Personality Disorders Flashcards
What is a personality disorder?
Enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has its onset in adolescence or early adulthood, is stable over time, and leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Rules about diagnosing a personality disorder
We all have personality traits. There is a wide normal range.
Traits are not a disorder.
Never seize on one or two symptoms to make a diagnosis.
How common are personality disorders?
Between 9 and 16% of the general population has a personality disorder.
Starts in late adolescence, often with signs in childhood, but is not diagnosed until adulthood. In early adulthood, we see established patterns.
Symptoms wax and wane in response to life stress.
Note that Late-onset personality changes are suggestive of undiagnosed “other” problem (dementia, substance abuse, medical illness, neurological problem).
What are some lasting traits that are seen as agreeable in most cultures?
- Emotional Stability versus Neuroticism (Anxiety-prone)
- Agreeableness versus Antagonism
- Extraversion (Seeks stimulation and excitement. Short attention span) versus Introversion (Avoids stimulation, likes being left alone. Long attention span)
- Conscientiousness (Plans ahead, gets things done)
- Openness to experience
These traits feature in predicting Health and mortality, Academic success, Job performance, Capacity for lasting relationships, and Drug abuse and criminality
“Basic Trust”
Trust versus mistrust
Nature/Nurture issues
People who were raised in chaos and/or abuse are, understandably, deficient in “basic trust.”
Chaotic families typically beget chaotic offspring. How much is genetic and how much is due to environment?
What are defense mechanisms?
Unconscious cognitive strategies that help us deal with things that are too uncomfortable to contemplate.
What are some common defense mechanisms?
Repression: Early trauma is often “repressed,” i.e. not accessible to conscious memory. This may reveal itself in an unexpected context, such as during invasive procedures.
Projection: May explain irrational anger outbursts and accusations when the patient feels wronged and vulnerable, even though nobody meant any harm.
Denial: Unable to accept reality. Can serve a useful function if reality is too painful.
What are the subsets of Cluster A (Weird) personality disorders?
Paranoid
Schizoid
Schizotypal
These are all labels as “odd or eccentric” and marked by an inability to develop meaningful social relationships but there is NO psychosis
NOTE: Biological relatives of people with schizophrenia often are cluster A
Describe a diagnosable paranoid personality
What is the major defense mechanism of paranoid personality?
Projection
Describe a diagnosable schizoid personality
What is a distinction that should be made between schizoid personality and social phobias?
Social phobic pts desire relationships but are afraid to persue them (and also suffer from other things like stage fright, voice cracks, etc.), while a schizoid personality suggests a lack of interest in seeking relationships
Describe a diagnosable schizotypical personality
What is trichotillomania?
also known as hair pulling disorder, is an impulse control disorder characterised by a long term urge that results in the pulling out of one’s hair. This occurs to such a degree that hair loss can be seen.
Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress
