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