Personality Disorders Flashcards
Personality disorder - population?
NOT under the 18yo (b/c the brain is still growing and developing)
Personality disorder?
enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture and affects life
Personality disorder -before dx?
LONG TERM PATTERNS- multiple interview
EARLY adulthood
cautious of 3rd party info
Personality disorder - dx?
pattern of two or more areas: -cognition: ways of perceiving and interpreting self and others -affectivity -interpersonal fxning -impulse control pattern is INFLEIBLE and PERSVASIVE distress in life pattern is STABLE 18+yo
Personality disorder - etiology?
genetics
cultures
environmental factors: foster care, large family
Personality disorder - 3 clusters?
Cluster A, B, and C
Personality disorder - Cluster A?
paranoid
schizoid
schizotypal
Personality disorder - Cluster B?
antisocial
narcissistic
borderline
histrionic
Personality disorder - Cluster C?
avoidant
obsessive
dependent
Other specified PD and unspecified?
personality change d/ to another medical condition
PD - Paranoid personality disorder?
cluster A
Paranoid PD - dx?
4+: SUSPECT Spousal infidelity suspected Unforgiving Suspicious Perceives attacks Enemy or friend binary Confiding in other is feared Threats perceived in benign events
Paranoid PD - prevalence?
males > females
70 yr male, war veteran
hx of chronic back and knee pain (war) + fibromyalgia
emotional, psychological and physical abuse in childhood
alienated family and friends d/t lack of trust
demanding of friends and family
self sufficient and active
unable to calm down - uses drugs
paranoid PD
Paranoid PD?
blame on others
outside party feels “walking on egg shells”
suspicious
distrust
Schizoid PD?
detachment from social relationships AND restricted range of expression of emotions in interpersonal settings
Schizoid PD - dx?
4+: DISTANT Detached affect Indifferent to criticism or praise Sexual experience of little interest (sex w/self - not with others) Tasks performed solitarily Absence of close friends Neither desires nor enjoys close relations Takes pleasure in few activities
Schizoid PD - discriminating feature?
socially indifferent
lack social skills and lack of desire for sexual experiences
Schizoid PD - comorbid?
autsim
33 male
no hx of romantic relationships, only family
childhood - isolation, friendless
no motivation to seek friends, get good grades, career goals
Schizoid PD
Schizotypal PD?
cognitive or perceptual distortions and eccentricities of behavior
“magical thinking”
salad words
“ODD”
Schizotypal PD - dx?
5+: ME PECULIAR Magical thinking/odd beliefs Experiences unusual perceptions Paranoid ideation Eccentric behavior or appearance Constricted/inappropriate affect Unusual thinking and speech Lack close friends Ideas off reference Anxiety in social situation Rule out psychotic disorder
Schizotypal PD - discriminating features?
eccentric
how they cope w/ stress
31 female
OCD sx to pandas
magical and eccentric thinking in childhood
no hx of pervasive developmental disorders
lives alone
wars specific articles of clothing to act as “barrier” to others in public
rich and detailed fantasy life
Schizotypal PD
Antisocial PD?
pervasive pattern of disregard of AND violation of the rights of others
MUST have CONDUCT DISORDER @ 15 yo - but must be 18yo
Conduct disorders @ 16yo?
OTHER specific
Antisocial PD -dx?
3+: CORRUPT Conformity to law is lacking Obligations ignored Reckless disregard for safety of self or others Remorseless underhanded Planning insufficient (impulsive) Temper
Antisocial PD - discriminating features?
disagreeable callous deceitful lack empathy selfish
Antisocial PD - prevalence?
male > female
27 yo male
hx of conduct disorder, acting out (arson, car theft), drug seeking
quick tempered
attempted to manipulate staff in hospital
Antisocial personality disorder
Borderline personality disorder?
instability of interpersonal relationships, self-image and affects
frantic, desperate, dramatic presentation
threats of suicide, self mutilating behavior (now called: non suicide self injury)
Borderline personality PD- dx?
5+ I DESPAIRR:
Identity disturbance
Disordered, unstable affect
Emptiness is chronic
Suicidal behavior, gestures, and/or threats
Paranoid ideation can be transient, stress-related
Avoids abandonment
Impulsivity
Rage is inappropriate and intense
Relationships are unstable, intense extreme
Borderline PD - prevalence?
women > male
Borderline PD - discriminated feature?
unstable self-image/sense of self
self destructive
suicidal behavior
attention seeking
Borderline PD - comorbid?
eating disorders
Borderline PD - ddx r/o?
hypomanic
depressive
manic
38 male
no hx dx
significant hx of childhood emotional, psychologicalc, physical, sexual abuse
relationships characterized by instability
hx of suicide attempts
Borderline PD
Histrionic PD?
pattern of excessive emotionality and attn seeking
sexually seductive or provocative behavior
Histrionic PD - discriminating feature?
attention seeking
seek to control romanic partners through emotional manipulation
romantic relationships characterized by lack of emotional intimacy
will dress seductively or extravagantly, often inappropriate for setting
Histrionic PD - dx?
