Personality Disorders

Question 1

Personality disorders

Answer 1

Personality can be defined as an individual’s set of emotional and behavioral traits, which are generally stable and predictable. Personality disorders are defined when one’s traits become chronically rigid and maladaptive and affect most aspects of one’s life.

Onset by early adulthood.

“MEDIC”

Maladaptive, Enduring, Deviate from cultural norms, Inflexible, Cause impairment in social or occupational functioning

Question 2

Diagnosis of personality disorders

Answer 2

1) Ask about attitudes, mood variability, activities, and reaction to stress
2) Patients have chronic problems dealing with responsibilities, roles, and stressors. They may also deny their behavior, have difficulty changing their behavior patterns, and frequently refuse psychiatric care

Question 3

Tx of personality disorders

Answer 3

1) Psychotherapy is mainstay

2) Pharm is reserved for cases with comorbid mood, anxiety, or psychotic signs/symptoms

Question 4

Clusters

Answer 4

Cluster A: Weird

1) Paranoid
2) Schizoid
3) Schizotypal

Cluster B: Wild

1) Borderline
2) Histrionic
3) Narcissistic
4) Antisocial

Cluster C: Worried and Wimpy

1) OCPD
2) Avoidant
3) Dependent

Question 5

Cluster A disorders

Answer 5

1) Paranoid - distrustful, suspicious, interpret others’ motives as malevolent
2) Schizoid - isolated, detached “loners.” restricted emotional expression.
3) Schizotypal - Odd behavior, perceptions, and appearance. Magical thinking. Ideas of reference. brief episodes of psychotic symptoms may appear after stress.

Patients are suspicious and distrustful of psychiatrists, making it difficult to form therapeutic relationships between patient and psychiatrist

Be clear, honest, noncontrolling, and nondefensive

Question 6

Cluster B disorders

Answer 6

1) Borderline - unstable mood, relationships, and self-image. Feelings of emptiness. Impulsive. History of SI or self-harm. Brief psychotic episodes (esp after stressful situations).
2) Histrionic - excessively emotional and attention seeking. Sexually provocative, theatrical
3) Narcissistic - Grandiose; need admiration; have sense of entitlement. Lack empathy
4) Antisocial - violate rights of others, social norms and laws. Impulsive. Lack remorse. Begins in childhood as conduct disorder. Must be over 18.

Patients change the rules and demand attention. They are manipulative and demanding and will split staff members (BPD)

Be clear and consistent about boundaries and expectations

Question 7

Cluster C disorders

Answer 7

1) OCPD - Preoccupied with perfectionism, order, and control at the expense of efficiency. Inflexible morals and values. Excessively devoted to work.
2) Avoidant - Socially inhibited; rejection sensitive. Fear being disliked or ridiculed. Unable to get involved with people. Can’t take risks.
3) Dependent - Submissive, clingy; have a need to be taken care of. Have difficulty making decisions. Feel helpless. Can’t assume responsibility. Can’t make decisions. Seeks relationships.