personality disorders Flashcards
personality disorders
enduring pattern of subjective experiences and behavior that deviate from cultural standards
pattern is rigidly pervasive
significant distress and impairment in social functioning
not due to mental illness or substance abuse
3 clusters
1) ODD=paranoid,schizoid,schizotypal
2) SAD=antisocial,borderline,histrionic,narcissistic
3) ANXIOUS=avoidant,dependent,obsessive compulsive
paranoid
suspect being exploited or deceived
doubts loyalty or trustworthiness of friends
reluctant to confide
reads hidden meaning
bear grudges
perceives attacks on reputation and quick to react
suspicious about spouse fidelity
paranoid Dx and Tx
differentials:schizo.,delusional disorder
lifelong and may go to have schizophrenic breakdown
Tx with psychotherapy,don’t do well in groups.may consider antianxiety and neuroleptics
more common in males,immigrants,deafs,minorities
schizoid
no desire nor enjoy close relationships
solitary activities
no interest in sexual relationship
no close friends
indifferent to praise or criticism
emotional detachment
schizoid Tx
men>women
onset early in childhood–> lifelong
Tx.psychotherapy,neuroleptics,benzos,SSRI
schizotypal
ideas of reference
odd beliefs
unusual perceptual experiences
odd thinking
suspecious
inappropriate or constricted affect
odd behavior or appearance
brief psychotic episodes
schizotypal Tx
more likely in relatives of schizophrenia
risk of suicide
schizophrenic breakdown
Tx.neuroleptics and psychotherapy
antisocial
inability to conform to social norms
multiple criminal acts
impulsivity or failure to plan ahead
aggressiveness
lack of remorse
Hx of conduct disorder in childhood
Dx and Tx
high in prison mates
EEG abnormalities
Tx.self-help groups,psychotherapy,antiepileptics,beta adrenergic antagonist for aggression
borderline (BPD)
symptoms in 4 domains of psychopathology
1) affective disturbance
2) disturbed congnition
3) impulsivity
4) intense unstable relationships
BPD
pervasive pattern of instability of interpersonal relationships,self-image and affects as well as marked impulsivity beginning early adulthood and present in a variety of contexts as indicated by 5 or more of following:
contexts of BPD
1) frantic efforts to avoid real or imagined abandonment
2) pattern of unstable and intense interpersonal relationships charecterized by alternating between extremes of idealization and devaluation
3) identity disturbances
4) impulsivity in at least 2 areas that are self damaging
5) recurrent suicidal behavior
6) affective instability due to marked reactivity of mood
7) chronic feeling of emptiness
8) difficulty controling anger
9) transient stress-related paranoid ideation or severe dissociative symptoms
Tx of BPD
psychotherapy is recommended primary technique
dialectical behavior therapy superior
most common in women
other factors for BPD
adverse childhood experiences major effect
2 parts of dialectical behavior therapy
1) individual component:meeting with therapist to discuss issues came up during the week
2) group component:once weekly for 2-2.5 hours
histrionic
colorful dramatic and extroverted
uncomfortable if they are not in center of attention
sexually promiscuous
exaggerated display of emotion
considers relationsships to be more intimate than they are
more common in women
narcissistic
grandiose sense of self importance
preoccupied of fantasies of unlimited success and power
they’re special
requires excessive admiration
sense of entitlement
unable to show empathy
ARROGANT
avoidant
extreme sens. to criticism
not asocial but fear rejection
preoccupied with fear of being criticized or rejected in a social situation
view self as socially inept and unappealing
dependent
needs lots of advise to make decisions
difficulty expressing disagreement
can’t initiate projects on their own
dysfunctional relationships because they don’t like to be alone
chronic pessimism and self doubt
obsessive compulsive
emotional constriction
orderliness
stubbornness
indecisiveness
does not get the big picture
pervasive pattern of perfectionism and inflexibility
personality disorder NOS
passive aggressive
depressive