5+ PRAISE ME: Provocative behavior Relationships considered more intimate than really are Attn seeking Influenced easily Speech affected Emotions rapidly shift and are shallow Manipulative
Histrionic PD vs antisocial PD?
histrionic: attn seeking
antisocial: profit, power, material gain
30 bisexual female
complains of abdominal pain
presents in revealing, provocative clothing
idealization of providers and dismissive of support staff
significant hx of childhood/adolescent emotional, psychological and sexual abuse
romantic relationships: little emotional intimacy and/or domestic violence
Histrionic PD
Narcissistic PD?
grandiosity need for admiration lack of emphty superficial beginning by early audlthood
Narcissistic PD - dx?
5+ SPEECIAL: Special Preoccupied with fantasies of success and power Envious Entitled Excessive need for admiration Conceited Interpersonally exploitive Arrogant Lack of empathy
Narcissistic PD - discriminated feature?
self-centered entitled grandiose expect others to agree w/ them and go alone w/t their desires/plans lack empathy
Narcissistic PD - prevalence?
male > female
Histrionic PD vs Narcissistic PD?
excessive pride in achievements
Borderline PD vs Narcissistic PD?
relative stability of self-image, lack of self-destructiveness
Avoiddant vs Social phobia?
avoidant:
-inhibited
-avoid ANY opportunity to be neg evaluated
-suspicious of compliments
social phobia:
-avoid performance situations and social interactions
-estabilsh and maintain close interpersonal relationships w/select others
Avoidant PD - dx?
4+ CRINGES: Certainty of being liked required Rejection-phobic Intimacy is avoided New relationships are avoided Gets around interpersonal contact Embarrassment is expected, prevents new activities Self viewed as inept, inferior, unappealing
Avoidant PD - comorbid?
panic disorder w// agoraphobia
35 gay man computer programmer
hx of social phobia
interpersonal distant - avoids eye contact
anxious in social settign: clammy palms, tightness in chest, flush easily, freezes when noticed
avoid intimate social gathering
anxious about medical appointments due to fear of being criticed or negaitve eval
Avoidant PD
Dependent PD?
submissive and clinging behavior and fears of separation
Dependent PD - prevalence?
female > male
Dependent PD - dx?
5+ RELIANCE: Require reassurance and advice Expressing disagreement is difficult Life responsibilities are assumed by others Inability to initiate projects Avoid being alone Nurturance is ultimate goal Companionship sought urgently Exaggerated fears of being left to care for self
Dependent PD - discriminating feature?
submissive
clinging behaviors
intense fear of seperation from care givers
timid and afraid to disagree/disapprove of others opinions or actions
58 female
hx dx: panic disorder w/ agoraphobia
refuses to be alone w/out husband or son
husband and son assume majority of responsibility for her care taking
intense and unrealistic fear of abandoment, chronic care seeking inappropriate for developmentla dn chronological age
Dependent PD
Obsessive compulsive PD?
preoccupation with orderliness, perfectionism and mental interpersonal control
OCPD- discriminated feature?
perfectionistic
preoccupie w/ orderliness and mental and interpsonal control
rigid maintenance of rituals, schedules
OCPD-dx?
4+ LAW FIRMS: Loses sight of greater pic d/t rules and details Ability to complete tasks Worthless objects retained Friends and leisure << WORK Inflexible Reluctant to delegate Miserly Stubborn
OCPD vs narcissistic PD?
NPD: achieved perfectionism
OCPD: more self critical in striign to obtain and maintain perfectionism
OCPD vs OCD?
OCD: true obsessiona dn compulsoins and should be considered when hoarding is extreme
65 male type A personality numerous car accidents due to distraction by min details while driving hx of nervous breakdown hoards money (but not poor) rigid routine
OCPD
Personality change d/t another medical condition?
d/t medical condition (primary)
Other specified PD & Unspecified PD?
Other: -full criteria for ANOTHER PD NOT met Unspecified PD? -full criteria for another PD not met and clinician does not indicate specific reason -not enough info
“Others are untrustworthy and they try to take advantage of me”
paranoid PD
“I’d like to have friends but its hard b/c people find me pretty strange”
schizotypal PD
“I enjoy taking advantage of people and I never feel bad”
antisocial PD
“I need people desperately and fall apart completely when they reject me”
borderline PD
“I’m emotional and sexually charming person and I need to be the center of attn!”
histrionic PD
“I’m talented and special and I get angry and depressed when ppl don’t recognize me”
narcissistic PD
“I’m really afraid of what people will think of me so I avoid making new friends”
avoidant PD
“I’m passive and dependent on other and I go far out of my way to please those who are important to me”
dependent PD
“I’m perfectionist, I keep lists, drive myself hard, and I’m very serious about life”
OCPD
