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personality disorders Flashcards

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1
Q

ICD 10 criteria for a PD?

A
  1. enduring, deeply ingrained pattern of maladaptive behaviour in several areas of functioning in an adult person’s life
  2. can trace the behaviour back to adolescence or childhood
  3. behaviour causes personal distress
  4. behaviour is abnormal culturally or religiously
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2
Q

what areas of functioning?

A
  1. cognition
  2. affect regulation
  3. interpersonal relations
  4. impulse control
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3
Q

3 Ps of PD?

A

Pathological
pervasive
persistent

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4
Q

cluster A PDs

A

paranoid

schizoid

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5
Q

cluster B PDs

A

dissocial
emotionally unstable
histrionic

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6
Q

cluster C PDs?

A

anxious
dependent
anankastic
other

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7
Q

what are the five domains of personality?

A

OCEAN

  1. openness to experience/novelty seeking
  2. conscientiousness
  3. extra/introversion
  4. agreeableness
  5. neuroticism
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8
Q

aetiology of PDs?

A
  1. genes - serotonin/dopamine transporter

2. environment - disorganised attachment style, maltreatment, trauma

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9
Q

heritability of PD?

A

possible cluster B

schizotypal

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10
Q

prevalence of PD?

A

community 2-14%
OPD 40%
inpatients 50%
male prisoners 60%

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11
Q

typical female PDs?

A

borderline
dependent
histrionic

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12
Q

typical male PDs?

A

dissocial

narcissistic

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13
Q

px BPD?

A

only 25% still have dx at age 50
average marriage rates
25% have kids
generally employed

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14
Q

personality traits _______ over time

A

become less prominent

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15
Q

dx of dependent PD?

A

at least 4 of:

  1. dependence
  2. fear of not coping
  3. subordination
  4. helplessness
  5. undemanding
  6. need to be reassured
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16
Q

dx of anxious/avoidant PD?

A

at least 4 of:

  1. anxiety
  2. restricted life
  3. inferiority
  4. social avoidance
  5. afraid to trust
  6. fear of rejection
17
Q

anankastic personality disorder dx?

A

at least 4 of:

  1. cautious
  2. rigid
  3. orderly
  4. pedantic
  5. perfectionist
  6. preoccupied with productivity
  7. insistence that others submit to their way of doing things
18
Q

EUPD dx?

A

2 types

impulsive - at least 3 of:

  1. unpredictable
  2. lacking consistency
  3. quarrelsome
  4. capricious
  5. explosive

borderline type: 3 of above + 2 of:

  1. chronic feeling of emptiness
  2. self harm
  3. frequent relationship crises
  4. poor self image
  5. fear of abandonment
19
Q

histrionic PD dx?

A

at least four of

  1. seductive
  2. superficial affect
  3. dramatic
  4. suggestibility
  5. vain
  6. stimulus seeking
20
Q

antisocial PD dx?

A

at least 3 of:

  1. callous
  2. blames others
  3. irresponsible
  4. lack of guilt
  5. short relationships
  6. low frustration tolerance
21
Q

paranoid PD dx?

A

at least 4 of:

  1. suspicious
  2. mistrustful
  3. jealous
  4. sensitive
  5. argumentative
  6. self centred
  7. grudging
22
Q

schizoid PD dx?

A

at least 4 of:

  1. emotionally cold
  2. indifferent
  3. introspective
  4. friendless
  5. humourless
  6. solitary
  7. unconventional
  8. loveless
  9. detached
23
Q

what is schizotypal PD?

A

DSM only

basically prodromal schizophrenia - is under SCZ in ICD10

24
Q

DSM criteria for schizotypal PD

A
  1. pervasive pattern of social and interpersonal deficits
  2. cognitive or perceptual distortions
  3. eccentric behaviour
  4. starts early adulthood
  5. not just during psychotic illness or ASD
25
Q

narcissistic PD?

A

only DSM

  1. grandiosity, need for admiration, lacks empathy
  2. starts early adulthood
  3. fantasies of success, power
  4. thinks they’re unique and special
  5. entitlement
  6. exploitative
  7. envious
  8. arrogant
26
Q

meds in mx of PD?

A

meds only if comorbid illness
off label:
1. neuroleptics - cluster B and A
2. antidepressants - impulsive, depressed or self-harming + cluster C
3. anticonvulsants/lithium - affective instability/impulsivity

27
Q

psych tx of PD?

A
  1. individual - CBT, psychodynamic, psychoanalytic

2. group: DBT, psychodynamic group tx

28
Q

what is DBT?

A

dialectical behavioural therapy

1. discuss opposing ideas to find the truth

29
Q

pitfalls in mx of PD?

A
  1. countertransference - PD patients evoke strong reactions
  2. often undertreated
  3. “I hate you- don’t leave me”
30
Q

why think that PD is real?

A

high rates of suicide and premature death

there are effective treatments

Psych (23 decks)

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