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Clinical Disciplines (Melicia) > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

What are personality traits?

A

enduring patterns of perceiving, relating to and thinking about the environment and oneself

exhibited in a wide range of important social/personal contexts

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2
Q

What is a personality disorder?

A

enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals’s culture

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3
Q

In a pt with a personal disorder, how can maladaptive patterns manifest?

A

(in two or more of the following)

cognition- how we perceive/interpret internal and external events

affect

interpersonal interactions

impulse control

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4
Q

What are some traits of personal disorder?

A
  • inflexible and pervasive over broad range of situations
  • clinically significant distress/impairment
  • pattern stable over time, traced back to at least adolescence or early adulthood
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5
Q

What are the “clusters: of personality disorders

A

10 disorders divided into 3 “clusters”

A: paranoid, schizoid, Schizotypal

B: antisocial, borderline, histrionic, Narcissistic

C: Avoidant, dependent, obsessive compulsive

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6
Q

Describe cluster A personality disorders

A

odd or eccentric

Includes: Paranoid, Schizoid, Schizotypal

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7
Q

Describe cluster B personality disorders

A

dramatic, acting out, problem with empathy

Includes: Antisocial, borderline, histrionic, narcissistic

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8
Q

Describe cluster C personality disorders

A

prominent anxiety and novelty avoidance

Includes: Avoidant, Dependent, Obsessive-compulsive

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9
Q

Describe general personality disorder

A

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s cultures.

leads to clinically significant distress or impairment in social, occupation or other important areas of functioning.

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10
Q

What are some diagnostic features of general personality disorder?

A
  • inflexible/maladaptive personality traits –> sig. functional impairment/distress
  • belief/behaviors deviate from culture norm
  • long term pattern (must have developed by early adulthood)
  • distinguished from behavior/thinking during stressors or transient mental states
  • Ind. doesn’t see personality traits as problematic
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11
Q

If a personality disorder is dx in a pt younger than 18 y/o the disorder must be present for at least….

A

one year

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12
Q

When diagnosing a personality disorder you must be mindful of…

A
  • person’s culture
  • don’t confuse acclimating to new culture with PD
  • don’t confuse with religious belief
  • should only be dx if defining features/long-term behavior before age 18
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13
Q

Describe Paranoid PD

A

Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood

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14
Q

Pts with paranoid PD may believe that…

A
  • suspects w/out basis that others are exploiting, harming or deceiving them
  • reluctant to confide in others due to fear that info will be used maliciously
  • reads hidden demeaning or threatening meanings into benign remarks or events
  • persistent bears grudges

etc.

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15
Q

Tx for personality disorder?

A

these pts rarely present for tx

little research but individual therapy may help

early termination of tx is common

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16
Q

Pharmacotherapy for paranoid PD?

A

Generally NONE- contraindication, arouses unnecessary suspicion

But if severe anxiety –> anti-anxiety med

if severe agitation/delusional thinking –> anti-psychotic

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17
Q

Describe Schizoid PD

A

pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning in early adulthood

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18
Q

Characteristics of schizoid PD?

A
  • neither desires not enjoys close relationships
  • almost always chooses solitary activities
  • little interest in sexual experiences w/ another person
  • takes pleasure if few if any activities
  • lacks close friends
  • shows emotional coldness, detachment or flattened affectivity
19
Q

How does schizoid PD differ from avoidant PD?

A

their indifference to others

20
Q

Tx for schizoid PD

A

psychotherapy

these pts are unlikely to seek treatment, usually short in nature

21
Q

Characteristics of Schizotypal PD

A
  • ideas of reference
  • odd beliefs, magical thinking inconsistent with cultural norms
  • illusions
  • odd thinking/speech
  • suspicious/paranoid ideation
  • inappropriate/constricted affect
  • lack of close friends
  • odd/eccentric behavior, often unkempt manner of dress
  • excessive social anxiety
22
Q

Tx for schizotypal PD?

A

pts usually seek tx for associated anxiety/depression

23
Q

Describe antisocial PD

A

Pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years

24
Q

Characteristics of antisocial PD?

