Personality Disorders

Question 1

Definition of Personality Disorder

Answer 1

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is persuasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment

Question 2

The enduring pattern of personality disorder manifests in four identified areas:

Answer 2

1. Thinking
2. Feeling
3. Interpersonal relationships
4. Impulse control

Question 3

Before a diagnosis of a personality disorder can be made, a person must demonstrate significant and persistent difficulties in at least two of the four core areas which include:

Answer 3

1. Thinking
2. Feeling
3. Interpersonal relationships
4. Impulse control

Question 4

It is important to recognize that everyone can demonstrate some of the identified personality traits that are identified in the DSM-5 criteria lists. To meet diagnostic requirements for a personality disorder, these traits must be ____________________ and _____________________.

Answer 4

inflexible (repeatedly observed without regard to time, place, and circumstance) and must cause significant functional impairment and/or subjective distress. (the symptoms are incredibly distressing to the person and make it difficult and problematic to function in society.

Question 5

The 10 separate personality disorders are placed into 3 clusters. These clusters are not diagnoses; rather, they represent grouping based on ________________.

Answer 5

Descriptive similarities

Question 6

Research has shown that there is a tendency for personality disorders within the same cluster to co-occur.

True or false?

Answer 6

True

Question 7

Cluster A is commonly referred to as the “_______” cluster and includes _____________.

Answer 7

“odd or eccentric” cluster and includes paranoid, schizoid, and schizotypal personality disorders

Question 8

Cluster A personality disorders are dominated by:

Answer 8

distorted thinking

Question 9

Common features for individuals with Cluster A personality disorders:

Answer 9

social awkwardness and social withdrawl

Question 10

List some features of paranoid personality disorder

Answer 10

• demonstrates a pervasive distrust and suspiciousness of others
• consistent suspicion of the motives of other people
• have the belief that others are out to harm them, take advantage of them, exploit them, or deceive of humiliate them in some way (even if no evidence exists to support these perceived expectations
• do not trust others
• “protect” themselves from others by keeping their distance and appearing removed

Question 11

How can the occupations of an individual with paranoid personality disorder be effected by their distrust in others?

Answer 11

Because they do not trust others they keep their distance from others to “protect” themselves. This lack of trust manifests itself in an excessive need to be self-sufficient, thereby a string sense of autonomy and a reluctance to confide in others. This can limit social participation and can cause a lack of a support system for participation in meaningful occupations. People with this disorder are extremely sensitive to other people’s comments and are quick to take offence.

Question 12

People with the diagnoses of paranoid personality disorder are diagnostically different from individuals with paranoid schizophrenia in that….

Answer 12

People with paranoid personality disorder experience suspicions that are plausible, whereas people with schizophrenia experience suspicions that are psychotic in nature. People with paranoid personality do not experience ideas of reference nor the delusions that are associated with schizophrenia (they may however experience brief psychotic episodes lasting minutes to hours)

Question 13

How is schizoid personality disorder characterized?

Answer 13

A pervasive pattern of social detachment and a restricted range of emotional expression in interpersonal settings

Question 14

Individuals with schizoid personality disorder tend to…

Answer 14

extremely introverted, they have little desire to have friends and voluntarily choose to be socially isolated. They almost always choose solitary activities and seem to take little pleasure in activities, although they may participate in mechanical or abstract tasks such as computer or mathematical games

Question 15

Schizoid personality disorder falls into cluster _____

Answer 15

A

Question 16

Paranoid personality disorder falls into cluster ______

Answer 16

A

Question 17

List some features of schizoid personality disorder:

Answer 17

• oblivious to social cues
• appear socially inept and superficial
• often daydream
• have limited range of emotions
• largely apathetic
• emotionally aloof, detached, and cold

Question 18

People with schizoid personality disorder are rarely seen in clinical settings because…

Answer 18

by their very nature, their subjective distress is low, and impairments would be evident only as perceived by others (whom they typically avoid)

Question 19

Schizotypal personality disorder falls into cluster _____

Answer 19

A

Question 20

List some features of schizotypal personality disorder:

Answer 20

• pervasive pattern of social and interpersonal deficits marked by acute discomfort, reduced close relationships, cognitive or perceptual distortions, and eccentricities in behavior
• cognitive and perceptual distortions distinguish this disorder from schizoid
• having odd beliefs of “magical thinking” (paranormal or superstitious beliefs)
• believing their own thoughts are being stolen from their heads
• suspicious
• experience paranoid ideation
• demonstrate odd speech patterns(vague, circumstantial, metaphorical, overelaborate, or stereotyped), dress and mannerisms
• illusions or misperceptions are of real external stimuli (they are not hallucinations in which stimuli are internal)
• excessive social anxiety that does not diminish with familiarity of the place or people
• lack of close friends
• many have concurrent major depression, which may bring them into treatment

Question 21

How are cluster B personality disorders characterized?

Answer 21

Dramatic, emotional, or erratic

Question 22

What are the cluster B personality disorders?

Answer 22

• antisocial
• borderline
• histrionic
• narcissistic

Question 23

Borderline personality disorder falls into which cluster?

