Personality Disorders Flashcards
An enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and oneself
Personality trait
A pervasive, inflexible, maladaptive manner by which the world is viewed, which originates in adolescence or earlier, and alters how the patient views the world; Dysfunctional characteristics of a person’s personality that are incongruent with social norms
Personality disorder
Conflict between the person and the world; a depressed patient knows they are depressed and they want to change it. Basically, they are “aware” of their condition.
Ego-dystonic
No conflict between the person and the way they view the world; thus, they rarely see difficulty with how they act and thus rarely seek help and tend to have maladaptive lives riddled with legal and other social dysfunction; “Unaware” of their condition
Ego-syntonic
What 4 areas do personality disorders tend to affect? (To diagnose someone with a personality disorder they have to have 2 out of 4 manifestations of these areas)
- Cognition
- Affectivity
- Interpersonal functioning
- Impulse control
Are there FDA approved medications to treat personality disorders?
NO! Only “off-label” uses
What disorders are cluster A disorders? (Weird, wacky, odd and eccentric)
Paranoid, schizoid, schizotypal
What disorders are cluster B disorders? (Dramatic, emotional, erratic, and wild)
Antisocial, borderline, histrionic, narcissistic
What disorders are cluster C disorders? (Anxious, fearful, and worried)
Dependent, obsessive-compulsive, avoidant
Marked by intense distrust due to assuming that the motives of others are malicious. A person with this disorder may perceive even an innocuous interaction as a character assassination. The result of this is extreme suspicion and strained interpersonal relationships and the ability to interact becomes stilted.
Paranoid Personality Disorder (A)
Blunted affect associated with feelings of detachment and desire relationships to be distant and often choose to be solitary. As they do not show much emotion, they often are perceived as having an emotionally cold disposition.
Schizoid personality disorder (A)
Inability to interact with others due to discomfort which arises from the actual act of having to interact. NOT due to negative self-image. They may also demonstrate cognitive distortions, odd speaking patterns, and experience strange perceptual occurrences influencing their behavior.
Cluster A - Schizotypal (A)
Pervasive pattern of disregard for and violation of the rights of others. Very impulsive and show disregard for the safety and welfare of others and of themselves. They fail to conform to social norms, participate in unlawful activities, and lack remorse for those they have wronged.
Antisocial (B)
Instability in self-image and interpersonal relationships. Impulsivity may lead to self-harm, such as drug abuse and promiscuous sex, and relationships are often polarized (black and white) such that a pattern of extreme valuation-devaluation is expressed. This can lead to efforts to avoid real or imagined abandonment and feelings of emptiness.
Borderline (B)
Emotionality and attention seeking behavior is expressed, and they are not happy unless they are the center of attention. In order to gain attention, they are often swayed by fads, become overly trusting, and may even interact in inappropriate sexual manners. Displays of emotion are often theatrical and overly dramatic, yet are superficial and can change immediately
Histrionic (B)
Prone to grandiose fantasies, with the need for admiration. Generally lacking empathy, these patients are arrogant and feel a sense of entitlement. They expect others to acknowledge their supposed superiority and feel very jealous when others receive praise.
Narcissistic (B)
They want friends, but they do not know how to obtain them. Dysfunction in ability to act interpersonally due to discomfort. They have self-inadequacy. Because of their fear of shame, ridicule, or rejection, they choose to interact with others as little as they possibly can. New activities are rarely attempted and new relationships are seldom formed.
Avoidant (C)
Excessively clingy and have a pervasive need to be cared for. They are prone toe experience separation anxiety, and jump from relationship to relationship when one ends. They have trouble making everyday decisions on their own, and they go out of their way to make sure others have responsibility to make major decisions.
Dependent (C)
Inflexible and strive for perfection (Type “A” personality, “anal-retentive”); rigidity is to the point that projects and tasks cannot be completed on time because they are not perfect enough. The preoccupation with details, rules, lists, and organization can be very invasive to the point that it affects interpersonal functioning.
Obsessive-compulsive PERSONALITY (C)
What is the treatment for borderline personality disorder?
