Personality Disorders

Question 1

constellation of motivations, beliefs, and interpersonal behaviors

helps organize behavior in response to stress

Answer 1

personality

Question 2

enduring pattern of maladaptive traits that are inflexible and pervasive that case significant distress or impairment

Answer 2

personality disorder

onset usually in adolescence

Question 3

3 cluster A: odd, eccentric

Answer 3

paranoid
schizoid
schizotypal

*seen among relatives of schizophrenia

Question 4

4 cluster B: dramatic, emotional

Answer 4

antisocial
borderline
histrionic
narcissistic

Question 5

3 cluster C: anxious, fearful

Answer 5

avoidant
dependent
obsessive-compulsive PD

Question 6

Cloninger neurobiological model’s 3 dimensions of temperament

4 dimensions of character

Answer 6

novelty seeking (DA)
reward dependence (NE)
harm avoidance (5HT)

persistence
self-directedness
cooperativeness
self-transcendence

Question 7

five-factor model (CANOE)

Answer 7

extraversion
agreeableness
neuroticism (5HT transporter abnormality)
openness to experience
conscientiousness

Question 8

impulsivity/aggression assoc with abnormalities in fxn of which NT?

Answer 8

serotonin

Question 9

physical/sexual abuse assoc w?

childhood maltreatment assoc w?

Answer 9

BPD

antisocial PD

Question 10

cannot make dx of personality d/o during when?

Answer 10

acute presentation of another psychiatric d/o

Question 11

medical conditions that cause a change in personality

Answer 11

neoplasia
TBI
infection
endocrine
autoimmune
epilepsy
cerebrovascular
neurodegenerative (alzheimer's/Huntington's)

Question 12

effects to which two areas of brain are linked to personality d/o’s?

Answer 12

frontal/temporal lobes

Question 13

pervasive distrust/suspiciousness of others, that their motives are interpreted as malevolent

similar presentation to delusional d/o

Answer 13

paranoid personality d/o

Question 14

pervasive detachment from social relationships and restricted range of expression of emotions

socially isolated by choice

Answer 14

schizoid personality d/o

Question 15

sx include ideas of reference, odd beliefs, unusual perceptions, odd thinking/speech/behavior, suspiciousness or paranoia, iappropriate/constricted affect, lack of close friends, social anxiety

Answer 15

schizotypical personality d/o

3% prevalence

Question 16

disregard for and violation of rights of others, lack of empathy, truancy, fire-setting, cruelty to animals; these folks will have met criteria for which d/o during childhood?

Answer 16

antisocial PD
conduct d/o: aggression to people/animals, destruction of property, deceitfulness or theft, violations of rules

higher rates of suicide and accidents, criminality, domestic violence
chronic, 10% remission over 30y

Question 17

criteria for APD

Answer 17

A. disregard for/violation of rights of others, since age 15 via 3+ of: conform, deceitfulness/lying, impulsivity, irritability/aggressiveness, disregard for safety, irresponsibility, lack of remorse/indifference of hurting another
B. >18yo
C. conduct disorder before age 15
D. behavior not exclusive to schizo/bipolar

Question 18

arising in individuals with high emotional vulnerability exposed to an invalidating environment during childhood: non-responsiveness, att to control emotions, rejection of emotions

Answer 18

borderline PD
(F:M 3:1)
10% complete suicide
1/2 remit 10 years after initial dx

Question 19

BPD criteria

Answer 19

Instability of relationships. self-image, affects, impulsivity w/5+ of: 1) avoid abandonment, 2)idealization/devaluation of relationships, 3) identity disturbance (self-image), 4) impulsivity in self-damaging, 5) suicidal/self-mutilating behavior, 6) unstable affect, 7) emptiness, 8) anger, 9) stress-related paranoid ideation

Question 20

excessive emotionality/attention seeking; uncomfortable in situations when not center of attention; rapidly shifting emotions; physical appearance to draw attention; theatrical/dramatic; easily influenced

Answer 20

histrionic PD

Question 21

grandiosity; need for admiration; lack of empathy; egotistical; manipulative of others to achieve own aims

Answer 21

narcissistic PD

Question 22

social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation, socially isolated, don’t desire human contact BECAUSE of fear of embarrassment (unlike schizoid)

Answer 22

avoidant PD

overlaps with social phobia

Question 23

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

Answer 23

dependednt PD

Question 24

perfectionistic, orderliness and details, inflexible, stubborn, overly conscientious; but are pervasive, present in most situations and interfere w fxn

Answer 24

obessive-complusive PD

Question 25

OCPD distinguished from OCD by?

Answer 25

level of insight

OCD folks find sx disturbing (dystonic)

Question 26

personality change in mid/late life indicates?

common sx?

Answer 26

medical etiology
affective instability, poor impulse control, outbursts of aggression or rage, marked apathy, suspiciousness, paranoid ideation

Question 27

tx for personality d/o?

Answer 27

dialectical behavioral therapy: 1x/wk for a yr (validation, mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness skills)

antidepressants for dysphoria/anxiety
antipsychotics for dissociative/psychotic sx
anticonvulsants for mood instability/impulsivity
AVOID BZDs (cause disinhibition and abuse)
NO TCA’s due to overdose risk

Question 28

recommend interpersonal tx approach:
dependent:clinging
O-C:insistence on rules/standards
paranoid:accusations/attacks
narcissistic:entitled/puts down others
histrionic:theatrical/charming
antisocial:exploits others
borderline:idealizing/devaluating

Answer 28

limit-setting, reassurance
logical suggestions
acknowledgement of fears/encouragement
collaboration
consistent/stabilzing responsiveness
limit-setting/legal backup
validating, limit setting