Personality Disorders

Question 1

Define personality disorders

Answer 1

Personality disorders = cover a variety of maladaptive personality traits - that cause significant psychosocial distress + interfere with functioning

These traits = remain relatively persistent in the person over time + impact their life and relationships

Question 2

What are personality disorders characterised by?

Answer 2

Personality disorders = characterised by patterns of:
* Behaviour
* Emotion
* Thought
That differ from what is normally expected

More specifically, deviation has to manifest in more than one of the following areas:
* Cognition
* Affectivity
* Occupational + social performance
* **Impulse control + need gratification **
* Interpersonal function

Leads to:
* Difficult relationships
* Reduced QoL
* Poor physical health

Question 3

Causes of personality disorders

Answer 3

Combination of genetic + environmental factors

Often Hx of early childhood trauma + difficult circumstances

Question 4

When do symptoms of personality disorders typically start to emerge?

Answer 4

Teenage or early adult years

Symptoms depend on type + individual

Question 5

What are the 3 categories of personality disorders in the DSM-5

Answer 5

• Cluster A - Suspicious
• Cluster B - Emotional or impulsive
• Cluster C - Anxious

Mad, bad, sad

Question 6

What are the 3 suspicious personality disorders?

Answer 6

• Paranoid personality disorders - difficulty in trusting or revealing personal info to others
• Schizoid personality disorders - lack of interest or desire to form relations wth others + feeling no benefit from them
• Schizotypical personality disorder - unusual beliefs, thoughts, behaviours + social anxiety (forming relationships = difficult)

Question 7

What are the 4 emotional and impulsive personality disorders?

Answer 7

• Antisocial personality disorder - reckless + harmful behaviour with lack of concern for consequences or impact of their behaviour on other people - often involves criminal misconduct
• Borderline personality disorder (BPD) - fluctuating strong emotional + difficulties with identity and maintaing healthy relationships
• Histrionic peronality disorder - need to be centre of attention + performing for others to maintain that attention
• Narcissistic personality disorder - feelings that they are special + need others to recognise this, otherwise they get upset. They put themselves first.

Question 8

What are the 3 anxious personality disorders?

Answer 8

• Avoidant personality disorder - severe anxiety about rejection or disapproval + avoidance of social situations or relationships
• Dependent personality disorder - heavy reliance on others to make decisions + take responsibility for their lives - taking a very passive approach
• Obsessive-compulsive personality disorder - unrealistic expectations of how things should be done by themselves + others. Cataastrophising about what will happen if these expectations are not met

Question 9

Management for personality disorders

Answer 9

• Risk management (short and long term) - e.g. ongoing self-harm, suicide, harm to others
• Main treatment = psychological treatment (CBT or dialectial behaviour therapy (DBT))
• MEDICATIONS = NOT RECOMMENDED long-term
• Short-term: sedative medication (sedative antihistamines) - used for less than one week in a crisis

Personality disorders = can co-exist with other psychiatric problems (e.g. depression), where medications may be helpful

Question 10

Info: Medications for personality disorders
(Most effective if individually tailored and symptom focused)

Answer 10

• Antipsychotics - cognitive symptoms, impulsivity, tense angry effect
• Monoamine oxidase inhibitors - EUPD to alleviate abnormal mood
• Carbamazepine + Lithium - episodic behavioural dyscontrol + aggression