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BM: Unit 4 > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

Define personality disorder

A
  1. Enduring pattern of inner experience and behavior

A. Cognitive, emotional, interpersonal, and behavioral components
B. Leads to distress or impairment
C. Pervasive and inflexible
D. Onset in adolescence or early adulthood and stable over time

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2
Q

What is the repetition compulsion?

A
  1. Freud noticed that people tend to repeat the same pattern of interactions over and over again. The more severe the personality disturbance, the more rigid, repetitive, and stereotypical these interactional patterns become.
  2. So, for example, someone with obsessive compulsive personality disorder is likely to repeatedly get into control struggles and be judgmental of others in relationships, and will do this over and over again, regardless of circumstance.
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3
Q

What are Wilheim Reich’s 4 personality character types?

A
  1. Narcissistic
  2. Compulsive
  3. Hysterical
  4. Masochistic
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4
Q

What is Reich’s narcissistic personality?

A

Narcissistic character was described as contemptuous and grandiose, essentially describing persons who overvalue themselves relative to other people. On the other end of the spectrum, masochistic character is described as long-suffering, complaining, self-deprecatory, and dependent, undervaluing themselves relative to other persons.

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5
Q

What is Reich’s compulsive personality?

A

Compulsive character is described as controlled, decisive, and distrustful, essentially displaying an over control of their instincts, emotions, and behaviors, and a need for perfection. Opposite this is hysterical character, described as seductive, anxious, and dramatic, displaying under control over their instincts, emotions, and behaviors

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6
Q

What is the DSM-V Cluster A disorders?

A
  1. Paranoid, Schizoid, Schizotypal

A. Cluster A disorders are characterized by psychotic-like thinking and mannerisms.

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7
Q

What is the DSM-V Cluster B disorders?

A
  1. Antisocial, Histrionic, Narcissistic, Borderline

A. Cluster B disorders tend to be associated with poorly controlled, impulsive behaviors and unstable mood.
B. They also tend to engender the most dread among doctors and induce very strong emotional reactions within us.

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8
Q

What is the DSM-V Cluster C disorders?

A
  1. Avoidant, Dependent, Obsessive-Compulsive

A. Cluster C disorders are characterized by anxiety.

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9
Q

What are the characteristics of paranoid PD?

A
  1. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood
  2. Does not occur exclusively during the course of schizophrenia or other psychotic disorder
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10
Q

What are the characteristics of schizoid PD?

A
  1. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions
  2. Does not occur exclusively during the course of schizophrenia or other psychotic disorder
  3. May meet criteria fro ASD.
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11
Q

What are the characteristics of schizotypal PD?

A
  1. A pervasive pattern of interpersonal deficits marked by cognitive or perceptual distortions and eccentricities of behavior. “magic thinking”
  2. Does not occur exclusively during the course of schizophrenia or other psychotic disorder
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12
Q

What are the characteristics of antisocial PD?

A
  1. Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years
  2. Evidence of a Conduct Disorder with onset before age 15 years
  3. Antisocial behavior is not exclusively during schizophrenia or a manic episode
  4. Interactions with physicians may involve deceit, manipulation, and malingering.
  5. They expect others to be manipulated, which then gets reinforced by our responses
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13
Q

What are the characteristics of histrionic PD?

A
  1. Pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood, such as:

A. Sexually seductive or provocative behavior
B. Self-dramatization, theatricality, exaggerated emotional expression
C. Is easily influenced by others
D. Considers relationships to be more intimate than they actually are

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14
Q

What are the characteristics of narcissistic PD?

A 
1. A pervasive pattern of grandiosity (in fantasy and behavior) beginning by early adulthood
A. Need for admiration
B. Lack of empathy
C. Sense of entitlement
2. Expect others will humiliate them
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15
Q

What are the characteristics of borderline PD?

A

A. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood. > 5/9 needed

  1. Frantic efforts to avoid real or imagined abandonment
  2. Unstable and intense interpersonal relationships, alternating idealization and devaluation
  3. Persistently unstable self-image or sense of self
  4. Impulsivity that is potentially self-damaging
  5. Recurrent suicidal behavior or threats, or self-mutilation
  6. Mood lability and reactivity
  7. Chronic feelings of emptiness
  8. Frequent or intense anger outbursts
  9. Transient paranoid ideation or severe dissociative symptoms
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16
Q

What are the characteristics of avoidant PD?

