personality disorders Flashcards
ICD 10 criteria for a PD?
- enduring, deeply ingrained pattern of maladaptive behaviour in several areas of functioning in an adult person’s life
- can trace the behaviour back to adolescence or childhood
- behaviour causes personal distress
- behaviour is abnormal culturally or religiously
what areas of functioning?
- cognition
- affect regulation
- interpersonal relations
- impulse control
3 Ps of PD?
Pathological
pervasive
persistent
cluster A PDs
paranoid
schizoid
cluster B PDs
dissocial
emotionally unstable
histrionic
cluster C PDs?
anxious
dependent
anankastic
other
what are the five domains of personality?
OCEAN
- openness to experience/novelty seeking
- conscientiousness
- extra/introversion
- agreeableness
- neuroticism
aetiology of PDs?
- genes - serotonin/dopamine transporter
2. environment - disorganised attachment style, maltreatment, trauma
heritability of PD?
possible cluster B
schizotypal
prevalence of PD?
community 2-14%
OPD 40%
inpatients 50%
male prisoners 60%
typical female PDs?
borderline
dependent
histrionic
typical male PDs?
dissocial
narcissistic
px BPD?
only 25% still have dx at age 50
average marriage rates
25% have kids
generally employed
personality traits _______ over time
become less prominent
dx of dependent PD?
at least 4 of:
- dependence
- fear of not coping
- subordination
- helplessness
- undemanding
- need to be reassured
dx of anxious/avoidant PD?
at least 4 of:
- anxiety
- restricted life
- inferiority
- social avoidance
- afraid to trust
- fear of rejection
anankastic personality disorder dx?
at least 4 of:
- cautious
- rigid
- orderly
- pedantic
- perfectionist
- preoccupied with productivity
- insistence that others submit to their way of doing things
EUPD dx?
2 types
impulsive - at least 3 of:
- unpredictable
- lacking consistency
- quarrelsome
- capricious
- explosive
borderline type: 3 of above + 2 of:
- chronic feeling of emptiness
- self harm
- frequent relationship crises
- poor self image
- fear of abandonment
histrionic PD dx?
at least four of
- seductive
- superficial affect
- dramatic
- suggestibility
- vain
- stimulus seeking
antisocial PD dx?
at least 3 of:
- callous
- blames others
- irresponsible
- lack of guilt
- short relationships
- low frustration tolerance
paranoid PD dx?
at least 4 of:
- suspicious
- mistrustful
- jealous
- sensitive
- argumentative
- self centred
- grudging
schizoid PD dx?
at least 4 of:
- emotionally cold
- indifferent
- introspective
- friendless
- humourless
- solitary
- unconventional
- loveless
- detached
what is schizotypal PD?
DSM only
basically prodromal schizophrenia - is under SCZ in ICD10
DSM criteria for schizotypal PD
- pervasive pattern of social and interpersonal deficits
- cognitive or perceptual distortions
- eccentric behaviour
- starts early adulthood
- not just during psychotic illness or ASD
narcissistic PD?
only DSM
- grandiosity, need for admiration, lacks empathy
- starts early adulthood
- fantasies of success, power
- thinks they’re unique and special
- entitlement
- exploitative
- envious
- arrogant
meds in mx of PD?
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
psych tx of PD?
- individual - CBT, psychodynamic, psychoanalytic
2. group: DBT, psychodynamic group tx
what is DBT?
dialectical behavioural therapy
1. discuss opposing ideas to find the truth
pitfalls in mx of PD?
- countertransference - PD patients evoke strong reactions
- often undertreated
- “I hate you- don’t leave me”
why think that PD is real?
high rates of suicide and premature death
there are effective treatments