Answer 23

B

Question 24

Individuals with cluster B personality disorders share the common feature of…

Answer 24

Problems with impulse control and emotional regulation/response

Question 25

List some features of antisocial personality disorder:

Answer 25

• disregard for, and a violation of the rights of others
• behavioral patterns of this disorder often show up at the age of 15
• behavioral patterns often manifest as hostility and/or aggression
• deceit and manipulation are central features that may present in childhood (may hurt or torment animals or people)
• engage in hostile acts such as bullying
• may demonstrate a reckless disregard for property such as setting fires
• inflated and arrogant self-appraisal
• reckless disregard for the well-being of others
• lack empathy
• tend to be callous, cynical and contemptuous of the feelings and suffering of others
• adept at reading social cues
• exploitive, manipulative behavior to gain personal profit/pleasure
• take little or no responsibility for their actions (blame others)
• irritable and aggressive
• commit crimes
• act on impulsive urges

Question 26

List some features of borderline personality disorder:

Answer 26

• instability of interpersonal relationships, self-image, and affect, along with marked impulsivity
• making frantic efforts to avoid real or perceived abandonment
• fear of abandonment
• perceive a polarized and oversimplified world
• intense emotional reactions
• drastic mood swings
• difficulty regulating emotions
• impulsive behavior
• self-inflicted abusive behaviors
• unstable sense of self
• may develop psychotic-like symptoms during times of acute stress

Question 27

List some features of histrionic personality disorder:

Answer 27

• excessive emotionality
• attention-seeking behavior
• feel uncomfortable or underappreciated when not the center of attention
• use physical appearance to draw attention to themselves
• overly concerned with appearance
• expend excessive time, energy and money on clothes and grooming
• can be flamboyant and exhibit exaggerated degree of emotional expression and behavior
• tend to turn emotions on and off quickly
• their emotional expression can also be vague, shallow and lacking in detail
• may seek to control others through emotional manipulation or seductiveness
• tend to be easily influenced by others’ suggestions and opinions

Question 28

List some features of narcissistic personality disorder:

Answer 28

• grandiosity (in fantasy and behavior)
• need for admiration
• lack of empathy
• grandiose sense of self-worth/ vanity
• powerful sense of entitlement
• arrogant
• preoccupation with fantasies of unlimited success, power, prestige, brilliance, and beauty
• lack of sensitivity for others
• exploitation of others
• condescending attitudes and behaviors
• have fragile self-esteem
• may use manipulation as a means to receive admiration
• vocational functioning may be low and reflects an unwillingness to take risks in competitive situations

Question 29

How might the ADL’s of a person with narcissistic personality disorder be affected?

Answer 29

Getting caught up in fantasies of unlimited success, power, prestige, brilliance, and beauty may lead to not directing their energies toward daily living efforts or toward accomplishing goals

Question 30

Cluster C includes which personality disorders?

Answer 30

• avoidant
• dependent
• obsessive compulsive personality disorders

Question 31

Cluster C is referred to as the “_________” cluster

Answer 31

“Anxious and fearful”

Question 32

List some features of avoidant personality disorder:

Answer 32

• social inhibition
• feelings of inadequacies
• hypersensitivity to any form of criticism
• want to have friends but avoid activities that involve any significant interpersonal contact
• feelings of insecurity
• vigilance in their appraisal of other’s intentions
• over personalizing the movements and expressions of others
• perceive themselves as socially inept, personally unappealing, or inferior to others
• fearful anxiety
• appear painfully shy

Question 33

Individuals with cluster C personality disorders share a high level of _________

Answer 33

anxiety

Question 34

How might occupational participation of an individual with avoidant personality disorder be affected?

Answer 34

They perceive themselves to be socially inept, personally unappealing, or inferior to others. This leads to a restricted social life with only a small circle of friends that they see as confidants. They tend to become attached to and even dependent on these friends. Low self-esteem and hypersensitivity to embarrassment and rejection by others makes occupational participation extremely difficult.

Question 35

List some features of dependent personality disorder:

Answer 35

• excessive need to be taken care of
• submissive and clinging behaviors
• fear of separation
• difficulty making independent decisions without advice and reassurance from others
• tend to be passive
• allow for others to take initiative
• willing to surrender important responsibilities
• intense fear of losing the support of others may lead to vulnerability and manipulation of others
• difficulty advocating for themselves

Question 36

List some features of obsessive compulsive personality disorder:

Answer 36

• preoccupation with orderliness
• perfectionism
• mental and personal control at the expense of flexibility, openness, and efficiency
• attempts to maintain sense of control through painstaking attention and adherence to rules, trivial details, procedures, lists , and schedules to the extent that the major focus of the activity is lost
• decision-making is painful and all-consuming
• perfectionism and self-imposed high standards interfere with task completion and lead to significant stress and dysfunction
• self-critical
• excessive devotion to work and productivity to the exclusion of leisure activities and friendships
• may perceived by others as rigid, controlling, stubborn

Question 37

Please explain the key difference between obsessive compulsive personality disorder and obsessive compulsive disorder:

Answer 37

There is some overlap in characteristics. Individuals with OCD have insight - they view their thoughts and subsequent behaviors as abnormal, unwanted, and distressing. Individuals with OCPD view their thinking as normal and beneficial.