Personality Disorders

Question 1

Cluster A Disorders

Answer 1

Schizoid, Schizotypal and Paranoid

Patients seem eccentric, peculiar or withdrawn
Familial association with psychotic disorders.

WEIRD

Question 2

Cluster B Disorders

Answer 2

Anti-social, Borderline, Histrionic

Patients seem emotional, dramatic or inconsistent
Familial association with mood disorders.

WILD

Question 3

Cluster C Disorder

Answer 3

Avoidant, Dependent, Obsessive Compulsive (Personlaity Disorder, not true Obsessive Compulsive Disorder)

Patients seem anxious or fearful
Familial association with anxiety disorders.

WORRIED

Question 4

Personality

Answer 4

Ones set of stable, predictable, emotional and behavioral traits

Question 5

Personality disorder

Answer 5

Involve deeply ingrained, inflexible patterns of relating to others that are maladaptive

Question 6

What are patients with personality disorders prone to developing in times of stress ?

Answer 6

Axis I disorders

Question 7

DSM IV Criteria for Personality Disorders

Answer 7

Pattern of behavior/inner experience that deviates from the persons culture and is manifested in two or more of the following ways:

Cognition
Affect
Personal Relations 
Impulse Control
Not due to other mental illness r substance abuse

(CAPRI)

Question 8

Paranoid Personality Disorder

Answer 8

Pervasive Distrust and suspiciousness of others. Typically blame their problems on others and are typically angry and hostile. Pathologically jealous.

Begins by early adulthood and must have 4 of the following:

Suspicion that others are exploiting or deceiving him
Preoccupation with doubts of loyalty
Reluctance to confide in others
Interpretation of benign remarks as threatening or demeaning
Persistence of grudges
Fidelity issues with spouse

Higher in men than women (often associated with family hx of schizophrenia)

Tx is with psychotherapy but may respond to anti-anxiety meds or short course anti-psychotics

Question 9

Schizoid Personality Disorder

Answer 9

Lifelong hx of social withdrawal. Perceived as eccentric or reclusive. NO DESIRE FOR CLOSE RELATIONSHIPS

A pattern of voluntary social withdrawal and restricted range of emotional expression. Begins in early adulthood and presents in a variety of contexts

Does not enjoy or desire close relationships
Chooses solitary activities
Little or no sexual activity with others
Taking pleasure in few activities
Few close friends
Indifference to praise or criticism
Emotional coldness detachment or flattened affect

TX = Psychotherapy (2nd is low dose antipsychotics or antidepressants)

Question 10

Schizotypal Personality Disorder

Answer 10

Pervasive pattern of eccentric behavior and peculiar thought patterns. Perceived as strange and eccentric,

Ideas of reference
Odd beliefs or magical thinking
unusual perceptual experiences
Suspiciousness
Innapropriate affect
Odd or eccentric appearance
few close friends or confidants 
Odd thinking or speech 

Tx = Psychotherapy

Question 11

Antisocial Personality Disorder

Answer 11

Pattern of disregard for others and violation of the rights of others since age 15

Must be at least 18 to have this diagnose (otherwise it is called conduct disorder)
Failure to conform to social norms by committing unlawful acts
Deceitfulness/repeated lying, manipulation of others for personal gains.
Impulsivity/failure to plan ahead
Irritability and aggressiveness/repeated fights or assaults
Recklessness and disregard for safety of self or others
Irresponsibility/failure to sustain work or honor financial obligations
Lack of remorse for actions.

More prevalent in men (often concurrent with substance abuse)
Psychotherapy is generally INEFFECTIVE. Dialectical Behavior Therapy is best choice.

Question 12

CONDUCT

Answer 12

Symptoms of anti-social personality disorder

Capraciousness
Oppressive
Non-confrontational
Deceitful
Unlawful
Carefree
Temper

Question 13

Borderline Personality Disorder

Answer 13

Unstable mood, behaviors and INTERPERSONAL RELATIONSHIPS. Fear abandonment and have a poorly formed identity. Relationships form with INTENSE attachment and end at the slightest conflict. AGGRESSION common. PAST ATTEMPTS AT SUICIDE OR MUTILATION (rarely will a person with BPD succeed at suicide, typically done for attention). IMPULSIVE/DANGEROUS activity
Often use the defense mechanism of SPLITTING (someone is either all good or all evil)

Tx is with psychotherapy
Tx with pharm is usually to treat psychotic features or depression.

Question 14

IMPULSIVE

Answer 14

Borderline Personality Disorder moniker

Impulsive
Moody
Paranoid under stress
Unstable self image
Labile, intense relationships
Suicidal
Innapropriate anger
Vulnerable
Emptiness

Question 15

Histrionic Personality Disorder

Answer 15

Attention seeking behavior and excessive emotionality. Dramatic and flamboyant and extroverted but are unable to form long lasting meaningful relationships. Often sexually inappropriate and provocative.

5 of the following must be present:
Uncomfortable when not the center of attn
Innapropriately seductive or provocative behavior
Uses physical appearance to draw self attn
Has speech that is impressionistic and laking in detail
Theatrical and exaggerated expression of emotion
Easily influenced by others or situation
Perceived relationships as more intimate than they actually are.

More prevalent in women.

Tx is with Psychotherapy

Question 16

Narcissitic Personality Disorder

Answer 16

Pattern of grandiosity , need for admiration and lack of empathy beginning by early adulthood and present in a variety of context:

Exagerated self importance
Preoccupation with fantasy of unlimited money, success, brilliance
Belie vex that he or she is special or unique and can associate ply with high status individuals
needs excessive admiration
sense of entitlement
takes advantage of others for self gain
lacks empathy
envious of others believes other are envious of him or her.

Tx is psychotherapy

Question 17

Avoidant Personality Disorder

Answer 17

A pattern of social inhibition, hypersensitivity and feelings of inadequacy since early childhood. Seek jobs with little interpersonal interaction.Desire companionship but are extremely shy and easily injured

Question 18

Dependent Personality Disorder

Answer 18

Poor self confidence and fear of separation. They have an excessive need to be taken care of.
Five of the following must be present:
Difficulty making everyday decisions without reassurance from others
Needs others to assume responsibilities
Cannot express disagreement because of fear of loss or approval
Difficulty initiating projects due to lack of self confidence
Feels helpless when alone
Seeks relationships when one ends
Preoccupied with fears of being left to care of self

Question 19

Obsessive Compulsive PERSONALITY DISORDER

Answer 19

Pattern of preoccupation with orderliness, control and perfectionism at the expense of efficiency. Present in early adulthood . Appear stiff, serious, with constricted affect.

At least 4 of the following are present:
PReocupation with details, rules, lists and organizations such that the major point of activity is lost. 
Perfectionism that is detrimental to completion of task
Excessive devotion to work 
Scrupulousness about morals or ethics
Will not delegate tasks
Unable to discard worthless objects
Miserly
Rigid and stubborn

Mainly Men > Women

Question 20

Passive Aggressive Personality Disorder

Answer 20

Frequently Make excuses for themselves and lack assertiveness. Attempt to manipulate others to do their chores, errands and the like. Frequently Complain of their own misfortunes