Personality Disorders

Question 1

Describe the types of Personality Clusters and the conditions that fit in each?

Answer 1

‘the mad’, ‘the bad, and ‘the sad’

Cluster B - most common, interpersonal relationships as micro-PTSD (traumatised by intimacy). Traumatised personality - avoidance. Divide the world into idealised and denigrated form. 10% mortality.
- borderline, Antisocial and narcissistic

Cluster A - schizoidal, continuum to schizophrenia. Don’t like to get close. Unavailable and detached with outbursts. Don’t come for help come with a partner.

Cluster C - Dependent personality disorder. Excessively avoidant of relationships, somatise distress. Dependent, extremely needy. Present with pain.

Question 2

What is an Acronym for Borderline Personality Disorder?

Answer 2

• I - identity disturbance
  
  • D - dissociation
  • E - emptiness
  • S - suicidal behaviour
  • P - paranoid ideation
  • A - abandonment
  • I - impulsiveness
  • R - relationships (unstable, splitting)
  • R - rage

Question 3

Antisocial Personality disorder Acronym?

Answer 3

CURRUPT 
C - cannot conform 
O - obligations ignored 
R - reckless disregard for safety 
R - remorseless 
U - underhanded (deceitful) 
P - planning insufficient (impulsive) 
T - temper (irritable + aggressive)

Question 4

Dependent Personality disorder Acronym?

Answer 4

Reliance
R - reassurance required
E - expressing disagreement is difficult
L - life responsibilities assumed by others
I - initiating projects difficult
A - alone (feels helpless/uncomfortable when alone)
N - nurturance (will go to excessive lengths to get it)
C - companionship sought urgently if carer leaves
E - exaggerated fears of being left to care for self.

Question 5

Name some ego defence mechanisms for BPD?

Answer 5

· Splitting (happens with projection)

· Projection (feeling angry, not happy they project anger onto someone)

Question 6

What are some ethical complications that you should think about in PD?

Answer 6

- allegations 
     reportable? 
     reasonable doubt
- gifts 
     no definite line, explore the context of what it means to the patient. Special meaning is more dangerous or to get some kind of reward/secondary benefit. 
- don't see them at the end of the day, in the morning. 
- room safety 
- often on surgical wards 
     continue to self harm 

go from being idealised to denigrated very quickly.

how to deal with these?

• boundaries
• set a discharge date (not beneficial to keep in hospital for long time - regress)
• try not to feed into the split