A
  1. Pervasive pattern of social inhibition beginning by early adulthood
  2. Inhibited in social situations because of feelings of inadequacy
  3. Hypersensitive to criticism or rejection
  4. Avoidant personality disorder essentially represents an exaggerated shyness. Persons with this disorder are socially inhibited and worry about humiliation. They avoid social situations, such as parties, where they try to blend in with…the wallpaper. There is a very blurry line between this disorder and so-called social phobia or social anxiety disorder and the terms are often used interchangeably.
17
Q

How can avoidant and schizoid personality disorder be differentiated?

A

Avoidant personality also needs to be differentiated from schizoid personality. Persons with an avoidant personality generally want relationships, but are afraid of rejection or humiliation. Persons with schizoid personality couldn’t care less.

18
Q

What are the characteristics of obsessive compulsive PD?

A
  1. By early adulthood:
    A. Preoccupied with details, rules, lists, schedules
    B. Perfectionism interferes with task completion
    C. Excessively devoted to work and productivity
    D. Scrupulous about morality, ethics, and values
    E. Unable to discard worn-out objects
    F. Micro-manages tasks
    G. Miserly spending style
    H. Rigid and stubborn
19
Q

How is OCD different from Obsessive compulsive PD?

A

Individuals with obsessive-compulsive personality disorder are preoccupied with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, spontaneity, and openness. This is different from obsessive compulsive disorder, which is characterized by obsessions and compulsions, such as counting, checking, and hand-washing. Sometimes the two disorders can occur together.
Persons with this personality disorder may have impossibly high expectations for themselves, but then can put those impossible expectations on others and be very judgmental and not very likeable. In small quantities, of course, a tendency towards perfectionism helps occupational functioning, and is a trait most patients want to see in their doctors, if not their friends.

20
Q

What are the characteristics of dependent PD?

A
  1. Pervasive and excessive need to be taken care of beginning by early adulthood
  2. Indecisive
  3. Submissive and clingy
    4 .Difficulty expressing disagreement
  4. Lack of self-confidence, feeling of helplessness
  5. Goes to excessive lengths to obtain nurturance and support from others
21
Q

What is included in the 5 factor model?

A
  1. Extraversion
  2. Neuroticism
  3. Openness to experience
  4. Conscientiousness
  5. Agreeableness
22
Q

What is included in the temperament and character inventory?

A
  1. Novelty seeking
  2. Reward dependence
  3. Harm avoidance
  4. Persistence
23
Q

What are the risk factors for PD?

A

not married, impoverished, poorly educated

24
Q

What PD are more common in men?

A

Antisocial

25
Q

What PD are more common in women?

A

Paranoid, avoidant, and dependent PD were more prevalent in women

26
Q

What exacerbating factors can contribute to PD?

A
  1. Substances
  2. Medical/psychiatric disorders
  3. Stress
  4. Close relationships
27
Q

What are the biological markers of PD?

A
  1. Neurotransmitters and neuropeptides

2. Neuroimaging

28
Q

How are cluster A PD treated?

A
  1. Little studied

2. Antipsychotic medication and psychotherapy may provide modest benefit

29
Q

How are cluster B PD treated medically?

A
  1. Psychopharmacology:
    A. Modest efficacy, especially mood stabilizers, antipsychotics.
    B. Benzodiazepines may exacerbate condition
    C. Co-occurring conditions (depression, anxiety, etc.) may also respond poorly to medications
30
Q

How are cluster B PD treated with therapy?

A
  1. Psychotherapy.
    A. Case reports and series suggest that all are potentially treatable.
    B. RCTs. Only borderline PD. 3 psychodynamic and 2 cognitive behavioral models shown to be highly effective.
    C. Borderline PD prognosis: 70% remission in 6 years and 88% in 10 years (Zanarini et al. 2006)
31
Q

How are cluster C PD treated?

A
  1. Psychopharmacology – avoidant PD

2. Psychotherapy – RCT indicated efficacy for CBT and psychodynamic

32
Q

True/false: PD can achieve remission

A

True-ish. pts may not meet criteria, but functioning still remains impaired

BM: Unit 4 (5 decks)

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