Personality disorders Flashcards
What is personality?
-what are the 5 components of personality?
a cluster of relatively predictable patterns to thinking, feeling and behaving that is generally consistent across time, space and context
-Openness Conscientiousness extroversion Neuroticism Agreeableness
What is a personality disorder? (6 aspects)
1. enduring pattern of inner experience and behaviour that deviates markedly from expectations of the individuals culture. manifested in 2+ of the following: cognition affectivity interpersonal functioning impulse control
- endurig pattern is inflexible and pervasive across broad rang of personal and social situations
- leds to clinically significant distress or impairment in social/occupational areas
- stable and of long duration, onset traced to adolescence or early adulthood
- not explained by another mental disorder
- no attributable to a substance or head trauma
What is Anankastic (obsessional) PD? (8)
Feelings of excessive doubt and caution.
Preoccupation with details, rules, lists, order, organization or schedule.
Perfectionism that interferes with task completion.
Excessive conscientiousness and scrupulousness.
Undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships.
Excessive pedantry and adherence to social conventions.
Rigidity and stubbornness.
Unreasonable insistence that others submit to exactly his or her way of doing things, or unreasonable reluctance to allow others to do things.
how common are they?
-risk factors?
- 6% of the population have them
- more prevalent in the psychiatric population
DSM 5 classification (3 clusters)
A: odd and eccentric
paranoid
Schizoid
Schizotypal
B: dramatic, emotional, erratic Antisocial Borderline Histrionic Narcissistic
C: anxious & fearful
avoidant
Dependent
Obsessive-Compulsive
Paranoid personality disorder
- overview?
- give the 7 indications?
-A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts
- 4 or more of the following:
1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them.
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
4. Reads hidden demeaning or threatening meanings into benign remarks or events.
5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
Schizoid PD
- overview
- what are the 7 indications?
-A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts
- 4 or more of the following:
1. Neither desires nor enjoys close relationships, including being part of a family.
2. Almost always chooses solitary activities.
3. Has little, if any, interest in having sexual experiences with another person.
4. Takes pleasure in few, if any, activities.
5. Lacks close friends or confidants other than first-degree relatives.
6. Appears indifferent to the praise or criticism of others.
7. Shows emotional coldness, detachment, or flattened affectivity.
Antisocial PD
- overview
- what are the 7 indications?
-A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years
- 3 or more of the following:
1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
Narcissistic personality disorder
-what are the 12 indications?
- Having an exaggerated sense of self-importance
- Expecting to be recognized as superior even without achievements that warrant it
- Exaggerating your achievements and talents
- Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believing that you are superior and can only be understood by or associate with equally special people
- Requiring constant admiration
- Having a sense of entitlement
- Expecting special favors and unquestioning compliance with your expectations
- Taking advantage of others to get what you want
- Having an inability or unwillingness to recognize the needs and feelings of others
- Being envious of others and believing others envy you
- Behaving in an arrogant or haughty manner
Borderline PD
- overview?
- what are the 9 indications?
-pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts
-5 or more of the following:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex,
substance abuse, reckless driving, bingeeating).
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria,
irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of
temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Histrionic PD
- overview?
- what are the 7 indications?
-pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts,
- 5 or more of the following:
1. Is uncomfortable in situations in which he or she is not the center of attention.
2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
3. Displays rapidly shifting and shallow expression of emotions.
4. Consistently uses physical appearance to draw attention to self.
5. Has a style of speech that is excessively impressionistic and lacking in detail.
6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.
7. Is suggestible (i.e., easily influenced by others or circumstances).
8. Considers relationships to be more intimate than they actually are.
Avoidant PD
- overview?
- what are the 7 indications?
-pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts
- 4 or more of:
1. Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
2. Is unwilling to get involved with people unless certain of being liked.
3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
4. Is preoccupied with being criticized or rejected in social situations.
5. Is inhibited in new interpersonal situations because of feelings of inadequacy.
6. Views self as socially inept, personally unappealing, or inferior to others.
7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
Dependent PD
- overview?
- what are the 8 indications?
-pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts
-5 or more of:
1. Has difficulty making everyday decisions without an excessive amount of advice and
reassurance from others.
2. Needs others to assume responsibility for most major areas of his or her life.
3. Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
7. Urgently seeks another relationship as a source of care and support when a close relationship ends.
8. Is unrealistically preoccupied with fears of being left to take care of himself or herself.
OCPD
- overview?
- what are the 8 indications?
-pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts
-4 or more of:
1. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
2. Shows perfectionism that interferes with task completion
3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships.
4. Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values.
5. Is unable to discard worn-out or worthless objects even when they have no sentimental
value.
6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
7. Adopts a miserly spending style toward both self and others; money is viewed as
something to be hoarded for future catastrophes.
8. Shows rigidity and stubbornness.
treatment of PD
- general?
- avoidant?
- borderline?
- antisocial?
treatment of co-morbidity should be the focus
-social skills training, maybe antidepressants
- dialectal behavioural therapy (DBT) or mentilisation
pharmacological: lamotrigine, Topiramate, valproate, Antidepressants, antipsychotics
-psychological interventions