A
  • failure to conform to social norms, repeatedly performing acts that are grounds for arrest
  • deceitfulness, lying, using aliases
  • impulsivity
  • irritability/aggressiveness
  • disregard for safety of others
  • lack of remorse
25
Q

In order to dx antisocial PD disorder…

A

Pt must be at least 18 y/o with sxs onset before 15 y/o

26
Q

Antisocial PD epidemiology

A

related with low SES in urban settings

more common in males

27
Q

Treatment for antisocial PD

A

dif. working w/ these pts due to tendency to blame others, and low tolerance for frustration

cognitive behavioral therapy

+/- meds to reduce agression- NONE routinely used

28
Q

Describe borderline PD

A

Pervasive pattern of instability of interpersonal relationships, self image, and affects and marked impulsivity, beginning by early adulthood and present in a anxiety

29
Q

Characteristics of borderline PD

A
  • frantic efforts to avoid real/imagined abandonment
  • unstable and intense interpersonal relationships
  • unstable self image
  • impulsivity (spending, sex, substance abuse, etc.)
  • recurrent SI
  • marked mood reactivity
  • chronic feelings of emptiness
  • inappropriate intense anger
  • transient, stress related paranoid ideation
30
Q

Pts with…may react in despair to clinician’s announcing the end of the hour, panic or fury when someone important to them is just a few minutes late

A

Borderline personality disorder

31
Q

How do pts with borderline PD often present?

A

to ER in crisis

clinician should contact the pts PCP or primary therapist

32
Q

Borderline PD tx

A

should be encouraged to find additional support within community rather than presenting to ED

  • psychotherapy
  • SSRIs (unless comorbid bipolar d/o)
33
Q

Characterisitics of Histrionic PD

A
  • discomfort with not being center of attention
  • often inappropriate sexual seductiveness
  • labile/shallow expression of emotions
  • uses appearance to draw attention to self
  • impressionistic speech
  • melodramatic, theatrical emotional reactivity
  • highly suggestible
  • sees relationships as more intimate than they actually are
34
Q

In a pt with….PD opinions and feelings are easily influenced by others and by current fads

A

Histrionic PD

35
Q

Tx for Histrionic PD

A

individual psychotherapy

36
Q

Tx for obsessive compulsive PD

A

focused on short term sxs

work on coping mechanisms

CBT not effective

meds not indicated but +/- SSRI

37
Q

Characterisitics of Narcissistic PD

A
  • grandiose sense of self importance
  • fantasies of unlimited success, power, beauty, love
  • belief that they are special and should only associate with similarly elite ind.
  • requires excessive admiration
  • sense of entitlement
  • interpersonally exploitative
  • lacks empathy
  • envious of other or believes others are envious of the
  • arrogant, haughty
38
Q

Tx for narcissistic PD?

A

tx for sxs related to crises or other diagnoses

psychotherapy

39
Q

Characteristics of avoidant PD

A
  • avoids interpersonal contact for fear of criticism or rejection unless certain of being liked
  • restraint with intimacy for fear of shame or ridicule
  • preoccupation with criticism or rejection in social situation
  • self image: socially inept, unappealing or inferior
  • avoids personal risks, new activities for fear of embarrassment
40
Q

Tx for avoidant PD

A

psychotherapy

most effective when: short term, oriented toward finding solutions to specific life problems

41
Q

Characteristics for dependent PD?

A
  • trouble with everyday decisions-need for excessive advice
  • needs others to assume responsibility for most major ares of their life
  • dif. disagreeing with others due to fear of losing approval/support
  • dif. initiating projects
  • uncomfortable/helpless when alone
  • urgently seeks another relationship when close relationship ends
42
Q

Tx for dependent PD

A

short term psychotherapy aimed at specific problem solving

meds contraindicated unless a

43
Q

Characterisitics of obsessive-compulsive PD?

A
  • preoccupation with rules, lists, details, order
  • perfectionism interferes w/ task completion
  • excessive devotion to work/productivity-> excludes leisure/social interactions
  • over conscientious and inflexible on matters of morality, ethics or valves
  • excessive hoarding of worthless items
  • reluctance to delegate or work with others
  • miserly spending style
  • rigidity and stubbornness

Clinical Disciplines (Melicia) (9 decks)

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