Personality Disorders Flashcards
Define Personality Disorder
Enduring pattern of inner experience or behavior that deviates from expectations of culture, manifested in two or more of the following: cognition, affectivity, interpersonal functioning, or impulse control
Diagnostic Criteria for Personality Disorders
Pattern leads to distress, impairment
Patter is stable & of long duration
Pattern not explained by another disorder
Pattern not due to substance abuse or medical condition
What are personality disorders linked to?
Mortality
Heart disease
Life satisfaction & well-being
Are personality disorders costly?
Yes
When there is a co-morbid personality disorder and Axis I disorder which disorder should you treat first?
Personality disorder
Will help the Axis I pathology
Cluster A Personality Disorders
Paranoid
Schizoid
Schizotypal
Cluster B Personality Disorders
Histrionic
Antisocial
Borderline
Narcissistic
Cluster C Personality Disorders
Compulsive
Avoidant
Dependent
6 Types of Personality Disorders Based on DSM 5
Antisocial Avoidant Borderline Narcissistic Obsessive-Compulsive Schizotypal
Which cluster of personality disorders is described as odd or eccentric?
Cluster A
Which cluster of personality disorders is described as dramatic, emotional, erratic?
Cluster B
Which cluster of personality disorders is described as anxious or fearful?
Cluster C
What does cluster A personality disorders not have?
Psychosis
Define Paranoid Personality Disorder
Lack of trust in others
Fear that friends may be disloyal, unfaithful
Being hypersensitive, overly suspicious, perceived as hostile
Paranoid Personality Disorder DSM-V Criteria
Pervasive distrust
Suspicion of others
Suspects that others are exploiting, harming, deceiving
Preoccupied with unjustified doubts of loyalty or trustworthiness of people
Reluctant to confide in others
Reads hidden, demeaning, threatening meaning into benign actions
Persistently bears grudges
Perceives attacks on reputation
Unjustified suspicions about fidelity of others
Epidemiology of Paranoid Personality Disorder
Men > Women
Co-occuring Disorders with Paranoid Personality Disorder
GAD
Panic disorder
Delusional disorder
Other personality disorders
Treatment for Paranoid Personality Disorder
CBT to challenge paranoid thoughts
SSRI’s to reduce suspiciousness
Day treatment programs
DSM-V Criteria for Schizoid Personality Disorder
Detachment from social relationships
Restricted emotions
Neither desires nor enjoys social relationships
Prefers solitary activities
Has little interest in sexual experiences
Gets pleasure from few activities
Lacks close friends
Appears indifferent to praise or criticism
Shows emotional coldness, detachment, flat affect
Treatment for Schizoid Personality Disorder
Not likely to seek help
Social skills training
Low dose antipsychotics or antidepressants
DSM-V Criteria for Schizotypal Personality Disorder
Acute discomfort with social relationships Eccentric behavior Ideas of reference Odd beliefs Unusual perceptual experiences Odd speech Suspiciousness or paranoid ideation Inappropriate or constricted affect Odd or eccentric appearance & behavior Lack of close friends Excessive social anxiety
Treatment for Schizotypal Personality Disorder
Social Skills Training
Low dose antipsychotics or antidepressants
Difference Between Schizoid & Schizotypal
Schizotypal: avoid social interaction because of fear of people
Schizoid: feel no desire to form relationships
Characteristics of Cluster B Personality Disorders
Self-absorbed
Prone to exaggerate importance of events
Difficulty maintaining close relationships
DSM-V Criteria for Antisocial Personality Disorder
Pattern of disregard for rights of others since age 15
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
Individual is at least 18
Evidence of CD before 15
Occurrence not exclusively during course of schizophrenia or a manic episode
Epidemiology of Antisocial Personality Disorder
Men > Women
Highest prevalence: men 25-44
Higher rates in prison, forensic settings, & substance abuse treatment programs
Treatment of Antisocial Personality Disorder
Court ordered
Anger management
Medication to treat impulsivity, aggressiveness, explosiveness & violence
Group therapy
Define Borderline Personality Disorder
Enduring pattern of thinking, behavior that involves instability of mood, self-image, interpersonal relationships; frantic efforts to avoid real or imagined abandonment; unrealistically positive or negative opinions about others
Epidemiology of Borderline Personality Disorder
Women > Men
Threats/actions of self-harm common
Black & white thinking
Common Co-morbidities with Borderline Personality Disorder
