the individuals culture,
  2. is pervasive and inflexible,
  3. has an onset in adolescence or early adulthood,
  4. is stable over time,
  5. and leads to distress or impairment

Question 2

Why are personality disorders categorical?

Answer 2

Personality disorders are separate and distinct from each other

Question 3

Why are personality traits dimensional?

Answer 3

Personality trait continuum from normal to maladaptive

Question 4

What disorders are in cluster A of personality disorders?

Answer 4

Paranoid, schizoid. schizotypal

Question 5

What disorders are in cluster B of personality disorders?

Answer 5

Antisocial, Borderline, Histrionic, and Narcissistic

Question 6

What disorders are in cluster C of personality disorders?

Answer 6

Avoidant, Dependent, Obsessive-compulsive

Question 7

What is a paranoid personality disorder?

Answer 7

Pattern of distrust and suspicion. Others’ motives are interpreted as malevolent

Question 8

What are the diagnostic criteria for paranoid personality disorder?

Answer 8

At least four out of the following:

1. suspects that others are exploiting, deceiving or harming them
2. Preoccupied with unjustified doubts about the trustworthiness of friends
3. Reluctant to confide in others
4. Reads hidden/threatening meaning into normal things
5. Persistently bears grudges
6. Perceives attacks on their character and is quick to counter attack
7. Has recurrent suspicions without justification

Question 9

What is borderline personality disorder?

Answer 9

Pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.

Question 10

What is dependent personality disorder?

Answer 10

Pattern of submissive and clinging behaviour related to excessive need to be taken care of

Question 11

Why have personality disorders got to be present in under 18’s for at least a year before diagnosis?

Answer 11

Under 18 patterns must be present for at least a year before diagnosis. Don’t want to stigmatize with a long term diagnosis - Adolescence is a turbulent time where personality is still developing

Question 12

who coined the big five personality model?

Answer 12

Shiner and Tackett, 2014

Question 13

What are big five personality categories?

Answer 13

Neuroticism, Extraversion, Agreeableness, Conscientiousness, Intellect

Question 14

How does disorganized attachment influence our personality?

Answer 14

Participants diagnosed with BPD were 8x more likely to have a disorganized attachment style (Khoury et al., 2019)

Question 15

What are the methodological issues with diagnosing personality disorders?

Answer 15

In assessing adolescents it is essential for clinicians to assess for personality pathology. Consider the possibility not just in patients that have prototypical obvious features of PD

Question 16

Why do we aim to diagnose personality disorders so young?

Answer 16

Because if someone young has a personality disorder then evidence shows this will transfer to adulthood and can cause considerable impairment. Personality disorders can be easily treated if caught young with personality change intervention.

Question 17

what are the principals for addressing a PD?

Answer 17

1. Avoid unwarranted assumptions about manifestations or causes of PDs. e.g. abuse/neglect associated, but should not assume as does not hold true for not all cases. Assess for this separately
2. Evaluate personality pathology comprehensively to ascertain the possible presence of more than one PD diagnosis
3. Consider PD-NOS. Patient has general features but does not meet specific criteria for one PD
4. Determine if traits/behaviours are impairing pathological patterns versus normative manifestations of adolescence
5. Be attentive to acute symptoms and underlying personality patterns. Newer models suggest current stress contributes to acute symptoms
6. Gather information from adolescents and others that know them well
7. Assess personality strength as well as difficulty. Most troubled youth have areas of strength as well as difficulty

Question 18

Name two assessment instruments for personality disorders and who administers them.

Answer 18

• Coolidge personality and neuropsychological inventory for children (CPNI, 1998). Parent informs, 5-17yrs
• Dimensional personality symptom item pool (DIPSI, 2006). Adolescent 11-17yrs or parent 5-17yrs
• Schedule for nonadaptive and adaptive personality – youth version (SNAP-Y, 2003). Adolescent or parent 12-18

Question 19

What is the modified adult treatment for personality disorders?

Answer 19

• Dialectical behavior therapy (A mix of CBT & Zen mindfulness practices).
• Mindful meditations
• Social skills training
• Self-awareness focused understanding past on present behavior
• Unconscious processes focus in present behavior

Question 20

Who provided evidence for mentalization based treatment for PD?

Answer 20

Beck et al., 2020

Question 21

What did Beck et al., 2020 find out about mentalization based treatment for PD?

Answer 21

No differences between the control group and treatment group.