Personality Disorders

Question 1

Describe Personality Disorder

Answer 1

Personality disorder covers a variety of maladaptive personality traits that cause significant psychosocial distress and interfere with functioning.
- characterised by pattern of thought, behaviour and emotion that differ from what is normally expected. It leads to difficult relationships, reduced quality of life and poor physical health.

Question 2

Borderline personality disorder (BPD) possible symptoms

Answer 2

• strong and intense emotions (e.g. anger)
• emotional instability (rapidly changing emotions)
• difficulty managing emotions
• difficult maintaining relationships
• poor sense of identity
• feelings of emptiness
• fear of abandonment
• impulsive and risk behaviour
• recurrent self-harm
• recurrent suicidal behaviours

Question 3

There are many different types of personality disorders based on the dominant features. In the DSM-5, they fall into three categories:

Answer 3

• Cluster A - suspicious
• Cluster B - emotional or impulsive
• Cluster C - anxious

Question 4

describe some cluster A (suspicious) personality disorders

Answer 4

• Paranoid personality disorder - features a difficulty in trusting or revealing personal information to others.
• Schizoid personality disorder - features a lack of interest or desire to form relationships with others and feeling that this is of no benefit to them.
• Schizotypal personality disorder - features unusual beliefs, thought and behaviours, as well as social anxiety makes forming relationships difficult.

Question 5

describe some cluster B (emotional and impulsive) personality disorders

Answer 5

• Antisocial personality disorder - features reckless and harmful behaviour, with a lack of concern for the consequences of impact of their behaviour on other people. Often involves criminal misconduct.
• Borderline personality disorder - features fluctuating strong emotions and difficulties with identity and maintaining healthy relationships.
• Histrionic personality disorder - involves the need to be the centre of attention and performing for others to maintain that attention.
• Narcissistic personality disorder - features feeling that they are special and need other to recognise this, or else they get upset. They put themselves first.

Question 6

describe some cluster C (anxious) personality disorders

Answer 6

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

Question 7

Personality disorder management

Answer 7

• risk management is important, considering short and long-term risks (e.g., ongoing self-harm, suicide and harm to others). MDT involvement.
• psychological treatment is the main treatment e.g. CBT, dialectical behavour therapy
• medications not recommended for long-term treatment. Sedative medications (e.g. sedative antihistamines) are sometimes used short-term (e.g. for less than one week) in a crisis. Personality disorders can co-exist with other psychiatric problems (e.g., depression), where medications may be beneficial.