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Psychopathology Test 2 > Personality disorders > Flashcards

Personality disorders Flashcards

1
Q

What is the prevalence of PDs?

A
  • 6-9%
    *higher in people with other mental disorders
    *most PD’d people never come to the attention of MH professionals
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2
Q

What are some of the typical characteristics of people with personality disorders?

A
  • difficulty dealing with others
  • inflexible, always right
  • POOR insight -> ego syntonic symptoms
  • very little beh change
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3
Q

How does the ICD-10 describe PDs?

A
  • disturbances in personality, beh, funtioning
  • deviations from normal patterns
  • distress
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4
Q

PD symptoms are ….

A

ego syntonic = feels like a normal part of oneself

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5
Q

When are most PDs recognizable?

And when do they tend to have a lesser effect on individuals?

A

Adolescence

Middle adulthood (except narcissists)

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6
Q

BPD tends to have what two key characteristics?

A
  • project bad aspects of themselves onto you and make you play that role
  • want people to cling to and stay by them
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7
Q

Outline the etiological factors for PDs

A

Bio:
- abnormalities in certain hormones and neurotransmitters

Psycho social:
- stress and trauma in childhood
- fixation at one stage of psychosocial stage of dev
- attachment issues
- struggle at intimacy vs isolation phases

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8
Q

PD’d people’s personalities are….

A

largely determined by defense mechanisms

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9
Q

What are the PD clusters and their associated PDs

A

Cluster A: (weird)
- Odd/eccentric ebeh
- Schizoid, paranoid, schizotypal

Cluster B: (Wild)
- dramatic, emotional, erratic
- anti-soc, BPD, histrionic, narcissistic

Cluster C: (worried)
- anxious, fearful beh
- avoidant, dependant, OCD

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10
Q

Outline the Cluster A PDs

A

Paranoid
- distrust and suspicion, others motives seen as malevolent

Schizoid
- detached from social relationships, restricted range of emotional expression

Schizotypal
- acute discomfort in close relationships, cog and perceptual distortions, eccentric beh

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11
Q

Outline Paranoid PD presentation

A
  • suspicious of others motives (expects/interprets exploitation)
  • appear cold and serious
  • refuse responsibility for their own actions
  • hostile, angry, irritable
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12
Q

Outline the course and prognosis of paranoid PD

A
  • 0.5% of gen pop
  • relatives of those with schizophrenia
  • men>women
  • lifelong occupational, marital and relationship struggles
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13
Q

Outline the diagnosis for paranoid PD

A
  • unwarranted tendency to interpret others actions as demeaning/threatening
  • constant muscular tension
  • humorless
  • scans environment for clues
  • pathologically jealous
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14
Q

Outline treatment for paranoid PD

A

Psych0theray = trtmnt of choice
- therapist must be straight forward in their dealings w client
- honesty and apology > defensive explanations
- don’t be overly warm w client (struggle w trust and intimacy)
- no group therapy
- deal with delusional reactions realistically and gently

Pharmacotherapy
- anti-anx drugs eg valium
- anti-psychs in small doses can be helpful

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15
Q

Outline schizoid PD presentation

A
  • indifferent to relationships
  • aloof, detached
  • eccentric, lonely
  • missing the “human part”
  • 2:1 male : female
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16
Q

Outline the diagnosis of schizoid PD:

A
  • appears ill at ease
  • can’t tolerate eye contact
  • unsocial, quiet, distant
  • can be very attached to animals or things
  • lifetime inability to express anger
17
Q

Outline treatment for Schizoid PD

A

Psychotherapy:
- may open up in a deep and trusting relationship

Group therapy:
- can be good for providing social contact, but must be protected from aggressive members

Pharmacotherapy:
- small doses of anti-psychs and anti-deps (makes them less sensitive to rejection

18
Q

Outline Schizotypal PD

A
  • magical thinking (though not psychotic)
  • strikingly strange/odd
  • 3% of pop
  • “distant cousin” of schizophrenia
19
Q

Outline BPD presentation

A
  • instability in mood/rel/self image
  • reckless beh
  • deep fear of abandonment
  • almost always in crisis
  • black and white thinking
20
Q

Defense mechanism in BPD?

A

Projection
- intolerable aspects of them are projected onto another, induce other person plays projective role

21
Q

What are the primary comorbid conditions associated with BPD

A
  • MDD
  • Bipolar
  • Bulimia
  • Subs-use
22
Q

What are some of the possible causes of BPD?

A
  • genetic/bio links
  • history of neglect/abuse/separation
  • react strongly to stress
  • devalued and invalidated when young
23
Q

Outline the use of psychotherapy for BPD

A
  • often v difficult for both patient and therapist
  • v draining for therapist (a lot to hold)
  • problems with transference and c/trans

-DBT to control impulses and angry outbursts
- social skills training

24
Q

Other than DBT, what are some of the management techniques for BPD?

A
  • psycho-ed programmes
  • schema focused therapt (CBT) - reframing the way people view themselves and others
25
Q

Outline DBT

A

For chronically suicidal BPD patients
Teaches four sets of beh skills
- mindfulness
- distress tolerance (tolerate distress w/out changing it)
- interpersonal effectiveness (ask for what you want, so no, maintain respect
- emotional regulation (body work, control impulsivity

26
Q

What is the hierarchy of treatment stages for BPD

A
  1. Life threatening beh
  2. Therapy interfering beh
  3. Quality of life beh
  4. Skills acq
27
Q

Another helpful technique for regulation in BPD is…

A

Sensory based activities (touch/taste/smell/sight/sound)

28
Q

Final steps for managing BPD is?

A

Hospitalization
- often do well in this setting (indi and group therapy)
- limits to their actions

29
Q

What are the pharmacological routes for BPD management?

A
  • Anti-psychs (control anger/brief psych episodes
  • Anti-deps (improve mood)
  • Monoamine oxidase (reg impulsive beh)
  • Benzos (dep and anx)
30
Q

Outline the key aspects of histrionic PD

A
  • constant attention seeking, emotional overreaction and suggestibility
  • feel rejected if need for excessive attention and appreciation isn’t met
  • self-centered and inappropriately seductive
  • shallow emotional expression
31
Q

Outline the key elements of narcissistic PD

A
  • inflated sense of importance/ need for admiration
  • low self-esteem, vulnerability to any criticism
  • no empathy
  • unfulfilling relationships
  • tend not to stay in therapy once they feel criticized
32
Q

Outline avoidant PD

A
  • feelings of inadequacy, sensitivity to what others think
  • feel socially inept -> avoid socializing/interacting
  • similar to schizoid PD, but DESIRE affection/acceptance
33
Q

Outline Dependent PD

A
  • need to be taken care of
  • fear of abandonment/separation from NB individuals
  • results in dependent and submissive behaviors to elicit care-giving from others
  • pessimistic, self-doubting and publicly belittle themselves
  • avoids responsibility as they can become easily anxious when faced with decisions
34
Q

Outline Obsessive compulsive PD

A

OCPD:
- preoccupation with perfectionism, orderliness, and mental and interpersonal control
- doesn’t delegate, overly conscientious
- rigid, stubborn, hoards resources

OCD:
- characterized by obsessions and compulsions

35
Q

General guidelines for psychotherapy with PDs?

A
  • straightforward and matter of fact
  • don’t directly challenge ideas of distrust or odd thinking
  • professional and distanced stance is NB (attempts to form close bonds often backfire due to paranoid characteristics)
36
Q

ggg

A

Psychopathology Test 2 (7 decks)

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