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Psychiatry > Personality disorders > Flashcards

Personality disorders Flashcards

1
Q

Cluster A

A

schizoid, schizotypal, paranoid

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2
Q

Cluster B

A

antisocial, borderline, histrionic, narcissitic

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3
Q

Cluster C

A

avoidant, dependent, OCPD

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4
Q

histrionic

A

cluster B

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5
Q

schizotypal

A

cluster A

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6
Q

OCPD

A

cluster C

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7
Q

antisocial

A

cluster B

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8
Q

borderline

A

cluster B

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9
Q

schizoid

A

cluster A

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10
Q

paranoid

A

cluster A

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11
Q

avoidant

A

cluster C

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12
Q

narcissistic

A

cluster B

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13
Q

dependent

A

cluster C

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14
Q

What do most patients with personality disorders lack?

A

INSIGHT about their problem; their symptoms are ego-syntonic and viewed as immutable

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15
Q

4 diagnostic criteria of personality disorder

A 
CAPRI
Cognition
Affect
Personal Relations
Impulse control
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16
Q

cluster A personality disorders have a familial association with which psychiatric disorder?

A

psychotic disorders

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17
Q

cluster B personality disorders have a familial association with which psychiatric disorder?

A

mood disorders

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18
Q

cluster C personality disorders have a familial association with which psychiatric disorder?

A

anxiety disorders

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19
Q

DSM diagnosis of paranoid personality disorder

A

pervasive distrust and suspiciousness of others

4 of the following:

  • suspicion without evidence
  • preoccupation with doubts of loyalty or trustworthiness
  • reluctance to confide in others
  • holds grudges
  • inteprets benign remarks as threatening or demeaning
  • perception of attacks on his/her character that are not obvious to others
  • pathologically jealous (of their sexual partners/spouses)
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20
Q

What 4 prominent personality trait characterizes paranoid personality disorder?

A

suspiciousness
intimacy avoidance
hostility
unusual beliefs

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21
Q

common defense mxn people with paranoid personality disorder use

A

projection

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22
Q

DSM diagnosis of schizoid personality disorder

A

voluntary social withdrawal and restricted affect

4 of the following

  • no enjoyment/desire for close relationships
  • solitary activities
  • little interest in sexual activity with another person
  • pleasure in few activities
  • few close friends or confidants
  • indifferent to praise/criticism
  • restricted affect
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23
Q

How is schizoid personality disorder different from avoidant personality disorder?

A

schizoid - prefers to be alone; loneliness is egoSYNtonic

avoidant - strongly desires relationships with others, but afraid to reach out; loneliness is egoDYStonic

24
Q

DSM diagnosis of schizotypal personality disorder

A

pattern of social deficits marked by a pervasive pattern of eccentric behavior and peculiar thought patterns

5 or more must be present

  • ideas of reference
  • odd beliefs/magical thinking inconsistent with norms
  • odd/eccentric appearance or behavior
  • perceptual experiences
  • suspiciousness
  • restricted affect
  • excessive social anxiety
  • few close friends/confidants (due to discomfort w/ close relationships)
25
Q

Schizotypals may experience some magical thinking - what are some experiences

A

belief in

  • clairvoyance or telepathy
  • bizarre fantasies or preoccupations
  • superstitions
26
Q

fill in the blank: there is a greater prevalence of Schizotypal disorder in relatives of patients with ______

A

schizophrenia

27
Q

prognosis of patients with schizotypal personality disorder

A

chronic course; may develop schizophrenia

28
Q

treatment for schizotypal personality disorder - 2

A

psychotherapy - help patients develop social skills

low-dose antipsychotic - for transient psychosis, which can happen under stress, or help decrease social anxiety and suspicion in interpersonal relationship

29
Q

DSM diagnosis of schizotypal personality disorder

A

pattern for disregard for others/violation for right of others
>18 with a history of conduct disorder

3 of the following

  • failure to conform to societal norms (breaking law)
  • repeatedly lies + manipulates others for personal gain
  • impulsive/failure to plan ahead
  • irritable/aggressive
  • irresponsible
  • recklessness/disregard for safety
  • lack of remorse
30
Q

patients with antisocial personality disorder are frequently comorbid with what two psychiatric disorders

A

substance abuse
MDD
multiple somatic complaints

31
Q

treatment for patients with antisocial personality disorder

A

DBT (same for borderline)

32
Q

DSM diagnosis of borderline personality disorder

A

unstable mood, behaviors, interpersonal relationships; fear abandonment, have poorly formed identity

5 of the following

  • desperate attempts to avoid real/imagined abandoment
  • unstable, intense relationships
  • unstable self-image
  • impulsive (spending, sex, substance use, binge eating)
  • recurrent SI/attempts, self-mutilation
  • unstable mood/affect
  • feelings of emptiness
  • trouble controlling anger
  • paranoid ideation/dissociative sx with stress
33
Q

What 3 things are borderline patients known for?

