Personality Disorders Flashcards
General DSM V Criteria for Personality Disorders
Enduring pattern of inner experience or behavior that deviates from expectations of culture, manifested in two or more of the following:
- cognition (perception of self, others)
- affectivity (intensity, range of emotions)
- interpersonal functioning
- impulse control
What are the disorders classified in:
- cluster A
- Cluster B
- Cluster C
A: paranoid, schizoid, schizotypal. (Odd or eccentric) NO PSYCHOSIS
B: Antisocial, borderline, histrionic, narcissistic. (dramatic, emotional, erratic)
C: avoidant, Obsessive-compulsive, dependent (anxious or fearful)
Paranoid Personality Disorder:
- clinical features
- DSM V criteria
Features:
- excessive suspiciousness and distrust of others
- pathologically jealous and for no reason question fidelity of their spouse/sexual partner
- easily insulted/hostile
DSM V: pervasive distrust, suspicion of others, and 4 or more of the following:
- suspects others are exploiting, harming, or decieving them
- preoccupied with unjustified doubts of loyalty or trustworthiness of people
- reluctant to confide in others b/c of fear it will be used maliciously against them
- reads hidden, demeaning, threatening meaning into benign actions
- persistently bears grudges
- perceives attacks on reputation
- has unjustified suspicion of fidelity of others.
Tx of Paranoid Personality Disorder
CBT
SSRI
Haldol or Valium for agitation/anxiety
DSM V Criteria for Schizoid Personality Disorder
Schizoid may resemble which other disorder?
Detachment from social relationships, restricted emotions, as indicated by 4 or more of the following:
- neither desires nor enjoys social relationships
- prefers solitary activities
- has little interest in sexual experiences
- pleasure from few activities
- lack close friends
- appears indifferent to praise or criticism
- shows emotional coldness, detachment, flat affect.
Schizoid may look like autism spectrum disorder.
Schizoid Personality Disorder:
-Tx
Social skills training, group therapy +/- anti-psychotics/antidepressants
DSM V Criteria for Schizotypal Personality Disorder
acute discomfort with social relationships, eccentric behavior, and 5 or more of the following:
- ideas of reference
- odd beliefs
- unusual perceptual experiences
- odd speech
- suspiciousness or paranoid ideation
- inappropriate or constricted affect
- odd or eccentric appearance and behavior
- lack of close friends
- excessive social anxiety
- magical thinking, clairvoyance (psychic)
Schizotypal Personality Disorder Tx
Group Therapy = Tx of choice
+/- anti-psychotics/antidepressants
What are the main similarities and differences between schizoid an schizotypal personality disorders?
Similarities:
-inability to initiate or maintain friendly and romantic relationships
Differences:
- Schiztypal: pts avoid social interaction b/c of fear of people (lonely and sad)
- schizoid: individuals feel no desire to form relationships.
Antisocial Personality Disorder DSM V Dx Criteria
pattern of disregard for rights of others as indicated by 3 or more of the following:
- failure to conform to social norms, respect lawful behavior
- deceitfulness, lying, conning others for profit or pleasure
- impulsivity, failure to plan ahead
- irritability, aggressiveness, repeated fights
- reckless disregard for safety of others
- consistent irresponsibility, failure to honor obligations
- lack of remorse
Tx of Anti-social personality disorder
anger management (harm reduction)
medication to tx impulsivity, aggressiveness, and violence
Group therapy w/ other APD pts
Borderline Personality Disorder DSM V Dx Criteria
Instability in mood*, relationships, self-image, marked impulsivity, andd 5 or more of the following:
- frantic efforts to avoid real or imagined abandonment*
- pattern of unstable, intense relationship
- identity disturbance
- impulsivity in two or more areas that are self-damaging
- recurrent suicidal behavior, gestures, threats (self harm)
- affective instability
- chronic feelings of emptiness
- inappropriate intense anger
- transient, stress-related paranoid ideas
Black and white thinking
Tx of Borderline Personality Disorder
Tx of Choice = dialectical behavioral therapy
Acute inpatient psychiatry
+/- anti-psychotics/anti-depressants/benzos for sx.
Histrionic Personality Disorder DSM V dx criteria
Excessive emotionality, attention-seeking and 5 or more of the following:
- being uncomfortable when not center of attention
- interactions characterized by provacative, sexually seductive behavior
- rapidly shifting and shallow moods
- consistently uses physical appearance to draw attention to self
- style of speech is excessively impressionistic and lacking in detail
- show self-dramatization, exaggerated expression of emotion
- is suggestible, easily influenced
- considers relationships more intimate than they are
Tx of Histrionic Personality Disorder
CBT
Group therapy
Narcissistic Personality Disorder DSM V Dx Criteria
Grandiosity in fantasy and behavior, need for admiration, lack of empathy, and 5 or more of the following:
- grandiose sense of self importance
- preoccupied with fantasies of power success, love
- believes he or she is special or unique
- requires excessive admiration
- sense of entitlement
- takes advantage of others to achieve own needs
- envious of others
- arrogant, haughty
Tx of Narcissistic
Anger management
Group therapy**
What are the cluster C personality disorders?
Avoidant
obessive compulsive
dependent
DSM V Criteria for Avoidant personality disorder
pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation indicated by 4 or more of the following::
-avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval or rejection
unwilling to get involved with people unless certain of being liked
shows restraint with intimate relationships b/c of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations.
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing or inferior to others
unusually reluctant to take personal risks or to engage in any new activities b/c they may be embarrassing
Avoidant Personality Disorder Tx
CBT
Group therapy
social skills training
SSRI
Obsessive compulsive personality disorder DSM V criteria
Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
Shows perfectionism that interferes with task completion
is excessively devoted to work and productivity to the exclusion of leisure activities and friendships
overconscientious, inflexible about morality, ethics, or values
Unable to discard worn-out or worthless object even when they have no sentimental value
reluctant to delegate tasks or to work with others unless they submit exactly to his or her way of doing things.
adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
Rigid and stubborn
Tx of OCPD
seek tx d/t anxiety attacks, sexual dysfunction, fatigue, or at the request of family members
CBT
Dependent Personality DIsorder DSM V criteria
must have 5 or more of the following:
-has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
needs other to assume responsiblity for most major areas of his or her life
has difficulty expressing disagreement with others b/c of feel of loss of support or approval
has difficulty initiating projects or doing things on his or her own.
Goes to excessive lengths to obtain nuturance and support from others, to the point of volunteering to do things that are unpleasant
feels uncomfortable or helpless when alone because of exaggerated fears or being unable to care for self.
Urgently seeks another relationship as a source of care and support when a close relationship ends.
is unrealistically preoccupied with fears of being left to take care of self.
Treatment of Dependent Personality Disorder
Meds
CBT
