Personality Disorders

Question 1

According to the old DSM-4, what are the 5 axis, and which types of disorders do each encompass?

Answer 1

1 = psychiatric disorder
2 = mental retardation & personality disorder
3 = contributing medical conditions
4 = psychosocial stressors
5 = global assessment of functioning (0-100)

Question 2

are psychiatric disorders typically ego-dystonic or ego-syntonic?

Answer 2

ego-dystonic

there is conflict between patient and the world (a depressed person knows they are depressed and wants to change it)

Question 3

are personality disorders typically ego-dystonic or ego-syntonic?

Answer 3

ego-syntonic

no conflict between person and the way they view the world; they think they are fine and rarely seek help

Question 4

in order to diagnose generalized personality disorder, a pattern of deviated behavior must manifest in 2+ of which areas?

Answer 4

1) cognition (ways of perceiving and interpreting self, other people, events)
2) affectivity (ie range, intensity, lability, appropriateness)
3) interpersonal functioning
4) impulse control

Question 5

what happens if someone comes in with an abrupt personality change (esp. if over 50)?

Answer 5

do a brain scan! more likely to be tumor

Question 6

what is true in terms of treatment of personality disorders?

Answer 6

MOST difficult to treat; ZERO medications are FDA approved to treat, nor are there any psychotherapies

exception: dialectical behavioral therapy for borderline personality disorder

Question 7

which disorder is characterized by intense distrust, belief that other’s motivates are malicious, and perception of character assassination?

Answer 7

paranoid

Question 8

which disorder is characterized by an expressionless affect, feelings of detachment, and a solitary lifestyle?

Answer 8

schizoid

Question 9

which disorder is characterized by cognitive distortions, odd speaking patterns, being friendless, and eccentric appearance/behavior?

Answer 9

schizotypal

Question 10

which disorder is characterized by unlawful activities, frequent lying, and a general lack of remorse? at what age must you be to DX this?

Answer 10

antisocial

must be 18 to dx’ before that its conduct disorder

Question 11

which disorder is characterized by frequent cutting and self-harm, being promiscuous to fill the void, and and overall instability and wild fluctuations?

Answer 11

borderline

Question 12

which disorder is characterized by attention seeking behavior, interacting in inappropriate sexual manners, and being overly dramatic yet very superficial & rapidly fluctuating?

Answer 12

histrionic

Question 13

what is true of the relationships of a histrionic person?

Answer 13

they see relationships as closer than they actually are

Question 14

in which disorder (as opposed to the others), do patient’s tend to do okay in life?

Answer 14

histrionic

Question 15

which disorder is characterized by a sense of entitlement, lack of empathy, a feeling of superiority, and feeling overly jealous when others receive praise?

Answer 15

narcissistic

Question 16

which personality disorder has the worst treatment success rate?

Answer 16

narcissistic

Question 17

which type of people crave friendships but have such a strong sense of fear, shame, guilt, and ridicule that they avoid relationships to avoid rejection?

Answer 17

avoidant

Question 18

which two personality disorders are often linked to domestic abuse?

Answer 18

avoidant and dependent

Question 19

which types of people are excessively clingy, have a constant need to be cared for, and won’t make big decisions on their own?

Answer 19

dependent

Question 20

which types of people hold an inflexible and rigid strive for perfection, often being unable to complete projects on time because they are so preoccupied with details?

Answer 20

obsessive compoulsive

Question 21

how do we treat personality disorders

Answer 21

no FDA approved meds

drugs are used to treat symptoms + CBT with whoever will take it

Question 22

TX of borderline personality disorder?

Answer 22

1) quetiapine (but weight gain)
2) dialectical behavior therapy is mainstay (core mindfulness, distress tolerance, emotion regulation, intrapersonal effectiveness)

Question 23

polypharmacy is common in borderline personality disorder, what percentage of patients are on 2 psychotrophics? how many on 5+?

Answer 23

2 = 50 percent

5+ = 11 percent