personality disorders

Question 1

this personality cluster involves social detachment with unusual behaviors: weird sx, odd, eccentric

Answer 1

cluster A

Question 2

what are the cluster A personality disorders?

Answer 2

schizoid personality disorder
schizotypal personality disorder
paranoid personality disorder

Question 3

long patter of voluntary social withdrawal, anhedonic introversion (constricted affect) “Hermit-like behavior” (reclusive)

Answer 3

schizoid personality disorder- usually males

Question 4

clinical manifestations of schizoid personality disorder

Answer 4

1. inability to form relationships, lifelong pattern of social withdrawal. prefer to be alone (take no enjoyment in close relationships, sex)
2. anhedonic: appears indifferent to others, lack of response to praise or criticism or feelings espressed by others
3. appear eccentric, isolated or lonely, “cold” flattened affect, quiet unsociable

Question 5

management of schizoid personality disorder

Answer 5

1. psychotherapy: including group thearpy

2. pharmacologic: +/- short-term low dose antipsychotics, antidepressants or psychostimulants

Question 6

odd eccentric behavior and peculiar thought patterns sugestive of schizoprenia but WITHOUT psychosis (delusions)- “strange eccentric” behavior

Answer 6

schizotypical personality disorder - usually early adulthood onset

Question 7

clinical manifestations of schizotypal personality disorder

Answer 7

1. odd eccentric behavior or appearance, inappropriate affect, “magical thinking” (believes in clairvoyance, telepathy, superstition etc) bizarre fantasies.
2. pervasive discomfort w close relationships, may talk to self in public

Question 8

management of schizotypal personality disorder

Answer 8

1. psychotherapy

2. parmacologic: +/- short term low doses antipsychotics, antidepressants or benzos

Question 9

cluster a personality disorder, distrust and suspiciousness, begins in early adulthood mostly in males

Answer 9

paranoid personality disorder

Question 10

clinical manifestations of paranoid personality disorder

Answer 10

distrust and suspiciousness: systemized delusions of persecutions or grandeur hallucinations. suspects other as malevolent, sees hidden messages, eaily insulted, appears cold and serious, lack of interest in social relationships, bears grudges, doesn’t forgive, blame problems on others. PREOCCUPATION WITH DOUBT REGARDING OTHERS LOYALTY. NO HALLUCINATIONS

Question 11

management of paranoid personality disorder

Answer 11

1. psychotherapy: including group therapy tx of choice!
2. pharmacologic: short-term low doses of antipsychotics if severe (Haldol) or benzos (for anxiety or agitation) if necessary

Question 12

what are cluster B personality disorders characterized by?

Answer 12

“dramatic”: wild sx, dramatic, emotional, erratic, impulsive

Question 13

what are the cluster B personality disorders?

Answer 13

anti-social personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder

Question 14

behaviors deviating sharply from the norms, values, and laws of society (harmful or hostile to society). VIOLATES THE RIGHTS OF OTHERS (may set fires, kill cates, other criminal actions)

Answer 14

anti-social personality disorder

Question 15

how old must someone be to diagnose them with anti-social personality disorder?

Answer 15

18- but may begin at childhood as conduct disorders (males 3x MC)

Question 16

clinical manifestations of anti-social personality disorder

Answer 16

inability to conform to social norms with disregard and violation of the rights of others, lack of empathy, pattern of criminal behavior, little anxiety. extremely manipulative, deceitful, impulsive, promiscuous, spouse/child abuse, lacks remorse, DRUNK-DRIVING COMMON

Question 17

management of anti-social personality disorder

Answer 17

1. psychotherapy

2. pharmacologic: not helpful. conduct disorders in children may lead to anti-social in adulthood

Question 18

conduct disorders in children may lead to what in adulthood?

Answer 18

anti-social personality disorder

Question 19

cluster B personality disorder: unstable, unpredictable mood affect, unstable self image and relationships. mostly seen in women. “MOOD SWINGS”, MOMENTS OF INTENSE ANGER

Answer 19

borderline personality disorder

Question 20

clinical manifestations of borderline personality disorder

Answer 20

1. extreme pattern of instability in relationships but cannot tolerate “being alone”
2. “black and white thinking”
3. self-harm: suicide threats, self-mutilation, marked impulsivity with self-damaging behaviors (substance abuse, reckless driving, bing eating) may develop feelings of emptiness

Question 21

management of borderline personality disorder

Answer 21

1. psychotherapy: including group therapy tx of choice!

2. pharmacologic: +/- short term low doses antipsychotics, antidepressants, or benzodiazepines

Question 22

cluster B personality disorder: overly EMOTIONAL, DRAMATIC, SEDUCTIVE. “ATTENTION-SEEKING”

Answer 22

histrionic personality disorder

Question 23

clinical manifestations of histrionic personality disorder

Answer 23

self-absorbed, ‘temper-tantrums’, efforts to draw attention to themselves with need to center of attention,” inappropriate, seductive, shallow or exaggerated emotion. seeks reassurance and praise often

Question 24

treatment of choice for histrionic personality disorder

Answer 24

psychotherapy;: including group therapy tx of choice

Question 25

cluster B personality disorder: grandiose often excessive sense of self-importance*but needs praise and admiration

Answer 25

narcissistic personality disorder

Question 26

clinical manifestations of narcissistic personality disorder

Answer 26

consider themselves special, entitled, require extra special attention BUT have a fragile self esteem (occupied with fantasies, jealous of others or believes others are envious of them. doesn’t tolerate rejection well, often become depressed. difficulty with aging process. lacks empathy)

Question 27

management of narcissistic personality disorder

Answer 27

psychotherapy: including group therapy tx of choice

Question 28

what are cluster C personality disorders characterized by?

Answer 28

anxiety and fearful: whiny, fearful, anxious, dependent

Question 29

cluster C personality disorder characterized by a desire for relationships but avoids them “inferiority complex”** (intense feelings of inadequacy, very sensitive to criticism, fears rejection and humiliation. timid, shy, lacks confidence

Answer 29

avoidant disorder

Question 30

management of avoidant disorder

Answer 30

1. psychotherapy: establishing limits

2. pharmacologic: +/- beta blockers for anxiety or SSRIs for depression

Question 31

cluster C personality disorder characterized by dependent, submissive behavior. constantly needs to be reassured, relies on others, will not initiate things, intense discomfort when alone, may volunteer for unpleasant tasks

Answer 31

dependent personality disorder

Question 32

cluster C personality disorder: perfectionists who require a great deal of order and control: rigid adherence to routine (rules, lists, details, inflexible, stubborn, lacks spontaneity). ORDER AND PERFECTION PARAMOUNT. preoccupied with minor details (may find it difficult to finish projects)

Answer 32

Obsessive-compulsive personality disorder

Question 33

management of obsessive compulsive personality disorder

Answer 33

1. psychotherapy: only personality disorder where patients frequently seek help
2. +/- beta blockers for anxiety or SSRI’s for depression