Personality Disorders Flashcards
What do individuals with personality disorders display?
- Significant challenges in self-identity or self-direction.
- Have problems with empathy or intimacy within their relationships.
Treatment is difficult and complex, as people with these disorders may have difficulty recognizing or owning the fact that their difficulties are problems of their personality.
What are the requirements for diagnosing personality disorders?
Verify duration of S&S – must have been present since early adulthood
Verify that S&S affect many areas – work, home, personal life
Fully meet criteria indicated in DSM-V
Eliminate any possible pathology
Must have two or more types of lasting problems involving the below
- Cognition (ways or perceiving and interpreting self, others and events)
- Affectivity (the range, intensity, lability, and appropriateness of emotional response)
- Interpersonal functioning
- Impulse control
What are common traits of personality disorders?
- Most are insistent
- Regard themselves as unique; little capacity for empathy
- Manipulative and/or exploitative
- Most are unhappy
- Vulnerable to other psychiatric problems
- Have an external locus of control
- Ego-syntonic
- Are not psychotic
Co-morbidities of personality disorders
- PDs frequently co-occur with disorders of mood and eating, anxiety, and substance misuse
- Personality disorders often amplify emotional dysregulation, a term that describes poorly modulated mood characterized by mood swings
- Life crises of any kind may be risk factors, for instance grief, loss, or trauma.
Describe cluster A disorders
- Individuals with these disorders demonstrate odd or eccentric behaviours (e.g., social isolation, detachment)
- They may also display perception distortions, unusual levels of suspiciousness, magical thinking and cognitive distortions, including:
- Paranoid personality disorder
- Schizoid personality disorder
- Schizotypal personality disorder
What personality traits do cluster A disorders exhibit?
Cluster A - refers to individuals with Paranoid, Schizoid and Schizotypal personality traits and exhibit the following:
- Withdrawn
- Cold
- Suspicious
- Irrational
Cluster A: paranoid PD characterisitcs
- Suspiciousness
- Longstanding distrust of others based on the unsupported belief that others want to exploit, harm or deceive
- Quick to take offence, hyper-vigilant
- Perceive actions of others as deliberately threatening – may provoke hostile responses by initiating a ‘counterattack’
- Jealous, controlling, and unwilling to forgive
- Very reluctant to share information about themselves
- Appear guarded but are actually scared of being harmed
- Often the object of rage and humiliation as kids – result in feelings of inadequacy as adults
- Tend to reject treatment
Cluster A: schizoid PD characteristics
- Solitary individuals – indifferent to social relationships
- Unsociable, seclusive people - loners
- Poor ability to function in their lives
- Emotionally detached; relationships are rare
- Indifferent to approval or rejection by others
- Employment jeopardized – can’t interact interpersonally (eg. Security guard at night – good job choice)
- May feel detached from oneself and the world
- Often raised in a cold, neglectful atmosphere
- Often family history of schizophrenia
Cluster A: schizotypal PD characteristics
- Intolerant of social relationships – prefer social isolation to avoid developing close and intimate relationships
- They have disturbed thought processes but are NOT psychotic
- ‘odd’ characteristics – magical thinking, derealization, rigid and peculiar ideas
- Rare; less than 1% of general population
- Some evidence of genetic involvement – family members may have history of schizophrenia
Describe cluster B disorders
- Respond to life’s demands with dramatic, erratic and at times chaotic traits
- Problems with impulse control, emotion processing and regulation, and interpersonal difficulties characterize this cluster of disorders
- Insight may be limited
- Borderline personality disorder
- Narcissistic personality disorder
- Histrionic personality disorder
- Antisocial personality disorder
Cluster B: borderline PD characteristics
- The major features of this disorder are patterns of marked instability in emotion regulation, unstable interpersonal relationships, identity or self-image distortions, and unstable mood
- Occurs in 2-3 % of population
- High utilization of health services
- Most common personality disorder, occurs 3 times more frequently in females
- Increased familial risk but not genetic
- Psychological and environmental factors may contribute to development
- Diathesis-stress model
What is splitting and what personality disorder is it associated with?
- A defence or coping style used by people with BPD
- “the inability to incorporate positive and negative aspects of self or others into a whole image”
- Black and white thinking
- Very concrete
- ‘I hate you – don’t leave me’
- Must hold regular staff meetings to discuss splitting behaviours on the unit
What is the DSM-V diagnostic criteria for borderline personality disorder?
Significant impairments in personality functioning manifest by:
- Impairments in self-functioning: either in identity or self-direction
- Impairments in interpersonal functioning: either in empathy or intimacy
Pathological personality traits in the following domains:
- Negative affectivity: emotional lability, anxiousness, separation insecurity, depressivity
- Disinhibition: impulsivity, risk-taking
- Antagonism: hostility
What does ‘IDESPAIRR’ stand for regarding BPD
I - Identity Disturbance
D - Disturbance in Affect (Mood lability)
E - Emptiness
S - Suicidal/self harm gestures/behaviour
P - Paranoia/Psychosis (brief/transient)
A - Abandonment (fear of real or perceived)
I - Impulsivity
R - Rage (difficulty controlling anger)
R - Relationships (unstable and intense)
Cluster B: narcissistic PD characteristics
- Self-centered; self-absorbed
- Decreased capacity for empathy
- Desire to be admired by others
- Feel very special with a grandiose view of their self-important
- Arrogant
- May take advantage of others
- Does not cause too much impairment in individual functioning and quality of life
- Underneath the façade of self-importance, may feel shame and fear of abandonment, and are afraid of their own mistakes as well as mistakes of others