A

increased risk of suicide (often because patients will make suicide gestures and kill themselves by accident)
brief psychotic episodes (under stress)
depression

34
Q

where does the borderline name come from?

A

the name comes from the patient being on the borderline of NEUROSIS and PSYCHOSIS

35
Q

4 common defense mechanism seen in borderline patients

A

splitting
idealization
devaluation
projection

36
Q

when borderline patients are under stress, what can happen?

A

they can experience transient psychotic symptoms

37
Q

treatment for borderline patients

A

DBT (same for antisocial patients)

38
Q

DSM diagnosis of histrionic personality disorder

A

excessive emotionality and attention seeking

5 of the following

  • uncomfortable when not the center of attn
  • seductive/provocative behavior
  • uses physical appearance to draw attention to self
  • impressionistic speech that is lacking in detail
  • theatrical, exaggerated emotions
  • easily influenced by others or situation
  • sees relationships as more intimate than they actually are
39
Q

common defense mechanism seen in histrionic patients

A

dissociation

repression

40
Q

DSM diagnosis of narcissitic personality disorder

A

sense of superiority/grandiosity, need for admiration, lack of empathy

5 or more of the following

  • exaggerated sense of self-importance
  • preoccupation with unlimited $$, success, brilliance
  • belief that one is unique/special
  • entitled
  • needs excessive admiration
  • takes advantage of others for self-gain
  • lacks empathy
  • envious of others/believes others are envious of him
  • arrogant
41
Q

What is the one thing that patients with narcissistic personality disorder do not handle well

A

AGING because of they value beauty, strength, youth

42
Q

3 common defense mechanism seen in narcissistic patients

A

devaluation of others
idealization of self
denial

43
Q

treatments for narcissistic patients

A

psychotherapy
group therapy - may help patients learn empathy
antidepressants - for depressive sx
lithium - for affective lability

44
Q

DSM diagnosis of avoidant personality disorder

A

pervasive pattern of social inhibition and intense fear of rejection such that they will avoid situations in which they will be rejected; desire companionship but are extremely shy and easily injured

at least 4 criterias

  • avoids or is cautious of interpersonal contact due to fear/preoccupation of criticism or rejection
  • unwilling to interact unless certain of being liked
  • inhibited in new social situations bc he/she feels inadequate
  • believes that he/she is socially inept and inferior
  • reluctant to engage in new activities for fear of embarassment
45
Q

how do patients with avoidant personality disorder differ than schizoid patients?

A

avoidant: desires companionship but extremely shy
schizoid: no desire for companionship

46
Q

how do patients with avoidant personality disorder differ than patients with social phobia?

A

avoidant: overall fear of rejection and sense of inadequacy

social phobia: fear of embarrassment in a particular setting

47
Q

how do patients with avoidant personality disorder differ than patients with dependent personality disorder?

A

avoidant: slow to get involved for fear of rejection
dependent: actively and aggressively seek relationships because they are afraid to function on their own

48
Q

patients with avoidant personality disorder are frequently comorbid with what 3 psychiatric symptoms?

A

depression
anxiety
anger

49
Q

Treatment for patients with avoidant personality disorder?

A

psychotherapy

ß blockers and SSRIs - control autonomic sx of anxiety

50
Q

Why do you want to avoid benzos in patients with avoidant personality disorder?

A

high potential for habit-formation

51
Q

common defense mechanism seen in avoidant patients?

A

regression (going back to a younger age of maturity)

52
Q

a

A

Poor self confidence and fear of separation; excessive need to be taken care of - feels helpless when left alone; requires others to make decisions for them

5 of the following:

  • difficulty making decisions on a daily basis
  • needs others to assume responsibility for their life
  • does not express disagreement b/c of fear of loss of approval
  • goes to extreme lengths to obtain support from others
  • feels helpless when left alone
  • serial dater - can’t be left alone
53
Q

patients with dependent personality disorder are prone to this psychiatric condition

A

depression - esp after the loss of a person whom they are dependent

54
Q

How should a physician handle a patient with dependent personality disorder

treatment?

A

schedule limited, but regular appointments with them, since they tend to be less proactive about their care

psychotherapy (groups and social skills training)

55
Q

DSM diagnosis of dependent personality disorder

A

pervasive pattern of perfectionism, inflexibility, and orderliness (but ø obsessions and compulsions) at the expense of efficiency

4 of the following:

  • preoccupation with details, rules, lists, organization
  • perfectionism at the expense of efficiency
  • excessive devotion to work/moralistic about other’s work habits
  • can’t delegate tasks
  • cheap and hoarder-like
  • rigid and stubborn
56
Q

∆ btwn OCD and OCPD

A

OCD: (+) obsessions & compulsions, egoDYStonic

OCPD: (-) obsessions and compulsions, egoSYNtonic

57
Q

∆ btwn Narcissistic PD and OCPD

A

both involve assertiveness and achievement

Narcissistic PD - motivated by status

OCPD - motivated by the work itself

Psychiatry (12 decks)

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