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Case Files Psychiatry > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

Guarding against uncomfortable emotional conflicts or stressors thorugh actions rather than reflections or feelings.

A

Acting out

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2
Q

Dealing with emotional conflict or stressors by falsely attributing to another person the individual’s own unacceptable feelings, impulses, or thoughts.

A

Projective identification

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3
Q

What are the basic critera that need to be present in order to make a diagnosis of ASPD?

A
  1. Pervasive disregard for & violation of the rights of others
    - 3+ associated symptoms
  2. Must be 18
  3. Evidence of conduct disorder before the age of 15
  4. Must occur in the absence of psychosis
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4
Q

What are the associated symptoms (7) required for ASPD?

A
  1. Repeated arrests
  2. Deceitfulness
  3. Impulsivitiy
  4. Repeated physical fights or assaults
  5. Reckless disregard
  6. Irresponsible
  7. Lack of remorse
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5
Q

Keys to the diagnosis of ASPD vs other antisocal behaviors.

A
  1. Lack empathy
  2. Lack remorse
  3. Exhibit reckless, impulsive, and antisocial behavior
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6
Q

If both substance abuse and antisocal acts coexist, when is it appropriate to diagnosis ASPD?

A

When the acts preced the substance abuse

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7
Q

How will ASPD patients appear in an interview?

A
  1. Colorful and seductive
  2. Manipulative
  3. Demanding
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8
Q

What is the focus of treating ASPD?

A

Reduce impuslive or aggressive behaviors and antisocial acts

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9
Q

What medications have shown promise in reducing aggressive sypmtoms associated with ASPD?

A

SSRIs

Mood stabilizers

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10
Q

What type of psychotherapy has shown to benefit patients with ASPD?

A

Group therapy with patients who have the same diagnosis

- They reduce the amount of rationalization and evasion show by others in the group

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11
Q

What type of psychotherapy has been unhelpful for treating ASPD?

A

Psychodynamic psychotherapy

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12
Q

What are the basic critera that need to be present in order to make a diagnosis of histrionic personality disorder?

A
  1. Excessive emotionality & attention seeking behavior

- 5+ associated symptoms

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13
Q

What are the symptoms associated with HPD?

A
  1. Must be center of attention
  2. Use of physical appearances to draw attention
  3. Inappropriate sexual/seductive behavior
  4. Rapidly shifting and shallow expression of emotions
  5. Exaggerated expression of emotion
  6. Excessively impressionistic speech that lacks detail
  7. Suggestible
  8. See relationships as more than they actually are
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14
Q

Clues to making a diagnosis of HPD?

A
  1. Theatrical and overblown speech

2. Seductive behavior

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15
Q

Dealing with stress by breaking down the usually integrated functions of consciousness, memory, perception of self or the environment, or sensory/motor behavior.

A

Dissociation

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16
Q

Dealing with stress by expelling disturbing wishes, thoughts, or experiences form their conscious awareness.

A

Repression

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17
Q

How can you differentiate borderline from histrionic?

A

Borderline

  • Suicide attempts
  • More often experience psychosis
18
Q

Do you address seductive behavior in office visits?

A

Yes, thought tactfully.

19
Q

What type of psychotherapy should be used with HPD patients?

A

Group therapy with patients who have the same diagnosis

- Focus should be on insight

20
Q

What type of psychotherapy should be avoided in HPD patients?

A

Dynamic psychotherapy

21
Q

What other disorder needs to be monitored in HPD patients?

A

Subtance abuse

- Used as a poor coping skill

22
Q

What should be high on the list of comorbid psychiatric disorders in patients with antisocial personality disorders?

A

Substance abuse

23
Q

What is the basic critera for narcissistic personality disorder?

A
  1. Pervasive pattern of grandiosity, need for admiration, and lack of empathy.
    - 5+ associated symptoms
  2. Begin in early adulthood
24
Q

What are the 9 symptoms associated with NPD?

A
  1. Grandiose sense of self importance
  2. Fantasy of unlimited…
  3. Speacial and unique, only understood or associate with others
  4. Excessive admiration
  5. Sense of entitlement
  6. Interpersonally exploitative
  7. Lacks empathy
  8. Envious of others or believes that others are envious of them
  9. Arrogant, haughty behaviors or attitudes.
25
Q

Refusing to acknowledge some painful aspect of external reality or subjective experience that is apparent to others.

A

Denial

26
Q

Attributing exaggerated negative qualities to themselves or to others.
i.e. therapist is the worst doctor in the world

A

Devaluation

27
Q

Attributing exaggerated positive qualities to themselves or to others.
i.e. doctor is the most empathic person in the world

A

Idealization

28
Q

How do NPD patients differ from BPD patients?

A

BPD

  • More chaotic lives
  • Multiple failed relationships
  • Suicidal gestures
29
Q

How do NPD patients differ from HPD patients?

A

HPD

  • Not entitled
  • Not arrogant or haughty
30
Q

What is the most defining characteristic of a NPD patient?

A

Grandiosity

Callous, needy, interactive style

31
Q

What is the major comorbid condition associated with NSD?

A

Depression

- Physician should be tactful and admiring if at all possible

32
Q

Why is treatment of these individuals difficult?

A

They rarely desire change and seldome seek help

Psychotherpy is often stopped once the patient is confronted

33
Q

What psychopharmacology is available for NPD patients?

A

Lithium- Affective lability

SSRI- Depression

34
Q

What are the diagnosit criterai for Borderline Personality Disorder?

A

Pervasive pattern of instability of interpersonal relationships, self image, and affects, and marked impulsivity
- 5+

35
Q

What are the symptoms associated with BPD?

A
  1. Tries to avoid abandonment
  2. Unstable and intense interpersonal relationships
  3. Identity disturbance
  4. Impulsivity (2+ areas) that are potentially self-damaging
  5. Suicidal behavior or self-mutilation
  6. Affective instability
  7. Chronic feelings of emptiness
  8. Intense anger or difficulty controlling anger
  9. Stress-related paranoid ideation or severe dissociative symptoms
36
Q

Set of expectations, beliefs, and emotional responses induced in the physician through interactions with a particular patient.

A

Counter transference

37
Q

Patients learn skills to confront and manage the volatile emotions and impulses they are feeling.

A

Dialectical Behavioral Therapy

38
Q

What is the most common psychosis in a BPD patient?

A

Paranoid ideation

39
Q

What type of symptoms are often absent when BPD patients have an psychotic episode?

A

Thought disorder

40
Q

How can you differentiate a BPD from a Paranoid personality disorder patient?

A

PPD

- Paranoid ideation will last longer and will be more pervasive

41
Q

Why are BPD patients difficult to work with?

A

The induce countertransference

42
Q

How should you go about interviewing BPD patients?

A

Give clear, nontechnical answers
Do not let them idealize you or other members of the team
Do not be avoidant or punitive
Set limits early and often on what behavior is acceptable

Case Files Psychiatry (10 decks)

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