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Disciplines Exam 1 > Personality Disorders 2 > Flashcards

Personality Disorders 2 Flashcards

1
Q

f•Tx of choice is individual psychotherapy

•Unlikely to seek tx unless under increased stress or pressure in life.

Tx usually short-term in nature until they have solved the immediate crisis or problem → patient will then likely terminate therapy

•Goals of tx are often solution-focused, using brief therapy approaches.

A

Tx for Schizoid PD

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2
Q
  • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
  • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
A

Antisocial PD

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3
Q

Does not occur exclusively during the course of:

  • schizophrenia
  • bipolar disorder or depressive disorder with psychotic features
  • another psychotic disorder
  • autism spectrum disorder
  • not attributable to the physiological effects of another medical condition.
A

Schizoid PD

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4
Q
  • Personality style → mercurial
  • Predominant theme → instability of interpersonal relationships, self-image, affects, and control over impulses
A

Borderline PD

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5
Q

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years

A

Antisocial PD

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6
Q
  • Impulsivity or failure to plan ahead.
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
  • Reckless disregard for safety of self or others.
A

Antisocial PD

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7
Q

•Because of the tendency to blame others, low tolerance for frustration, impulsivity and inability to form trusting relationships, working with these individuals is difficult.

A

Antisocial PD

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8
Q
  • Usually seek treatment for associated anxiety and depression rather than the PD
  • Over 50% admitted to clinical setting have a concurrent major depressive disorder
A

Schizotypal PD tx

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9
Q
  • Often react passively to adverse circumstances
  • Difficulty responding appropriately to important life events
  • Occupational functioning may be impaired, (particularly if interpersonal involvement is required)
  • may do well when they work under conditions of social isolation
A

Schizoid PD

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10
Q

Mnemonic for Antisocial PD

A

C – cannot follow law

O – obligations ignored

R – remorselessness

R – recklessness

U – underhandedness

P – planning deficit

T – temper

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11
Q
  • Frustration about patient’s misinterpretation of illness
  • Not wanting to connect with an odd and eccentric patient
A

Problematic behavior of provider caring for Schizotypal PD pt

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12
Q
  • Does not desire/enjoy close relationships (family)
  • Almost always chooses solitary activities
  • Little interest if any in sex
  • Pleasure in few activities
  • Lacks close friends other than 1st degree relatives
  • Indifferent to praise/criticism
  • Emotional coldness, detachment, flattened affect
A

Schizoid PD

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13
Q

Often present in to the Emergency Department (ED)

  • Utilize crisis hotline, or contact their therapist or treating provider directly
  • Caution with treating patient with this disorder in blind conjunction with another set of providers.
  • Every attempt should be made to contact the patients provider or primary therapist as soon as possible → ideally before the administration of medication
A

Tx for Borderline PD

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14
Q
  • Pervasive pattern of detachment from social relationships
  • Restricted range of expression of emotions in interpersonal settings
  • Beginning by early adulthood, present in variety of contexts
A

Schizoid PD

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15
Q
  • Inappropriate or constricted affect.
  • Behavior or appearance that is odd, eccentric, or peculiar.
  • Lack of close friends or confidants other than first-degree relatives.
A

Schizotypal PD

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16
Q

Schizoid PD Mnemonic

A

S – shows emotional coldness

O – omits close relationships

L – lacks close friends or confidants

I – involved in solitary activities

T – takes pleasure in few activities

A – appears indifferent to praise or criticism

R – restricted interest in sexual experiences

Y – yanks himself / herself from social relationships

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17
Q

Mnemonic for Borderline PD

A

A – abandonment

M – mood instability (marked reactivity of mood)

S – suicidal or self-mutilating behavior

U – unstable and intense relationships

I – impulsivity

C – control of anger

I – identity disturbance

D – dissociative or paranoid symptoms that are transient and stress related

E – emptiness

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18
Q
  • Respond with inappropriate anger when faced with unavoidable change
  • Frequent shifts of allegiance
  • Cannot tolerate being alone and will frantically search for companionship no matter how unsatisfactory
A

Borderline PD

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19
Q

Pharmacotherapy

  • SSRI Antidepressants → help to promote sense of well being and reduce depression, impulsiveness, rumination
    • Sertraline (Zoloft)
    • Fluoxetine (Prozac)
  • Mood stabilizerrs → help to modulate affective instability
    • Lamotrigine (Lamictal)
A

Tx for Borderline PD

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20
Q

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts

A

Borderline PD

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21
Q
  • Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
A

Borderline PD

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22
Q

There is overlap among which 3 things?

