Personality Disorders Flashcards
What are the 6 broad criteria for personality disorders in the DSM?
- An enduring pattern of inner experience and behavior that differs from expectations of the culture
- enduring pattern is inflexible and pervasive across a broad range of situations
- leads to clinically significant distress or impairment
- pattern is of long duration and stable
- not form another mental disorder
- not due to a substance or general med condition
Why does discrimination tend to occur against those labeled with personality disorders?
especially by insurance and healthcare employees - they tend to over-use services
If a change in personality occurs in mid-life or later, what should you consider?
you really should just look for other med conditions or substance abuse - if found, diagnose with personality change due to gen med condition or unrecognized substance-related disorder
Is a personality disorder a first-step diagnosis or more of a diagnosis or exclusion?
exclusion - you really should diagnose only after all possible relevant disorders have been excluded
How are the personality disorders organized in the DSM?
into 3 clusters
cluster a: odd/eccentric
cluster b: dramatic, emotional, erratic
cluster c: anxious, fearful
What are the 4 cluster A personality disorders?
odd/eccentric: paranoid PD, schizoid PD, and schizotypal PD
Describe paranoid personality disorder.
characterized by a pervasive distrust and suspiciousness of others
Describe schizoid personality disorder.
pervasive pattern of DETACHMENT FROM SOCIAL RELATIONSHIPS, constricted range of emotional expression in interpersonal situations - has no desire to be close to people, takes pleasure in very few activities
Describe schizotypal personality disorder.
pervasive pattern of acute discomfort with and reduced capacity for close relationships as well as perceptual distortions and eccentric behavior
How are schizoid and schizotypal PD different?
schizoid: have no desire for relationships, schizotypcal: want, but are too anxious for personal relationships
What are the treatment toals for the cluster a PDs?
- social skills training to reduce isolation
- help person accept and adjust to a solitary lifestype
- treat obvious symptoms (like illusions with haloperidol)
What are the cluster B disorders?
dramatic, emotional, erratic: antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder
Describe antisocial personality disorder.
a pervasive disregard for and violation of the rights of others
What is the age limit for antisocial PD?
you have to be at least 18 (younger = conduct disorder)
Describe borderline personality disorder.
pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity - begins in early adulthood
What is the treatment mainstay for BPD?
dialectical behavior therapy (DBT)
what is DBT?
it involves individual and group therapy where you do skills training - mindfulness skills, interpersonal effectiveness skills, emotional modulation skills, and distress tolerance skills
Describe histrionic PD?
it’s excessive emoitonality and attention seeking beginning by early adulthood and present in a variety of contexts - like to be the center of attention, inappropriatley seductive, uses physical appearance to draw attention
Describe narcissistic PD?
pattern of grandiosity (fantasy and behavior), need for admiration, lack of empathy - begins in early adulthood
What are the 3 cluster C PDs?
the fearful/anxious ones: avoidant personality disorder, dependent personality disorder, and obessive-compulsive PD
Describe aboidant personality disorder.
pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation - avoids people like the plague
Describe a dependent personality disorder.
pervasive need to be taken care of - leads to submissiveness and clinging behavior. fears separation
Describe obsessive-compulsive personality disorder?
pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control at expense of flexibility, openness and efficiency
Why is obsessive-compulsive PD hard to treat?
because these patients don’t realize the problem is them - “if everyone just did things the right way, we’d be fine.”
What is counter-transference?
it’s the projections in the physician that distort perceptions and reactions to a particular patient - make the MDs feel “hooked”
