Personality Disorders Flashcards
ICD10 definition of Personality Disorder?
A severe disturbance in the characterological condition and behavioural tendencies of the individual, usually involving several areas of the personality and nearly always associated with considerable personal and social disruption.
To diagnose what must you other differentials must you exclude? (3)
Psychosis and affective disorders
Substance misuse
Organic causes
Predisposing factors? (5)
Sexual, physical and emotional abuse Neglect Being bullied/bullying others Expulsion/suspension Self-harm
Paranoid PD?
They display pervasive distrust and suspicion.
Schizoid PD?
Withdrawal from affection, social and other contacts
Isolation and limited capacity to experience pleasure and express feelings
Indifference to praise and criticism
(think Bruce Wayne/Batman from recent Christopher Nolan films)
Dissocial PD?
Act outside social norms, a disregard for the feelings of others and an inability to modify behaviour in response to adverse events (eg, punishment).
Low threshold for violence and a tendency to blame others
Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
Emotionally unstable PD?
Impulsive and unpredictable.
Outbursts of emotion and quarrelsome behaviour.
Relationships tend to be unstable and there may be suicidal gestures and attempts.
Histrionic PD?
Shallow affect + manipulative
Dramatic, egocentric, craves attention + excitement
Anankastic PD?
Perfectionism + pedantic
Caution, doubt, indecisive
Avoidant PD?
Self-conscious, timid, insecure
Fear of negativity from others
Dependent PD?
Clingy, submissive, excess need for care
Feels helpless when not in relationship
Needs people to make decisions for them
Psychosocial management options? (4)
Psychotherapy - to improve perceptions of and responses to social and environmental stressors.
Psychodynamic psychotherapy: examines the ways that patients perceive events, based on the assumption that perceptions are shaped by early life experiences.
CBT
IPT
Medical Mx (although only symptomatic)
Mood stabilisers e.g. lithium
2nd generation A/P e.g. risperodone, olanzapine
Other PD disorders (narcissistic, borderline)
Narcissistic: Grandiosity, need for admiration, preoccupation with fantasies of unlimited success, power, or beauty
Borderline: Unclear identity, intense and unstable relationships, unpredictable affect (–> think nightmare boyfriend/girlfriend)