A
  • Antisocial PD
  • Psychopathy
  • Criminality
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23
Q

Mnemonic for schizotypal PD

A

M – magical thinking that influences behavior, superstitiousness or the paranormal

E – eccentric behavior or appearance

P – paranoid ideation

E – experiences unusual perceptions

C – constricted affect

U – unusual thinking & speech

L – lacks friends

I – ideas of reference

A – anxiety (socially)

R – rule out psychotic disorders

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24
Q

What is the difference between antisocial PD and antisocial behavior?

A

There IS a difference.

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25
Q
  • Overzealous attempts to connect with patient
  • Frustration at feeling unappreciated
A

Problematic behavior of provider treating schizoid pt

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26
Q
  • Try not to be turned off by patient’s odd appearance
  • Try to educate patient about the illness and its treatment
  • Do not become overly involved in trying to provide social support
A

Provider strategies for tx Schizotypal PD pt

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27
Q
  • Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.
  • Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder.
A

Schizotypal PD

28
Q
  • Help patient understand how they create their own problems and how their distorted perceptions prevent him from seeing themselves the way others view them
  • How to control behaviors
A

Cognitive behavioral therapy for Antisocial PD

29
Q
  • The individual is at least age 18 years.
  • There is evidence of conduct disorder with onset before age 15 years.
  • The occurrence of this type of behavior is not exclusively during the course of schizophrenia or bipolar disorder.
A

Antisocial PD

30
Q
  • May have difficulty expressing anger, even in response to direct provocation (contributes to the impression that they lack emotion)
  • May experience brief psychotic episodes in time of stress
  • Proverb interpretation is abstract
A

Schizoid PD

31
Q
  • Central feature is instability
  • Difficulty controlling anger
  • Feelings of chaos and emptiness
  • Thoughts of self-destruction
  • Marked impulsivity
A

Borderline PD

32
Q
  • Succumbing to patient’s manipulation
  • Angry, punitive reaction when manipulation is discovered
A

Problematic behavior of provider treating pt w/ Antisocial PD

33
Q

Individuals often appear dramatic, emotional, or erratic

  • Antisocial
  • Borderline
  • Histrionic
  • Narcissistic
A

Cluster B

34
Q
  • Mood and anxiety disorders, substance abuse disorders
  • Paranoid PD, schizotypal PD
A

Comorbid disordes or Borderline PD

35
Q
  • Irresponsible, impulsive, or dangerous health behavior, without regard for consequences to self or others
  • Angry, deceitful, or manipulative behavior
  • Often lack the motivation to improve and are notoriously poor self-observers → they simply do not see themselves as others do.
A

Problematic behavior of pt with Antisocial PD

36
Q
  • May delay care because of odd and magical beliefs about symptoms, may not recognize symptoms as a sign of illness
  • May appear odd and eccentric and paranoid toward others
A

Problematic behavior of Schizotypal PD pt

37
Q
  • Low dose antipsychotics
    • Risperidone (Risperdal)
    • Olanzapine (Zyprexa)
  • Long-acting anxiolytics for social anxiety
    • Clonazepam (Klonopin)
A

Tx for Schizotypal PD

38
Q
  • Lack of regard for society’s moral or legal standards and an impulsive and risky lifestyle
  • Irresponsible, impulsive, and deceitful
  • Lack a conscience, empathy, and remorse
A

Antisocial PD

39
Q
  • Can fool even the most experienced clinicians, appear composed and credible, but beneath the veneer there is tension, hostility, irritability and rage
  • Poor job performance, academic failure, illegal activities, impulsive behavior, reckless
A

Antisocial PD

40
Q

Psychotherapy has been the treatment of choice

  • Dialectical Behavior Therapy (DBT) – most effective
  • Schema focused therapy
  • Transference focused therapy
A

Tx for Borderline PD

41
Q
  • Personality style → adventurous / non-conforming
  • Predominant theme → disregard for and violating the rights of others, lying, stealing, defaulting on debts, neglect of children or other dependents
A

Antisocial PD

42
Q
  • Mistrust of providers and delay in seeking treatment
  • Intense fear of rejection and abandonment
  • Abrupt shifts from idealizing to devaluing caregivers; splitting
  • Self-destructive threats and acts
A