Mood disorder
Anxiety disorder
Substance use disorders
DSM-V Criteria for Borderline Personality Disorder
Instability in relationships
Instability in self-image
Marked impulsivity
Frantic efforts to avoid real or imagined abandonment
Pattern of unstable, intense relationships
Identity disturbance
Impulsivity in 2+ areas that are self-damaging
Recurrent suicidal behavior, gestures, threats
Affective instability
Chronic feelings of emptiness
Inappropriate intense anger
Transient, stress-related paranoid ideas
Treatment of Borderline Personality Disorder
Medications to treat target symptoms
Acute inpatient psychiatry
DBT- treatment of choice
CBT
Define Histrionic Personality Disorder
Enduring pattern of thinking, behavior characterized by excessive emotionality & attention-seeking behavior
Histrionic Personality Disorder Characteristics
Self-centered
Vain
Demanding
Dresses eccentrically, seductively
DSM-5 Criteria for Histrionic Personalty Disorder
Excessive emotionality
Attention-seeking
Being uncomfortable when not center of attention
Interactions characterized by provocative, sexually seductive behavior
Rapidly shifting & shallow moods
Consistently uses physical appearance to draw attention to self
Style of speech excessively impressionistic, lacking in detail
Shows self-dramatization, exaggerated expression of emotion
Suggestible, easily influenced
Considers relationships more intimate than they are
Treatment of Histrionic Personality Disorder
CBT
Group therapy
DSM-V Criteria for Narcissistic Personality Disorder
Need for admiration Lack of empathy Grandiose sense of self-importance Preoccupied with fantasies of power, success, love Believes he/she is special or unique Sense of entitlement Takes advantage of others to achieve own needs Often envious of others Arrogant, haughty
Treatment for Narcissistic Personality Disorder
Anger management
Psychotherapy for Axis I
Group therapy
DSM-V Criteria for Avoidant Personality Disorder
Pervasive pattern of social inhibition
Feelings of inadequacy
Hypersensitivity to negative evaluation
Avoids occupational activities that involve significant interpersonal contact (fear of criticism, disapproval, or rejection)
Unwilling to get involved with people unless certain of being liked
Shows restraint with intimate relationships because of fear of being shamed or ridiculed
Preoccupied with being criticized or rejected in social situations
Inhibited in new interpersonal situations because of feelings of inadequacy
Self view of socially inept, personally unappealing, or inferior to others
Unusually reluctant to take personal risks or engage in new activities
Treatment of Avoidant Personality Disorder
CBT
Group therapy
Social skills training
SSRIs
DSM-V Criteria for Obsessive Compulsive Personality Disorder
Preoccupied with details, rules, lists, order, organization, or schedules (major point of activity is lost)
Shows perfectionism that interferes with task completion
Excessively devoted to work & productivity to the exclusion of leisure activities & friendships
Overconscientious, scrupulous & inflexible about morality, ethics, or values
Unable to discard worn-out or worthless objects even when no sentimental value
Reluctant to delegate tasks or work with others
Adopts a miserly spending style toward both self & others
Rigid & stubborn
Treatment of Obsessive Compulsive Personality Disorder
CBT
Seek treatment for anxiety attacks, sexual dysfunction, fatigue, or request of family
DSM-V Criteria for Dependent Personality Disorder
Difficulty making everyday decisions without advice & reassurance from others
needs others to assume responsibility for most major areas of life
Difficulty expressing disagreement with others (fear of loss of support or approval)
Difficulty initiating projects or doing things on own
Goes to excessive lengths to obtain nurturance & support from others
Feels uncomfortable or helpless when alone (fear of unable to care for self)
Urgently seeks another relationship as source of care/support when close relationship ends
Unrealistically preoccupied with fears of being left to take care of self
Co-Morbid Conditions with Dependent Personality Disorder
Social phobia
PTSD
GAD
Treatment of Dependent Personality Disorder
Medication for specific symptoms
CBT
Psychodynamic
DSM-V Criteria for Personality Disorder
Significant impairments in self (identity or self-direction) & interpersonal (empathy or intimacy) functioning
One or more pathological personality trait domains or facets
Impairments in personality functioning & the individual’s personality trait expression are relatively stable across time & consistent across situations
