Personality disorders Flashcards
How old must patient be to be dx with personality disorder
18
Difference between autism and conduct d/o for minors
autism: see social interaction deficit
conduct: violates other people’s rights and space
BPD: (7)
Impulsivity self-damaging behavior
recurrent suicidal behavior (hallmark)
pattern of unstable intense interpersonal relationships
frantic efforts to avoid real or imagined abandonment
identity disturbances
chronic feelings of emptiness
inappropriate intensified affective anger responses
treatment for BPD
dialectical behavioral therapy
Antisocial disorder (7)
reckless disregard for the welfare of others
lack of remorse
indifferent to feelings of others
failure to conform to social norm
repeated acts that are grounds for arrest
deceitfulness, lying, use aliases for profit or pleasure
impulsivity
Narcissistic PD 320 (9)
Grandiose sense of self-importance.
Preoccupation with fantasies of power, success, brilliance, and beauty.
Belief in self-importance and being special and unique.
I think excessive admiration is required.
Unreasonable expectations or sense of entitlement.
Interpersonally exploitative.
Empathy lacking.
Envy of others and belief that others envy him or her.
arrogant
Schizoid personality disorder (ANCC) p318
indifferent to other people (hallmark)
voluntary social isolation*
doesn’t care if you’re criticizing or praising
shows little to no interest in sexual activity with other people
affect is flat, very cold, very detached* from environment
schizotypal personality disorder (closest to schizophrenia) whats the main difference
there are NO TYPICAL Manifestations of hallucinations or delusion
Schizotypal personality disorder s/s (8)
Interpersonal difficulties and social anxiety (different from schizoid because they don’t want to be social)
Few or no close friends
Odd beliefs
Ideas of reference
Magical thinking
Paranoid ideation
Inappropriate or constricted affect
Behavior overtly oddA
Autism deficits in (hallmark)
social interaction and communication across multiple settings
other s/s deficits of Autism 340-343
Social reciprocity
Nonverbal communication
Developing, maintaining, and understanding relationships
Restricted repetitive behavior (Frequent throwing)
Insistence on sameness
Highly restricted with fixed interests
CHILDREN often like to line up, stack, or organize and toys in long tidy rows (how they play is important)
Risk factors for autism
Male gender
intellectual disability
genetic loading
symptoms often reported by parents that hint towards Autism (342)
No response by name
Little to no eye contact
No imaginary play 2-3 yo
Little interest in playing with other children
Intense tantrum
Extremely short attention span
Self-injurious behaviors
Screening for autism 343
Modified checklist for autism in toddlers (KNOW NAMES)
Autism diagnostic observational schedule generic
Ages and stages questionnaires
Medications for autism
Antipsychotics: effective for tantrums, aggressive behavior, self-injurious behavior, hyperactivity, repetitive, stereotyped behaviors
Risperidone and abilify commonly prescribed
Disruptive mood regulation disorder (DMDD) (7) 355
Try not to diagnose bipolar before 18
Childhood depressive disorder that is diagnosed in children older than age 6 but younger than 18
On exam, presenting with mood disorder under 18 it is most likely MDD not BD
Chronic dysregulated mood (moody for no reason) (Hallmark)
Frequent intense temper outbursts/tantrums
Severe irritability
Anger
Tx for DMDD: (4)
stimulants
antipsychotics
antidepressants
Ritalin is common
Intermittent explosive disorder (3)
Involves repeated sudden episodes of impulsive, aggressive, violent behavior, or angry verbal outbursts in which the patient reacts grossly out of proportion to the situation
Can be children and adults
Like a pt becomes impulsive and violent because they want stimulants and won’t get it repeatedly
Tx for Intermittent explosive disorder (3)
SSRI Fluoxetine (mood stabilizers like lithium and carbamazepine
Fragile X (6)
overdeveloped structures
SHORT STATURE,
large head,
elongated face, hyperextensible joints, abnormally large testes
underdeveloped structures
Small eyes thin upper lip, short upturned nose, smooth skin between nose and upper lip
Deformities of joints, limbs, fingers
Slow physical growth before and after birth
Vision difficulties hearing problems
Small head circumference brain size
FAS
Pharmacological treatment for BPD with irritability, anger, self harming behaviors?
LITHIUM
BPD patient presents with depressed mood, emotional lability, interpersonal problems, rejection sensitivity, hostility
DEPAKOTE
other medications that can be used to help manage depression and anxiety in BPD
SSRIs - sertraline (zoloft) or fluoxetine (prozac)
avoidant personality disorder
avoidance of activities involving significant interpersonal contact
fear of criticism, disapproval, or rejection
unwillingness to be involved with people unless SURE of being liked
restraint in intimate relationships for fear of being shamed
preoccupation of being criticized or rejected
view of self as socially inept, personally unappealing
unusual reluctance to take personal risks or engage in new activities
difference between schizoid and avoidant personality disorder?
schizoid does NOT want to socialize
avoidant they really do want to socialize but they are scared
Conversion disorder
person has blindness, mutism, paralysis, or paresthesia (glove stocking syndrome) other nervous system symptoms that CAN NOT be explained by medical evaluation
When does conversion disorder symptoms usually start?
After a Stressful experience
Treatment for conversion disorder (2)
CBT and physical therapy
a repetitive and persistent pattern of behavior in which the rights of others or societal norms or rules are violated
Conduct disorder
aggression* towards people or animals-bullies, threatens, intimidates, initiates fights, uses a weapon, physically cruel to animals or people, stealing, forced sexual activity all fall under what disorder
conduct disorder
which is more aggressive ODD or conduct disorder?
Conduct disorder
goal of medication therapy for conduct disorder (2)
target mood and aggression
What medication options are used to treat aggression and agitation with conduct disorder? 4
antipsychotics
mood stabilizers
selective serotonin inhibitors
alpha agonists (clonidine and guanfacine)
If a child has ADHD AND conduct disorder what medications should typically be considered?
Clonidine or Guanfacine because it can help with ADHD and conduct disorder
