Personality disorders Flashcards
Personality disorder definition
3 Ps:
Pervasive - occurs in all/most areas of life
Persistent - evidence from adolescence & continues into adulthood
Pathological - causes distress to self or others, impairs function (occupational/social/relationships)
ICD-10 General criteria
Traits deviate markedly from cultural norm
More than one area of cognition, affectivity, control of impulses, gratification and ways of relating to others
Pervasive and inflexible
Distress, personal and to others
Long standing and stable
No organic cause or other mental disorder
Paranoid PD
Cluster A SUSPECT Sensitive Unforgiving Suspicious Possessive Excessive self importance Conspiracy theories Tenacious sense of rights
Schizoid PD
Cluster A ALL ALONE
Anhendonic
Limited emotional range
Little sexual interest
Apparent indifference to praise/criticism Lacks close relationships One player activities Normal social conventions ignored Excessive fantasy world
Schizotypal PD
Cluster A eccentric Odd beliefs and magical thinking Unusual perceptions Paranoid Vague Social withdrawal
Emotional unstable PD
Cluster B AEIOU Affectivity instability Explosive behaviours Impulsive Outbursts of anger Unable to plan or consider consequences
Borderline PD
Cluster B SCARS Self image unclear Chronic empty feeling Abandonment fears Relationships are intense and unstable Suicide and self harm *occasional psychotic features
Impulsive PD
Cluster B LOSE IT Lacks impulse control Outbursts of threats of violence Sensitivity to being criticised or let down Emotionally unstable Inability to plan ahead Thoughtlessness of consequences
Dissocial PD
Cluster B FIGHTS Forms but can't maintain relationships Irresponsible Guiltless Heartless Temper lost easily Someone else's fault
Histrionic PD
Cluster B ACTORS Attention seeking Concerned with own appearance Theatrical Open to suggestions Racy and seductive Shallow affect
Narcissistic PD
Grandiose sense of self importance
Need for admiration
Obsessive compulsive/ anakastic
Cluster C DETAILED Doubtful Excessive detail Tasks not completed Adheres to rules Inflexible Likes own way Excludes pleasure and relationships Dominated by intrusive thoughts
Anxious/avoidant PD
Cluster C AFRAID Avoids social contact Fears rejection/criticism Restricted lifestyle Apprehensive Inferiority Doesn't get involved unless sure of acceptance
Dependent PD
Cluster C SUFFER Subordinate Undemanding Feels helpless when alone Fears abandonment Encourages others to make decisions Reassurance needed
Epidemiology of PD
Community 5-15% commonly cluster c Inpatients 30-69% commonly cluster b Cluster b overall most common Equal sex distribution Decrease with age 40-80% self harm 50-80% in prisons
Aetiology of PD
Largely unknown Genetics Early adverse social circumstances Childhood temperament Disordered attachment Schizophrenic relatives Neuro chemical imbalance Maladaptive psychological defence mechanism
Principles of management of PD
Avoid exclusion Encourage autonomy and choice Develop a trusting relationship Carefully plan endings and transitions Assess sources of distress and co morbid illness
Management of PD psychological
Address and modify maladaptive traits Dialectical behaviour therapy Mentalisation based therapy -> understand their minds and the minds of others CBT Cognitive analytical therapy Dynamic psychotherapy Therapeutic communities Specialist PD unit
Management of PD biological
Antipsychotics-> transient psychotic experiences, decrease impulsivity and agitation
Antidepressants if co morbid depression
Mood stabilisers for cluster b
Management of PD social
Stigma
Social inclusion activities
Finances
Housing
Prognosis of PD
High morbidity and mortality
High suicide rates
Some remit with age
Personality traits definition
Enduring patterns of perceiving, relating to and thinking about the environment and oneself
Exhibited in a wide range of important social and personal contexts
