Personality disorders

Question 1

Define personality

Answer 1

A combination of traits and patterns that influence behaviour, thought, motivation, and emotion.

Question 2

Define personality disorders

Answer 2

Deeply ingrained and enduring behaviour patterns resulting in inflexible response to a range of situations.

Significant deviation from average perception/condition

Associated with distress and functional impairment

Question 3

What are the features of personality disorders?

Answer 3

• Symptoms begin in childhood or adolescence
• Continues into adulthood
• Stable over time despite fluctuating mood
• Manifest in different environments
• Recognisable to friends and acquaintances

Question 4

What are the features of dissocial personality disorder?

Answer 4

Any 3 of the following:

• Callous lack of concern for others
• Lack of remorse for actions
• Ignore social norms of acceptable behaviour
• Disregard rules and law
• Inability to maintain relationships
• Low threshold for frustration and violence
• Proneness to blame others

Question 5

What are the features of Emotionally Unstable PD - Impulsive type?

Answer 5

Quarrelsome behaviour, plus two of:

• Inability to control anger
• Difficulty maintaining a plan that offers no immediate reward
• Unstable and capricious (sudden unpredictable change) mood
• Unexpected actions without consideration of consequences

Question 6

What are the features of Emotionally Unstable PD - Borderline type?

Answer 6

• Unclear identity and preferences
• Intense and unstable relationships
• Emotional and affect instability: repeated crises
• Efforts to avoid abandonment
• Recurrent threats or acts of self-harm
• Chronic feelings of emptiness

Question 7

Name three predisposing factors for PDs

Answer 7

• Genetics
• Early life experiences, for example:
  
  • Abuse
  • Separation
  • Family rejection
  • Lack of rules

Question 8

What specific mental disorders are strongly associated with Dissocial and EUPD?

Answer 8

• Substance misuse
• Eating disorders - particularly bulimia nervosa
• Habit and impulse disorders
• PTSD and borderline EUPD
• Somatoform disorders

Question 9

What is the main indication for biological therapies in personality disorders?

Answer 9

Development of comorbid mental illness

Question 10

What psychological therapy beneficial for Dissocial PD?

Answer 10

CBT

Question 11

What psychological therapy is beneficial for Borderline EUPD?

Answer 11

Combination DBT + CBT

• Dialectical behavioural therapy
  
  • Group development of interpersonal skills
• Modified form of CBT
  
  • Additional skills of mindfulness, distress tolerance, and acceptance