Personality Disorders

Question 0

Key features of personality disorders

Answer 0

Enduring, highly chronic, not diagnosed before the age of 18

Question 1

A personality disorder is…

Answer 1

An enduring maladaptive pattern for relating to the environment and self, exhibited in a range of contexts

Rigid in inward experiences and outward behavior

Question 2

General PD stats

Answer 2

Rare in the general pop, but quite common in inpatient settings
0.5-2.5% compared to 10-30%

Question 3

Cluster A

Answer 3

Odd or eccentric

Paranoid, schizoid, schizotypal

Question 4

Cluster B

Answer 4

Dramatic, emotional, erratic

Antisocial, borderline, histrionic, narcissistic

Question 5

Cluster C

Answer 5

Anxious or fearful

Avoidant, dependent, obsessive-compulsive

Question 6

Paranoid personality disorder

Answer 6

A pervasive distrust and suspiciousness of others such that their moments are interpreted as malevolent

2.3-4.4%

Question 7

PPD causes and treatments

Answer 7

Genetic, maladaptive cognitive patterns

Rarely receive treatment, therapy is thwarted by their distrust of the therapist

Question 8

Schizoid PD

Answer 8

Pervasive pattern of detachment from social relationships and a restricted range of expression in emotions in interpersonal settings, usually chooses solitary settings, appears indifferent, shows emotional coldness

Question 9

Schizoid stats, treatment

Answer 9

3.1-4.9%
More common and severe in males

Treatment focuses on building social and emotional skills

Question 10

Causes of Schizoid PD

Answer 10

High rates of childhood abuse and neglect, may be genetically related to autism and schizophrenia

Question 11

Schizotypal PD

Answer 11

Pervasive pattern of social and interpersonal deficits marked by acute discomfort with close relationships, as well as cognitive or perceptual distortions or eccentricities of behavior

0.6-4.6%

Question 12

Schizotypal PD treatment and causes

Answer 12

Brain abnormalities, high dopamine, enlarged ventricles, loss of grey matter

Multimodal treatments: antipsychotic meds plus social skills training

Many have MDD that brings them in

Question 13

Avoidant PD

Answer 13

Pervasive patter of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation

2.4%

Question 14

APD characteristics

Answer 14

Extreme sensitivity to the opinions of others, fear of rejection, few interpersonal relationships, careful planned expressions, specific fear of relationships

Question 15

Avoidant PD causes and treatment

Answer 15

May be linked to social anxiety disorder, early experiences in rejection, neglect, isolation, lack of affection

Behavioral interventions, reduction in anxiety, building social skills

Question 16

Dependent PD

Answer 16

Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation

0.49-0.6%

Question 17

Dependent PD causes and treatment

Answer 17

Disruption of socialization process of becoming more independent, early attachment issues

Emphasis on building self confidence, assertiveness, challenging negative thoughts, may become dep. on therapist

Question 18

OCD PD

Answer 18

Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency

2.1-7.9%

Question 19

Common Comorbidities with OCD PD

Answer 19

MDD, generalized anxiety disorder, substance use

Question 20

OCD PD causes and treatment

Answer 20

History of difficulty asserting control and independence, series of illogical thinking processes

Rarely seek treatment, relaxation techniques, CBT, possibly SSRIs

Question 21

Histrionic PD

Answer 21

Pervasive pattern of excessive emotionality and attention seeking

1.84%

Question 22

Histrionic PD Characertistics

Answer 22

Provocative behavior, uncomfortable when not the center of attention, shall expression of emotions, dramatic, easily upset when criticized, may be manipulative

Question 23

Histrionic PD Causes and Treatment

Answer 23

Unhealthy caregiver relationships, abandonment, suggestibility and shallowness

Seek treatment willingly, change belief of helplessness, increase thinking and problem solving abilities

Question 24

Narcissistic PD

Answer 24

Pervasive pattern of grandiosity, need for admiration, and lack of empathy, sense of self importance, fantasies of power and success, arrogant and haughty
0.1-6.2% mostly male

Question 25

Narcissistic PD Causes and Treatment

Answer 25

Caregivers relating TOO positively, lack of modeling of empathy

CBT for building empathy, connections with others, interpretation of citicism

Question 26

Antisocial PD

Answer 26

Pervasive pattern of disregard for and violation of the rights of others occurring since the age of 15, failure to conform to norms, aggressiveness, lack of remorse
0.2-3.3%

Question 27

Psychopathy

Answer 27

Manifestations of amoral and antisocial behavior, lack of ability to love or establish meaningful personal relationships and extreme egocentricity

Question 28

Sociopathy

Answer 28

Indicative of having a sense of morality and a well-developed conscience, but the sense of right and wrong is not that of the parent culture

Question 29

ASPD causes

Answer 29

Modeling, imitation, lack of a theory of mind, low serotonin, frontal lobe dysfunction, low levels of anxiety, gene and environment interaction

Question 30

ASPD treatment

Answer 30

Rare and ineffective, highly manipulative of the therapist, focus on development of morals, identifying the needs of others, and emotional expression

Question 31

Borderline PD

Answer 31

Pervasive pattern of instability of interpersonal relationships, self image, and affects, marked by impulsivity, frantic efforts to avoid abandonment

1.6-5.9%

Question 32

BPD Causes

Answer 32

Childhood loss, trauma, instability, over active amygdala, under active prefrontal cortex, low serotonin, development of intrinsic difficulties

Question 33

BPD Treatment

Answer 33

Often seek treatment, medications modestly effective, best is dialectical behavioral therapy

Question 34

Dialectical Behavioral Therapy

Answer 34

Marsha Linehan, very intensive treatment, teaches distress tolerance, mindfulness, emotion regulation, interpersonal effectiveness, reduces suicidality, decreases hospitalization