personality disorders Flashcards
personality d/o egosyntonic or egodystonic
egosyntonic(not distressing to patient)
Very suspicious of others.
Patients tend to blame problems on others.
Preoccupied with the trustworthiness and loyalty of others
Feels threatened by others
Holds grudge
paranoid
cluster A
mad-weird
paranoid, schizoid, schizotypal
paranoid tx [2]
**Psychotherapy(individual)
Anti Anxiety meds
Voluntary social withdraw with no desire for close relationships
They will choose to be alone and have no interest in others
No interest in praise or criticism.
schizoid d/o
schizoid d/o tx[3]
Group therapy
Psychotherapy
maybe low dose anti-psychotics or antidepressant for comorbidities
Patients exhibit “magical thinking” – believing in telepathy, clairvoyance and other fantasies
Most likely personality disorder to progress to schizophrenia
Severe social anxiety
Schizotypal Personality Disorder
Schizotypal Personality Disorder tx [2]
Psychotherapy
Low dose antipsychotics if necessary
Most likely personality disorder to progress to schizophrenia
Schizotypal Personality Disorder
cluster B
bad and wild;
antisocial, borderline, histrionic, narcisscisitic
Patient must be 18 years or older. Otherwise see conduct disorder
Pattern of disregard for the rights of others
No empathy
Manipulative – may appear charming
Often a criminal pattern emerges
History of child abuse
History of starting fires, abusing animals etc.
EEG: abnormal
Antisocial Personality Disorder
Antisocial Personality Disorder tx [1 non med/2 meds]
Psychotherapy
SSRIs
Lithium
careful with meds due to abuse
which personality disorder can the pt act nml?
antisocial
Intense mood swings, impulsive behaviors, and severe problems with self-worth
Emotionally unstable and intense
Difficulty controlling anger
Cannot tolerate being alone, but exhibits intense anger/behavior with friends
“splitting”
Borderline Personality Disorder
Borderline Personality Disorder tx [2/3 meds]
Psychotherapy or “talk” therapy, Social skills training,
Group therapy, Assertiveness training
Beta-blockers – manages anxiety and depression, reduces sensitivity to rejection
SSRI – manages anxiety and depression, reduces sensitivity to rejection(Paroxetine, Sertralin, Escitalopram)
Benzodiazepines – used short-term for anxiety
splitting
Borderline Personality Disorder
which personality d/o has suicide ideation and harm higher incidence of MDD
borderline
Long standing pattern of attention-seeking behavior and a tendency to exaggerate thoughts and feelings
Affected individuals are exuberant and extroverted
Easily influenced by others
Somatization and substance-use disorders are very common
Defense mechanism: regression
Egocentrism
Self-indulgence
Persistent manipulation
Histrionic Personality Disorder
Histrionic Personality Disorder tx
[3 non med and 2 meds]
Psychotherapy Individual talk therapy Group therapy Antidepressants Anxiolytics
stress causes transient psychotic episodes, paranoia ideation, and dissociated symptoms
borderline
Inflated self image, pattern of grandiosity, need for admiration and lack for empathy
Long to be special, with arrogance and haughty attitude
Fragile self-esteem, prone to depression
Exhibitionist
Self-fixation
Exploitative and takes advantage of others to meet their own needs
manipulative others
Narcissistic Personality Disorder
Narcissistic Personality Disorder tx [2*, 3 other tx]
**Psychotherapy Cognitive behavioral therapy Group therapy *Lithium – for presence of mood swings Antidepressants – SSRIs Mood stabilizer – Lamotrigine Antipsychotic – Risperidone
which personality is difficult to treat
narcissistic
cluster C
worried, wimpy, sad;
avoidant, dependent, OCPD
Intense sensitivity to rejection
Feel inferior and as though no one would want to be around them
Hunger for company, but may completely avoid social situations due to fear of rejection.
Self loathing
Avoidant Personality Disorder
Avoidant Personality Disorder tx [3 non med/3 med]
Psychotherapy
Group therapy
Social skills and assertiveness training
BB, SSRI, benzos
Patients can not make decisions for themselves and feel others are better able to deal with the world.
Feel helpless
Clingy, submissive
Fear responsibility due to low self esteem
Fear being alone and need to form relationships for survival
Dependent Personality Disorder
Dependent Personality Disorder tx
[1*, 3 non med, 2 med]
** Insight oriented Psychotherapy Assertiveness training Group therapy Family therapy anxiolytics, antidepressants
OCD is ego-dystonic OCDP is ego-syntonic
Fixation on minute details and rules.
Obsession with lists and schedules
Extreme perfectionism
Inflexible and change in routine may cause significant anxiety
Obsessive cleanliness or hoarding
Polarised beliefs – things are either right or wrong
Obsessive-Compulsive Personality Disorder
Obsessive-Compulsive Personality Disorder tx
[3 non med/2 meds]
Psychotherapy
Group therapy
Behaviour therapy
SSRIs then cloimparamine 2nd line
which personality d/o is risk of depression high
dependent
which personality d/o can schizophrenia and MDD develop
obsessive compulsive personality d/o
Which personality disorder cluster is referred to as Bad?
Cluster B
Which personality disorder involves a person who desires the company of others, but is terrified of social situations of any kind?
Avoidant personality disorder
Which is ego-syntonic OCD or OCPD?
OCPD
The term “magical thinking” should make you think of which disorder?
Schizotypal personality disorder
“loners”
schzoid
most likely to progress to schizophrenia
schizotypal
(Paroxetine, Sertralin, Escitalopram)
SSRI
Cannot tolerate being alone, but exhibits intense anger/behavior with friends
borderline
attention-seeking behavior and a tendency to exaggerate thoughts and feelings
histrionic
lithium for what [3]
bipolar II, antisocial, narciss
TCA for what [2]
PTSD, panic d/o or attacks[maintenance]
insight oriented psychotherapy for who
phobia and dependent
individual psychotherapy for who
paranoid