Problematic behavior of pt w/ Borderline PD

43
Q
  • Ideas of reference (excluding delusions of reference).
  • Odd beliefs / magical thinking that influences behavior and is inconsistent with subcultural norms (superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).
  • Unusual perceptual experiences, including bodily illusions (perceptual distortions)
  • Odd thinking and speech (vague, circumstantial, metaphorical, overelaborate, or stereotyped).
  • Suspiciousness or paranoid ideation.
A

Schizotypal PD

44
Q
  • See things differently from other people / seems impossible to relate to them
  • Odd beliefs, behavior, appearance, and interpersonal style
  • Unable to negotiate the full range of affects and interpersonal cuing required for successful relationships
A

Schizotypal PD

45
Q
  • Identity disturbance: markedly and persistently unstable self-image or sense of self.
  • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
A

Borderline PD

46
Q
  • Schizotypal PD → premorbid personality of patient with schizophrenia
  • Major depressive disorder (MDD), bipolar I and II disorders, social and specific phobias, post-traumatic stress disorder
  • Schizoid PD, borderline PD
A

Comorbid disorders of Schizotypal PD

47
Q
  • Carefully, respectfully investigate patient’s concerns and motives
  • Communicate directly; avoid punitive reactions to patient
  • Set clear limits in context of medically indicated interventions
A

Provider strategies for pts w/ Antisocial PD

48
Q

If criteria are met prior to the onset of schizophrenia, add “premorbid,” e.g., “______ personality disorder (premorbid).”

A

Schizotypal

49
Q
  • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  • Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
A

Borderline PD

50
Q
  • Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
  • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
A

Antiscocial PD

51
Q
  • Don’t get too close to patient
  • Schedule frequent periodic check-ups
  • Provide clear, nontechnical answers to questions to counter scary fantasies
  • Tolerate periodic angry outbursts, but set limits
  • Be aware of patient’s potential for self-destructive behavior
  • Discuss feelings with coworkers and schedule multidisciplinary team meetings
A

Provider strategies for Borderline PD

52
Q
  • Personality style → solitary
  • Predominant theme → detachment from social relationships and a restricted range of expression of emotions in interpersonal settings
A

Schizoid PD

53
Q
  • Succumbing to patient’s idealization and splitting
  • Getting too close to patient causing overstimulation
  • Despair at patient’s self-destructive behaviors
  • Temptation to punish patient angrily
A

Problematic behavior of provider tx patient / Borderline PD

54
Q
  • Chronic feelings of emptiness.
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  • Transient, stress-related paranoid ideation or severe dissociative symptoms.
A

Borderline PD

55
Q
  • May delay seeking care until symptoms become severe, out of fear of interacting with others
  • May appear detached and unappreciative of help
A

Pt w/ schizoid PD

56
Q

•Legal term, not a psychological concept

A

Criminal

57
Q
  • Personality style → idiosyncratic
  • Predominant theme →
    • social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships
    • cognitive or perceptual distortions and eccentric behavior
A

Schizotypal PD

58
Q

If criteria are met prior to the onset of ______, add “premorbid,” i.e., “_____ personality disorder (premorbid).”

A
  • Schizophrenia
  • Schizoid
59
Q
  • Rarely tolerates eye contact
  • Speech is goal-directed
  • Short answers to questions
  • Avoid spontaneous conversation
A

Schizoid PD

60
Q

A pervasive pattern of social and interpersonal deficits marked by:

  • acute discomfort w/ or reduced capacity for, close relationships
  • cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts
A

Schizotypal PD

61
Q
  • Major depressive disorder (MDD), anxiety disorders, schizophrenia*, delusional disorders
  • Paranoid PD, schizotypal PD, avoidant PD
A

Comorbid disorders of Schizoid PD

62
Q

Severe aggression

  • Antipsychotics (1st line)
    • Risperidone (Risperdal)
    • Olanzapine (Zyprexa)
  • SSRI Antidepressants (2nd line)
    • Sertraline (Zoloft)
    • Fluoxetine (Prozac)
A

Tx for Antisocial PD

63
Q

•Conduct disorder*, social phobia, generalized anxiety disorder, substance abuse disorders

A

Comorbid disorders for Antisocial PD

64
Q

•Illegal or immoral behavior such as stealing, lying, or cheating

A

Antisocial behavior

65
Q

Provider strategy for which disorder?

  • Appreciate need for privacy / maintain a low-key approach
  • Focus on technical elements of tx (better tolerated)
  • Encourage pt to maintain daily routines
  • Do not become overly personally involved or too zealous in trying to provide social supports
A

Schizoid PD

Disciplines Exam 1 (13 decks)

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