Personality Disorders Flashcards
Key features of PDs
Persistent pattern
-cognition patterns, emotional experiences, behaviour, interpersonal functioning deviate from cultural expectation
-stable over time and cover a variety of personal and social situations
Impairment
-result in significant problems in one’s life, especially in relationships, work, social functioning
Duration
-stable over time, beginning as a teen and are not transient
Distress/dysfunction
-result in distress to the individual or others
NOT EXPLAINED BY ANOTHER MENTAL DISORDER, MEDICAL CONDITION, OR SUBSTANCE MISUSE
Classification of severity
-mild
-moderate
-severe
Mild
-some impairments in functioning, often limited to specific areas of life
-noticeable symptoms to others but do not cause pervasive distress or dysfunction
-can maintain relatively stable relationships and occupational roles
Moderate
-more significant impairments in multiple areas of life
-may struggle to maintain close relationships, may be greater interpersonal difficulties
-more distressing symptoms present, but can manage daily functioning with some effort or support
Severe
-profound impairments in all areas of life
-pervasive difficulties in interpersonal relationships, self identity, coping mechanisms
-significant distress, dysfunction, reduced QOL
-intensive and long-term therapeutic interventions needed
Personality disorder trait domains - ICD11
-negative affect
-detachment
-dissociality
-disinhibition
-anankastia
-borderline
Negative affect
-tendency to experience a wide range of negative emotions (anxiety, depression, guilt, anger)
-prone to mood swings, insecurity, emotional lability
Detachment
-avoid social interactions, emotional withdrawal, limited pleasure from relationships
-appear cold, aloof, isolated
Dissociality
-disregard for the rights and feelings of others, lack empathy, difficulty forming prosocial relationships
-impulsivity, manipulative behaviour
Disinhibition
-impulsiveness, risk taking, difficulty controlling behaviours
-struggle with planning, foresight, leading to reckless or irresponsible actions
Anankastia
-preoccupation with orderliness, control, perfectionism
-rigid, stubborn, excessively focused on rules and detail
Borderline
-emotional instability, intense, unstable interpersonal relationships
-fluctuating sense of identity, impulsivity
Old classification - paranoid
Hypersensitive, inforgiving attitude when insulted
Unwarranted tendency to question loyalty of friends
Reluctance to confide in others
Preoccupation with conspiratorial beliefs and hidden meaning
Unwarranted tendency to perceive attacks on their character
Old classification - schizoid
Indifference to praise and criticism
Preference for solitary activities
Lack of interest in sexual interactions
Lack of desire for companionship
Emotional coldness
Few interests
Few friends or confidants other than family
Old classification - schizotypal
Ideas of reference - different from delusions as some insight is retained
Odd beliefs, magical thinking
Unusual perceptual disturbances
Paranoid ideation and suspiciousness
Odd, eccentric behaviour
Lack of close friends other than family members
Inappropriate affect
Odd speech without being incoherent
Old classification - antisocial
Failure to conform to social norms with respect to lawful behaviours
-repeatedly performing acts that are grounds for arrest
More common in men
Deception
-repeatedly lying
-using aliases
-conning others for personal profit or pleasure
Impulsiveness or failure to plan ahead
Irritability and aggresiveness
-repeated physical fights or assaults
Reckless disregard for the safety of self or others
Consistent irresponsibility
-repeated failure to sustain consistent work behaviour, honour financial obligations
Lack of remorse
-indifferent to or rationalising having hurt, mistreated or stolen from others
Old classification - borderline/emotionally unstable
Efforts to avoid real/imagined abandonment
Unstable interpersonal relationship which alternate between idealisation and devaluation
Unstable self image
Impulsivity in potentially self damaging areas
-spending, sex, substance abuse
Recurrent suicidal behaviour
Affective instability
Chronic feelings of emptiness
Difficulty controlling temper
Quasi psychotic thoughts
Old classification - histrionic
Inappropriate sexual seductiveness
Need to be the center of attention
Rapidly shifting and shallow expression of emotions
Suggestibility
Physical appearance used for attention seeking purposes
Impressionistic speech lacking detail
Self dramatization
Relationships considered more intimate than they actually are
Old classification - narcissistic
Grandiose sense of self importance
Preoccupation with fantasies of unlimited success, power, beauty
Sense of entitlement
Taking advantage of others to achieve own needs
Lack of empathy
Excessive need for admiration
Chronic envy
Arrogant and haughty attitude
Old classification - obsessive compulsive
Occupied with details, rules, lists, order, organisation to the point that the key part of the activity is gone
Demonstrates perfectionism, hampering task completion
Extremely dedicated to work and efficiency to the elimination of spare time activities
Not capable of disposing of worn out/insignificant things even when they have no sentimental meaning
Unwilling to pass on tasks or work with others unless they surrender to your way of doing things
Stingy spending style towards self and others
Old classification - avoidant
Avoidance of activities involving significant interpersonal contact due to fears of criticism or rejection
Unwilling to be involved unless certain of being liked
Preoccupied with ideas that they are being criticised or rejected in social situations
Restraint in intimate relationships for fear of being disliked
Reluctance to take personal risks due to fears of embarrassment
Views self as inept and inferior to others
Social isolation accompanied by a craving for social contact
Difference between avoidance personality disorder and social anxiety disorder
Avoidant personality disorder
-a genuine belief that they are inferior and inadequate and rationalise feelings of criticism and rejection
-projection of their negative self evaluation onto others, assume that others will perceive them the same
-avoidance of all areas of social interaction
Social anxiety disorder
-have insight that their fears and worries are disproportionate and irrational
-performance anxiety is at the root of SAD, fear of saying or doing something that will cause people to judge them negatively
-avoidance of specific social interactions
Old classification - dependent personality disorder
Difficulty making everyday decisions without excessive reassurance from others
Need for others to assume responsibility for major areas of their life
Difficulty in expressing disagreement with others due to fears of losing support
Lack of initiative
Unrealistic fears of being left to care for themselves
Extensive efforts to obtain support from others
Unrealistic feelings that they cannot care for themselves
Difference between obsessive compulsive personality disorder and obsessive compulsive disorder
OCD
-can develop at any point in life
-highly aware of their obsessions and compulsions
-desire to control specific factors
-prone to feelings of anxiety
OCPD
-pervasive disorder that is stable over time
-lack of self awareness => more susceptible to acting on impulses without realising and causing harm to self or others
-desire to control whole situations
-prone to feelings of anger and rage
Management of personality disorders
1st line - dialectical behaviour therapy
Aims to help individuals
-understand and accept difficult feelings
-learn skills to manage these feelings
-make positive changes in their life
Dialectical - means trying to understand how 2 things that seem opposite could both be true (accepting yourself and changing behaviour)
Treat any coexisting psychiatric conditions
