Personality Disorders

Question 1

Cluster A personality disorders

Answer 1

‘Odd or eccentric’

Paranoid
Schizoid
Schizotypal

Question 2

Cluster B personality disorders

Answer 2

‘Dramatic, emotional or erratic’

Antisocial
Borderline (Emotionally Unstable)
Histrionic
Narcissistic

Question 3

Cluster C personality disorders

Answer 3

‘Anxious or fearful’

Anankastic /Obsessive-Compulsive
Avoidant
Dependent

Question 4

Cluster A personality disorders - Paranoid

Answer 4

Hypersensitivity and an unforgiving attitude when insulted
Unwarranted tendency to questions the loyalty of friends
Reluctance to confide in others
Preoccupation with conspirational beliefs and hidden meaning
Unwarranted tendency to perceive attacks on their character

Question 5

Cluster A personality disorders - Schizoid

Answer 5

Indifference to praise and criticism
Preference for solitary activities
Lack of interest in sexual interactions
Lack of desire for companionship
Emotional coldness
Few interests
Few friends or confidants other than family

Question 6

Cluster A personality disorders - Schizotypal

Answer 6

Ideas of reference (differ from delusions in that some insight is retained)
Odd beliefs and magical thinking
Unusual perceptual disturbances
Paranoid ideation and suspiciousness
Odd, eccentric behaviour
Lack of close friends other than family members
Inappropriate affect
Odd speech without being incoherent

Question 7

Cluster B personality disorder - antisocial

Answer 7

Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest;
More common in men;
Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
Impulsiveness or failure to plan ahead;
Irritability and aggressiveness, as indicated by repeated physical fights or assaults;
Reckless disregard for the safety of self or others;
Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations;
Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Question 8

Cluster B personality disorders - borderline personality disorder/EUPD

Answer 8

Efforts to avoid real or imagined abandonment
Unstable interpersonal relationships which alternate between idealization and devaluation
Unstable self image/identity issues
Impulsivity in potentially self damaging area (e.g. Spending, sex, substance abuse)
Recurrent suicidal behaviour and deliberate self harm
Affective instability (mood swings)
Chronic feelings of emptiness
Difficulty controlling temper
Quasi psychotic thoughts
Pseudohallucinations
Problems with food, sex, alcohol and drugs

Question 9

Cluster B personality disorders - narcissistic

Answer 9

Grandiose sense of self importance
Preoccupation with fantasies of unlimited success, power, or beauty
Sense of entitlement
Taking advantage of others to achieve own needs
Lack of empathy
Excessive need for admiration
Chronic envy
Arrogant and haughty attitude

Question 10

Cluster C personality disorders - anankastic/obsessive compulsive

Answer 10

Is occupied with details, rules, lists, order, organization, or agenda to the point that the key part of the activity is gone
Demonstrates perfectionism that hampers with completing tasks
Is extremely dedicated to work and efficiency to the elimination of spare time activities
Is meticulous, scrupulous, and rigid about etiquettes of morality, ethics, or values
Is not capable of disposing worn out or insignificant things even when they have no sentimental meaning
Is unwilling to pass on tasks or work with others except if they surrender to exactly their way of doing things
Takes on a stingy spending style towards self and others; and shows stiffness and stubbornness

Question 11

Cluster C personality disorders - avoidant/anxious avoidant

Answer 11

Avoidance of occupational activities which involve significant interpersonal contact due to fears of criticism, or rejection.
Unwillingness to be involved unless certain of being liked
Preoccupied with ideas that they are being criticised or rejected in social situations
Restraint in intimate relationships due to the fear of being ridiculed
Reluctance to take personal risks due to fears of embarrassment
Views self as inept and inferior to others
Social isolation accompanied by a craving for social contact

Question 12

Cluster C personality disorders - dependent

Answer 12

Difficulty making everyday decisions without excessive reassurance from others
Need for others to assume responsibility for major areas of their life
Difficulty in expressing disagreement with others due to fears of losing support
Lack of initiative
Unrealistic fears of being left to care for themselves
Urgent search for another relationship as a source of care and support when a close relationship ends
Extensive efforts to obtain support from others
Unrealistic feelings that they cannot care for themselves

Question 13

Class B personality disorders - Histrionic

Answer 13

Inappropriate sexual seductiveness
Need to be the centre of attention
Rapidly shifting and shallow expression of emotions
Suggestibility
Physical appearance used for attention seeking purposes
Impressionistic speech lacking detail
Self dramatization
Relationships considered to be more intimate than they are

Question 14

What are personality disorders?

