Personality Disorders Flashcards
Describe Personality
Complex pattern of characteristics that are not easily altered
Largely outside of the person’s awareness
Distinctive patterns of perceiving, feeling, thinking, coping and behaving
Emerges within a complexBio/psycho/social/spiritual framework
Describe personality disorders in general terms
An enduring pattern of inner experiences and behaviour. Starts without insight.
Deviates markedly from the expectations of a person’s culture
It is pervasive, inflexible and stable
Leads to distress, impairment and significant interference with interpersonal relationships
4 common features and Diagnostic Criteria for Personality Disorders
MESI
1) Maladaptive cognitive schema
(Don’t always interpret stimuli effectively)
2) Affectivity and emotional instability
(Minor Irritant becomes drama)
3) Impaired self identity
(Fragile self esteem, holds to others)
4) Impulsivity and destructive behaviour
(quick reactions without insight, can be destructive inwardly or outwardly)
Does gender impact PD prevalence?
No, affects both the same but women seem to report more.
General characteristics of cluster A
3 Subtypes?
Described as “odd” and “eccentric” personalities, thinking and/or behaviour
Common characteristics include social awkwardness and social withdrawal
These disorders are dominated by distorted thinking
3 Subtypes include:
Schizotypal, paranoid, schizoid
Describe Schizotypal Disorder
FOCUS is Delusional Beliefs
1) Perceptual distortion and eccentricity
2) Ideas of reference (newspaper example)
(broad statements speaking directly to pt)
3) Odd beliefs or magical thinking
4) Flat or incongruent emotional responses (emotional response don’t match situation)
Describe Paranoid Personality Disorder
Pervasive distrust and suspiciousness of other people
Assume that others are out to harm them, take advantage of them or humiliate them in some way
Tend to hold grudges, are litigious and may display pathological jealousy
What is the difference between paranoid PD and schizophrenia
Some overlap with paranoid symptoms of schizophrenia, but Schizophrenia includes voices and hallucinations.
Describe Schizoid PD
Pervasive pattern of social detachment and a restricted range of emotional expression. (Often experience little Joy)
Tend to be socially isolated, don’t seek out or enjoy close relationships and almost always chose solitary activities
Appear indifferent to both criticism and praise
Lacking a desire for intimacy
EX (tinkering with radio guy, not anxious about leaving house, but just didn’t care)
Describe Cluster B in general terms
“B” Subtypes?
DADE…
Described as dramatic, emotional and erratic cluster of personalities
General features include:
- Dissociation or denial
- Abusive behaviours (physical and emotional) -Splitting/dichotomous thinking
- Emotional dysregulation
SUBTYPES:
Histrionic, Narcissistic, antisocial, Borderline PD
Describe Histrionic Personality Disorder
Inappropriate, sexually seductive or provocative behaviour
Seek excitement and attention (attention-seeking behaviours) and quick attachment)
Outwardly appear charming and lively but have a threatened self-esteem and sense of attractiveness
Describes relationships as more intimate than they are.
Narcissistic personality DIsorder
Grandiosity (believes they are god like)
Believes that they are special, unique and can only be understood by high status
Sense of entitlement.
Needs constant admiration
Lacks empathy and takes advantage of others to achieve his/her own need. (tend to abuse others)
(require strict and uniform boundaries in care
Antisocial Personality Disorder
Disregards and violates others’ rights.
Can be charming BUT No remorse for wrongdoing and no empathy
Irritability and aggressiveness
Marked readiness to blame others or to offer plausible rationalizations for their behaviour
History of a conduct disorder before age 15 years. (oppositional defiant disorder)
Management of ASPD
Rarely seek help directly for ASPD Key assessments:
- Quality of relationship
- Impulsivity
- Violence risk
Self-awareness (nurse)
Structured, consistent environment
Describe Borderline PD
MURFI…
Mood lability (happy to suicide)
Unstable relationships, self image and affect
Recurrent suicidal behaviour, gestures, threats, self-mutilation
Fear of Rejection in relations (KEY feature, rejection can bring on break)
Impulsivity
etiologies of Borderline PD
Neurobiologic and genetic factors (First degree relative at risk, Serotonologic defecit)
Psychosocial risk factors
Psychological theories (Maladaptive cognitive processes- misunderstanding of events or environment)
Risk Factors of Borderline PD
Risk factors include :
-Physical and sexual abuse (55%-80%) -Parental abandonment and alienation
( 70% of people with BPD will have at least one suicide attempt in their lifetime, 10% will be successful)
What is Parasuicide
DEFINITION: Deliberate self-injury with the intent to harm oneself. (Not attention seeking, but maladaptive)
Compulsive self-injurious behaviour (often when numb, attempt to feel)
Why would DBT be particularly effective to someone with Borderline PD and involved in parasuicide?
It’s an attempt to reconnect with their body.
Mindfulness is reconnecting with one’s body
The behaviours that someone with Borderline Personality Disorder exhibit directly cause the outcome which they fear the most:
abandonment
Dialectical Behavioural Therapy (DBT)
(Common approach to Borderline PD)
4 common approaches?
-Skills group (could be facilitated by someone who has gone through Borderline PD)
-Interpersonal effectiveness skills -
(Build self image)
Mindfulness skills
-Distress tolerance
Tx for borderline PD
Dialectical Behavioural Therapy (DBT)
Psychopharmacotherapy
General characteristics of cluster “C”
Anxious or fearful thinking or behaviour
In isolation:
- Orderly
- Anxious
Passive-Aggression (indirect aggression):
-Self-chosen failure
- Masochistic (often exposed to harm and abuse and feel as though they deserve it)
- Dysthymic (Symptoms of depression on and off)
Subtypes of Cluster “C”
Obessive Compulsive, Dependent, Avoident
OCPD
Inhibited, stubborn, rigid and a perfectionist
Preoccupied with orderliness or perfection
Excessively devoted to work and productivity and excludes recreation and friendships
Reluctant to delegate tasks to others
Can have difficulty discarding worthless objects
Contrast OCD and OCPD
OCD requires an obsessive behviour which creates anxiety and is relived by compulsion.
Wheres OCPD there isn’t really anxiety, so much as the thought that this is the best way to do it
Dependent PD
Difficulty making everyday decisions without significant advice and reassurance from others
Need to be taken care of (Vulnerable to abuse)
Submissive behaviour as they fear disagreement and the loss of support/approval
Urgently needs to replace one relationship when another one ends
Avoidant PD
Socially inhibited, shy and lonely
Sense of inadequacy with low self-esteem
Desperate for relationships but avoid social contact. (Not anxiety, just avoid at all costs)
Reluctant to take risks or try new activities as they might be embarrassed
