Personality disorders

Question 1

What is a personality

Answer 1

• Characteristics of a personal that distinguishes them, allows them to be known by others and by themselves
• In psychiatry, thought of as the ‘baseline’ with the assumption illness is a break from this

Question 2

Development of the personality

Answer 2

• Before infant arrives → psychological and social life of the family
• Innate temperature of the infant
• Early soothing and early environment

Question 3

Exploring during development

Answer 3

• From a secure base, exploration → attachment behaviours
• Recapitulation in adolescence
• Continuous development process/ processes/ conflicts
• Something that continues lifelong
• Development of an internal working model

Question 4

Definition of personality

Answer 4

• Problems in functioning of aspects of:
  
  • Self (identity, self-worth, accuracy of self-view
  • Interpersonal function
• Presents as patterns of cognition, emotional experience, emotional expression and maladaptive behaviours
• Occurs in range of personal and social situations

Question 5

Clinically relevant personality disorders

Answer 5

• Borderline Personality Disorder
• Antisocial Personality Disorder
• The rest

Question 6

Borderline Personality Disorder

Answer 6

• Marked instability in affect, interpersonal relations and other functioning
• Prone to feel abandoned, frantic efforts to avoid it
• Effectively a disorder of attachment trauma, but not always
• Associated with self-injury and suicidal behaviours
• fMRI changes → altered functional connectivity between anterior cingulate gyrus and other frontal areas
• Treatment → more and more effectively recently from mentalisation therapy

Question 7

Management of BPD

Answer 7

• Good clinical care
• Psychotherapeutics
• Social treatment
• Psychopharmacological treatment
• Inpatient care

Question 7

Management of BPD

Answer 7

• Good clinical care
• Psychotherapeutics
• Social treatment
• Psychopharmacological treatment
• Inpatient care

Question 8

Antisocial personality disorder

Answer 8

• Psychiatry concept of psychopathy
• Medical word for criminality?
• Causes
  
  • 5-HIAA metabolite
  • Psychophysiologt differences
• Presentation
  
  • Antisocial behaviours
  • Risk-taking
  • Inability to learn from prior experience → punishment
• Treatment → little understood, supportive management

Question 9

Other specific personality disorders

Answer 9

• Schizoid
• Schizotypal
• Paranoid
• narcissistic
• Histrionic
• Anankastic/ obsessive-compulsive
• Dependent
• Avoidant