Psychotropics and DBT
What is the mainstay of therapy for personality disorders?
Psychotherapy (CBT)
Mental disorders characterized by physical symptoms but without a physical cause of symptoms
Somatoform disorders
A variety of complaints in one or more organ system lasting for months to years. Associated with excessive, persistent thoughts about symptoms; may co-occur with medical conditions
Somatic symptom disorder
Preoccupation with and fear of having a serious medical illness despite medical evidence and reassurance to the contrary
Illness anxiety disorder (hypochondriasis)
Sudden loss of sensory or motor function (paralysis, blindness, mutism, etc.) often following an acute stressor; patient is aware of but sometimes indifferent to the symptom; more common in females, young athletes, adolescents
Conversion disorder
Intentional/conscious production of false or grossly exaggerated physical or psychological symptoms and is motivated by external incentives; Exaggerating a condition in order to obtain secondary gain - complaints cease after gain
Malingering
Intentional/conscious production or feigning of physical or psychological illness based primarily upon a desire to assume the sick role and get medical attention, not as a response to external incentives
Factitious disorder
Factitious disorder involves ____ gain
PRIMARY
Chronic factitious disorder with predominantly physical signs and symptoms, characterized by a history of multiple hospital stays and willingness to receive invasive procedures
Munchausen syndrome
Dramatic, peculiar, and _____ medical complaints should clue you in to a malingering or factitious disorder
Changing
External gain, deliberate
Malingering
Person enjoys “sick role” as gain, psychiatric disorder, agrees to invasive procedures
Factitious disorder
Unexplained symptoms or complaints with no conscious attempt to deceive
Somatoform disorders
Syndrome characterized by gross impairments in the ability to assess reality, and to behave coherently
Psychosis
Sensory impressions that occur without external stimulation of the relevant sensory organ
Hallucinations
Fixed, false beliefs even in the presence of evidence to the contrary. The beliefs are firmly held and do not waver.
Delusions
Incoherence or rambling, such as intermittently muttering and shouting unintelligible statements and monologues
Disorganized speech
Aimless, bizarre, agitated, or grossly inappropriate behavior (wandering alone dressed inappropriately)
Disorganized behavior
AKA catatonia, marked motor abnormalities, including immobility, excessive motor activity, extreme negativism, mutism, posturing, stereotyped movements, echolalia, and echopraxia
Disorganized motor behavior
Diminished emotional expression and avolution
Negative symptoms
Delirium, dementia, major depressive disorder, bipolar disorder, autistic disorder, and psychotic disorders all have what in common?
Psychosis
Disorder characterized by psychosis, and disintegration of abilities to think logically and maintain normal social behavior; patients exhibit both positive and negative symptoms, as well as various other symptoms
Schizophrenia
Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms (diminished emotional expression, avolition)
DSM-5 Schizophrenia requirements, must have 2 or more of these PLUS post morbid decline
To diagnose someone with schizophrenia, the symptoms must persist for ___ months
6
Treatment for schizophrenia?
Antipsychotic medication, psychiatric follow-up
Schizophrenia symptoms for greater than 6 months
Schizophrenia
Schizophrenia symptoms for 1-6 months
Schizophreniform disorder
Schizophrenia symptoms for 1day to 1 month
Brief psychotic disorder
What differs schizophrenia, from schizophreniform disorder, from a brief psychotic disorder?
THE TIMELINE
A disorder characterized by a baseline psychosis with inter-episode mood symptoms, with at least a 2 week period with the absence of mood symptoms and just psychotic symptoms (mood can be depression, mania, hypomania, mixed states, etc.)
Schizoaffective disorder
How do you treat schizoaffective disorder?
Antipsychotics, mood stabilizers, and antidepressants
Disorder involving delusions about plausible events, such as being persecuted, having a serious illness, or having a secret relationship with another person; these people often not overly bizarre and thought process is generally organized, and their functioning is not markedly impaired
Delusional disorder
Erotomanic, grandiose, jealous, persecutory, somatic, mixed
Subtypes of delusions
