Personality disorders Flashcards
What are Cluster A disorders?
These condtions are about basic mistrust of other and tend towards a withdrawal from ordinary society. They include: Paranoid personality disorder Schizoid Personality disorder Schizotypical Personality Disorder
Define personality
Those characteristic aspects of a person that distinguishes them, that allows them to be known by others and by themselves
What are Cluster B Disorders?
These are characterised by serious problems of behaviour and impulse control. This includes: Boarderline personality disorder Narcissistic personality disorder Antisocial personality disorder Histrionic personality disorder
What are Cluster C disorders?
These condtions are characterised by consitutional difficult in the way anxiety is mangaed, particulalry anxiety relating to ordinary social roles and responsibilities.
What is Paranoid personailty disorder?
This is characterised by a general distrust of others that markedly gets in the way of any
ordinary relating. The distrust can be seen directly as distrust, or by its effect, such as a
tendency to anger and to feel slighted. This is rarely of significant clinical concern, because the
patients do not seek treatment. Sufferers may had important reasons to feel like their
boundaries, including those relating to their bodily integrity, are at threat—often because they
have been in the past.
What is Schzoid Personality disorder?
This is characterised by, outwardly, an indifference to social contact with others. Patients often
are strikingly unbothered by their lack of sociality. However, there is often a rich fantasy life, and
analytically-inclined psychiatrists can think that these patients have a deep yearning for
relatedness. The small number of patients who recognise that they have a problem and want it
to be different probably can improve in long-term psychodynamic psychotherapy.
What is Schizotypical Personality Disorder?
This is characterised by, outwardly, an indifference to social contact with others. Patients often
are strikingly unbothered by their lack of sociality. However, there is often a rich fantasy life, and
analytically-inclined psychiatrists can think that these patients have a deep yearning for
relatedness. The small number of patients who recognise that they have a problem and want it
to be different probably can improve in long-term psychodynamic psychotherapy.
What is Schizotypal Personality disorder?
In the ICD-10, this is considered not as a personality disorder but as a Schizophrenia-spectrum
condition. These are patients who come across as markedly odd—eccentric beyond eccentric.
They often have psychotic-like experiences, like intuitions, magical thoughts, and so on. This is
not a good prognostic sign for work in psychotherapy.
What is Boarderline personality disorder?
Borderline Personality Disorder is of particular clinical importance—and stands apart both for
its clinical relevance and for the degree of controversy about it. This is a problem characterised
by distress when relationships are strained, which leads to difficult behaviours to try to manage
the strong feelings. People often make frantic efforts to avoid abandonment, and often feel a
stormy sense of their emotions, below which they can often feel quite empty. There is also a
tendency to be unsure about one’s identity. What makes this controversial are mainly two
things: a suggestion it pathologises responses to the abuse that often has been part of the
history of people with the diagnosis; and a concern it is applied to a higher degree to women.
Clinically, though, it has a use because people whose main problem is BPD often find that
simple treatments—like antidepressants as though they have a mood disorder—simply do not
improve things. However, if people can engage with meaningful therapy, and want it, and are in
a good place to use it, things can change. The natural history of the disorder is of improvement
over time: Zanarini showed that 60% of people no longer met criteria at six years after
diagnosis.
This disorder has a high rate of self harm which is one of the criteria of this disorder.
What is Mentilisation based therapy?
Mentalization-Based Treatment aims to help people improve their ability to think about their
feelings at times they feel more distressed, and aims to help them make better sense of others’
intentions. Dialectical Behaviour Therapy has a different set of aims, and people often find their
skills for distress tolerance can be improved by it. One is chosen over the other, ideally, based
on the formulation of the person’s particular difficulties, and matching that to the treatment.
This is used often in BPD.
What is narcissistic personality disorder?
outwardly have a very high opinion of themselves, and very
little sense of what matters to others. However, most psychotherapists find these patients in
fact to have a deep sense of their inadequacy that is very painful for them to get close to, so
they deny it. It is not a disorder of particular clinical concern because people would only be
likely to present obliquely—why would someone with little wrong with them want treatment?
What is antisocial perosnality disorder?
It is characterised by persistent criminal conduct and a tendency to remorselessness about those affected by it. At one end of a spectrum is someone with a degree of antisocial
conduct, which developed on from adolescent Conduct Disorder, with a tendency to boredom
and anger, but who is not necessarily callous. At the other end is someone with a high degree
of callousness, even a complete enjoyment of violence, little capacity to experience anxiety,
and a manipulative, conning charm—someone who is highly psychopathic. That is certainly not
amenable to psychotherapeutic treatment, but people with antisocially but a low degree of
callous-unemotionality can, in rare cases, do well in therapy with specialist psychotherapists,
after careful assessment
What is Histrionic personality disorder?
A small number of patients have a
tendency to dramatic displays of emotion that seem to ring hollow, and may be openly
flirtatious and continuously seeking appreciation. While people may have histrionic traits that
they may work on in therapy—thinking about why their experience has led them to relate in this
way rather than more directly
What is Obsessive Compulsive personality disorder?
This is very different from the mental illness, Obsessive Compulsive Disorder, where someone
has strong intrusive thoughts that are calmed by rituals. It is about a tendency towards
obstinateness, rigidity, and significant anxiety at anything that is disorderly. It is not often
directly a presenting complaint: the presentation may be with the associated anxiety, which on
closer history-taking turns out not to be episodic but lifelong. People with OCPD can improve in
psychodynamic psychotherapy, but it is rarely that someone comes with a single OCPD
diagnosis. Someone may have OCPD and have had something happen that leads them into a
symptomatic anxiety disorder, say a Panic Disorder with Agoraphobia, and improve with
treatment of that but still have the OCPD.
What is dependant personality disorder?
This is a somewhat problematic idea of limited clinical relevance. This is where a person has a
marked difficulty with assuming appropriate adult responsibilities, and defers to others in all
areas, rarely seeing any way in which they can manage things themselves. This is not a
problem of significant clinical concern. If someone’s mental illness is complicated by
dependent traits, then usual clinical management of the co-occurring disorder would probably
be augmented by an approach that gently encourages the patient to see their own strengths.
