Personality disorders Flashcards
Loosely define personality and state how personality disorder is different
Personality - characteristic way of thinking, feeling and acting that has been present since adolescence and is pervasive and persistent
Personality disorder - characteristic way of thinking, feeling and acting…….that causes suffering to themselves or others
Roughly state the prevalence of personality disorders in the UK
5% of population (1 in 20)
State whether personality disorder patients have insight
Some extent of insight, however are in touch with reality and are responsible for themselves
List some factors that contribute to personality developement
- Temperament (from birth)
- Genetics
- Parenting
- Culture and society
- Adversity (trauma and internal world)
- Interactions / relationships with others
State conditions that fall into the 3 categories of personality disorder
- Cluster A
- Cluster B
- Cluster C
Cluster A = suspicious
Dysfunctional pattern of thinking and behavior
- Schizoid personality disorder
- Paranoid personality disorder
Cluster B = emotional / impulsive
Dramatic, overly emotional thinking or unpredictable behavior
- Emotionally unstable / borderline personality disorder
- Dissocial personality disorder
- Histrionic personality disorder
Cluster C = anxious
Anxious thinking or behavior
- Avoidant personality disorder
- Dependent personality disorder
- Obsessive compulsive personality disorder
Briefly explain the following cluster A personality disorders:
- Schizoid personality disorder
- Paranoid personality disorder
- Schizotypal personality disorder
Schizoid personality disorder - lack of interest / desire to form relationships with others if no benefit to them
Paranoid personality disorder - difficulty in trusting or revealing personal information to others
Schizotypal personality disorder - distorted perceptions and eccentric behaviours plus impaired social interactions
Briefly explain the following cluster B personality disorders:
- Emotionally unstable / borderline personality disorder
- Narcissistic personality disorder
- Psychopaths
Emotionally unstable / borderline personality disorder - fluctuating strong emotions, difficulties with identity and struggle to maintain healthy relationships
Narcissistic personality disorder - feelings that they are special and need for others to recognise this
Psychopaths - exploit, manipulate or violate the rights of others with lack of remorse
Briefly explain the following cluster C personality disorders:
- Avoidant personality disorder
- Dependent personality disorder
- Obsessive personality disorder
Avoidant personality disorder - severe anxiety about rejection or disapproval and avoidance of social situations or relationships
Dependent personality disorder - heavy reliance on others to make decisions and take responsibility for their lives
Obsessive personality disorder - unrealistic expectations of how things should be done by themselves and others, need to meet expectations
List ICD-10 characteristics of emotionally unstable (borderline) personality disorder
- Intense unstable relationships
- Conflict with others
- Unpredictable mood swings + emotional outbursts
- Impulsivity (without consideration of the consequences)
- Fear of abandonment
- Identity issues
- Self-destructive behaviour + substance misuse
- Rage
- Chronic emptiness
- Repeated deliberate self harm
- Pseudohallucinations
2 types
1) Impulsive type
- Emotional instability
- Lack of impulse control
2) Borderline type
- Disturbances in self-image
- Chronic emptiness
- Intense and unstable interpersonal relationships
- Self-destructive behaviour
State some reasons for deliberate self harm
Internal reasons:
- Self hatred
- Hate of body
- Overcome ‘numbness’
- Physical pain rather than psychological pain
- Self soothing
- Cope with strong emotions
- Aim to end life
External reasons:
- Communication / cry for help
- Make others feel something
- Make others do something
Outline the management of emotionally unstable (borderline) personality disorder
Bio:
- No medications unless comorbid conditions
Psycho:
- Psychoeducation regarding condition
- Psychological therapy especially Dialectal Behaviour Therapy (DBT) to encourage maturing of ego and provide stable base
Social
- Resolve any housing or occupational issues
Also develop a crisis plan that identifies potential triggers that could lead to a crisis
Avoid sectioning in EUPD - undo all work done in DBT
Outline some specific types of psychological therapy used in the management of emotionally unstable (borderline) personality disorder
Therapy aims to encourage maturing of ego and provide stable base
- DBT (dialectical behaviour therapy) which is similar to CBT but adapted for strong emotions
- Therapeutic community
- Cognitive analytic therapy (CAT)
- Psychodynamic therapy
State the main features of personality disorders
- Severe disturbances in the personality and behaviour of individuals, deviating from societal expectations
- Not directly resulting from disease / damage to the brain, or another psychiatric disorder
- Usually involves several areas of the personality
- Impairment of daily functioning
- Usually manifests in childhood or adolescence and continuing throughout adulthood
How are the delusions different in paranoid personality disorder and those seen in schizophrenia
Paranoid personality disorder tends to jump between various different paranoid topics
However, schizophrenia tends to present with a fixed delusion belief system (usually one focus)
List ICD-10 characteristics of Paranoid personality disorder
- Suspiciousness
- Unforgiveness of insults
- Misconstrue neutral or friendly actions of others as hostile or contemptuous
- Sensitivity to setbacks
- May be excessive self-importance