Answer 14

Personality disorders may be defined as a series of maladaptive personality traits that interfere with normal function in life. They are typically categorised as belonging to one of three clusters:
A, B, and C

Question 15

What is ‘splitting’

Answer 15

Relationships alternate between idealisation and devaluation

Question 16

What symptoms and behaviours may occur in personality disorders?

Answer 16

Strong, intense emotions
Emotional instability
Anger
Low self esteem
Impulsive behaviour
Substance abuse
Poor sense of identity
Difficulty maintaining relationships
Risky behaviour, such as risky sex
Violence and aggression
Self harm
Suicide attempts

Question 17

What is narcissistic personality disorder?

Answer 17

A class B personality disorder

Narcissistic personality disorder is characterised by a strong sense of self-importance. They can be manipulative to gain what they need and feel the need to only associate with others of higher stations than them. They have a sense of entitlement, a need for admiration and a lack of empathy for others or believe others are jealous of them.

Question 18

What is meant by personality? When does it develop?

Answer 18

A characteristic way of acting and feeling that has been persistent since adolescence and is pervasive and persistent in nature

Adolescence is the key time of personality formation, although babies are born with different temperaments and certain characteristics are evident in early childhood

Question 19

What effects personality development

Answer 19

Temperament
Genetics
Parenting
Culture and society
Adversity (trauma and internal world)
Relationships with others

Question 20

Clusters of personality disorder

Answer 20

Class A - odd or eccentric

Class B - dramatic, emotional or eccentric

Class C - anxious or fearful

Question 21

In personality disorders, when will problems begin?

Answer 21

Childhood/adolescence

Question 22

People with what personality disorder might be described as ‘psychopaths’

Answer 22

Antisocial personality disorder (type B cluster)

Question 23

EUPD/BPD defence mechanisms

Answer 23

Immaturity of the ego Results in Primitive defence mechanisms:

Projecting/projective identification (making others feel the unpleasant feeling)
Splitting

Question 24

Presentation of BPD/EUPD

Answer 24

Disturbed childhood

History of Abuse - emotional, sexual, physical

Feelings of Not good enough, unlovable, self loathing

Question 25

Management of EUPD

Answer 25

Therapeutic relationship

Encourage ‘maturing’ of ego

Provide stability and ‘a secure base’

Beware of sectioning

Boundaries care

Dialectical behavioural therapy - mindfulness, acceptance, distress, tolerance, emotional regulation

Question 26

What is a personality disorder

Answer 26

Personality disorders may be defined as a series of maladaptive personality traits that interfere with normal function in life.

Question 27

Shizotypal personality disorder vs schizotypical

Answer 27

Schizotypal personality disorder is characterised by cognitive or perceptual distortions, odd behaviour and the inability to maintain any close relationships. Those with schizotypal personality disorder have difficulties forming relationships and typically have few, if any, close friends. They also feel extreme anxiety in social situations and may act inappropriately, or not react at all, during conversations.

Schizoid personality disorder displays the negative symptoms of schizophrenia

Question 28

Briefly discuss some of the possible aetiologies of personality disorders

Answer 28

Childhood development – insecure childhood attachments, childhood trauma, inconsistent parenting. Genetic – there is some evidence that some personality traits can be inherited.
Psychodynamic theories – discusses the use of maladaptive or primitive defence mechanisms. Cognitive-behavioural theories – relates to the development of maladaptive schemata/core beliefs derived from early experiences.

Question 29

Dissocial pd ICD 10

Answer 29

Personality disorder characterized by disregard for social obligations, and callous unconcern for the feelings of others. There is gross disparity between behaviour and the prevailing social norms. Behaviour is not readily modifiable by adverse experience, including punishment. There is a low tolerance to frustration and a low threshold for discharge of aggression, including violence; there is a tendency to blame others, or to offer plausible rationalizations for the behaviour bringing the patient into conflict with society.