Personality Disorders

Question 1

Personality d/o

Answer 1

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

Main characteristics: emphasize emotion and behavior instead of etiology.

These are the most controversial diagnoses for lots of reasons.

Question 2

Traits of personality d/o

Answer 2

Traits: enduring characteristics that exist across situations; can be adaptive and maladaptive; the functionality of the trait depends on the situation; affect the way a person addresses problems in life and are the foundation for understanding differences within individual personalities.
States: associated with a specific point in time and circumstance
Traits: often pervasive, affecting all life areas, and not easily changed
Influence the range, intensity, consistency, and appropriateness of emotional responses; can influence impulse control and judgment.
Evident in the way a person thinks about self, others, and events.

Question 3

Cluster A

Answer 3

Paranoid personality disorder (2-4% Prevalence)
Schizoid personality disorder (<1% of population)
Schizotypal personality disorder (3-4% of population)

Question 4

Cluster B

Answer 4

Antisocial (3.63%)
Borderline (2.0%)
Histrionic (1.8%)
Narcissistic (6.2%; Gender 7.7% Male to 4.8% Female)

Question 5

Cluster C

Answer 5

Avoidant personality disorder (2.4%)
Dependent (.05%)
Obsessive-compulsive (7.9%)

Question 6

Enduring patterns of personality d/o

Answer 6

Enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. Pattern manifested in 2 or more: Cognition, Affectivity, Interpersonal functioning, Impulse control
Enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
Enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.
The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition.

Question 7

Paranoid personality d/o

Answer 7

distrust and suspiciousness

Cluster A

Question 8

Schizoid personality d/o

Answer 8

detachment from social relationships and a restricted range of expression of emotions in interpersonal settings

Cluster A

Question 9

Schizotypical personality d/o

Answer 9

social and interpersonal deficits marked by discomfort with and reduced capacity for close relationships, cognitive and perceptual distortions, and eccentricities of behavior.

Cluster A

Question 10

Antisocial personality d/o

Answer 10

pattern of disregard for and violation of the rights of others occurring since age 15 and include 3 or more criteria.

Cluster B

Question 11

Borderline personality d/o

Answer 11

instability of interpersonal relationships, self-image, and affects; marked by impulsivity in early adulthood with 5 criteria.

Cluster B

Question 12

Histrionic personality d/o

Answer 12

excessive emotionality and attention seeking, beginning by early adulthood with 5 or more criteria.

Cluster B

Question 13

Narcissistic personality d/o

Answer 13

pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy beginning early adulthood with 5 or more criteria.

Cluster B

Question 14

Avoidant personality d/o

Answer 14

social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation beginning in early adulthood with 4 or more criteria.

Cluster C

Question 15

Dependent personality d/o

Answer 15

excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation with 5 or more criteria in early adulthood.

Cluster C

Question 16

Obsessive-compulsive d/o

Answer 16

preoccupation with orderliness, perfectionism, and mental and interpersonal control and the expense of flexibility, openness, and efficiency in a variety of contexts by early adulthood with 4 or more criteria present

Cluster C

Question 17

Primary trait associated w/ personality d/o cluster C

Answer 17

Anxiety

Anxiety may stem from fear of rejection or humiliation, the need to be taken care of, or a preoccupation with perfection. Social discomfort, a sense of helplessness, the inability to make decisions, perfectionism, and inflexibility are characteristic.

Question 18

Personality Disorder Genetic Factors

Answer 18

More likely to have relatives with same personality disorder.

Question 19

Personality DisOrder Biological Factors

Answer 19

Can be attributed to hormones, platelet monoamine oxidase, and neurotransmitters.
Impulsive symptoms have higher levels of the hormone’s testosterone, 17-estradiol, and estrone than those who do not.
The amygdala found to be overactive in persons with borderline personality d/o and the prefrontal cortex seems underactive.

Question 20

Personality DisOrder Environmental Factors

Answer 20

40 – 71% of persons diagnosed with borderline personality d/o have been sexually abused, often by non-caregiver

Additionally, being in an environment where needs are not met may contribute (negative environmental factors); invalidating environment yields an adult who demonstrates difficulty with emotional regulation and responds erratically and inappropriately to life experience that do not trouble others.

Familial psychopathology

Question 21

Prevalence of personality d/o

Answer 21

13.2 to 14.8% of American adults have been diagnosed with at least 1 personality disorder (nearly 30.8 million)

Question 22

Course of personality d/o

Answer 22

Chronic conditions
Evidence supports effective interventions however, most don’t seek treatment.
Biggest challenge – engaging the individual in treatment.

Question 23

Gender differences of personality d/o

Answer 23

Risk of avoidant, dependent, and paranoid personality d/o higher in women than men
Borderline personality disorder more predominantly in women
Antisocial higher in men
No gender differences identified in obsessive-compulsive, schizoid, and histrionic personality disorder.

Question 24

Culture of personality d/o

Answer 24

It is essential to consider the social norm for the culture.
Consider the client’s ethnic, cultural, and social background.

Question 25

Impact on occupational perfromance w/ personality d/o

Answer 25

Social participation
Emotional modulation
Coping

Question 26

Cluster A medications

Answer 26

low dose antipsychotic

Question 27

Custer B medications

Answer 27

mood stabilizer or antidepressant

Question 28

Cluster C medications

Answer 28

SSRIs or related antidepressants in addition to short-term use of benzodiazepines

Question 29

OT interventions for personality d/o

Answer 29

Establish a therapeutic relationship.
Address occupational dysfunction.
Interpersonal skills: most common area of difficulty across personality disorders
Prevention of personality disorders: in prevention using an environmental enrichment program

Question 30

Medications for borderline personality d/o

Answer 30

low-dose anti-psychotics and mood stabilizer may decrease suicidal behavior

Question 31

Includes excessive and unstable expressions of emotions, maladaptive interpersonal relationships, and a disregard for the needs and rights of others.

Answer 31

Cluster B personality d/o

Question 32

Individuals tend to interpret the intentions and actions of others as negative.

Answer 32

Cluster A personality d/o

Question 33

Anxiety may stem from fear of rejection or humiliation, the need to be taken care of, or a preoccupation with perfection. Social discomfort, a sense of helplessness, the inability to make decisions, perfectionism, and inflexibility are characteristic.

Answer 33

Cluster C personality d/o