Personality Disorders Flashcards
What is identity?
Experience of oneself as unique, with clear boundaries between self and others
What is self-direction?
Pursuit of coherent and meaningful short term and life goals
What is empathy?
Comprehension and appreciation of others’ experiences and motivations
What is intimacy?
Depth and duration of connection with others; desire and capacity for closeness;
True or false: a healthy personality is flexible
True
True or false: a healthy personality has a varied repertoire of coping strategies
True
True or false: a healthy personality responds more to internal beliefs that to external stimuli
False–other way around
True or false: a healthy personality develops responses driven by current (rather than past) conditions
True
What is negative affectivity?
(“proneness to negative emotions”)–Frequent, intense experiences of high levels of a wide range of negative emotions
What is detachment?
Avoidance of socioemotional experience, including both withdrawl from interpersonal interactions and restricted affective experience and expression
What is antagonism?
Behaviors that put the individual at odds with other people, including an exaggerated sense of self-importances and a concomitant expectation of special treatment
What is disinhibition?
Orientation towards immediate gratification leading to impulsive behavior without regard for past learning or future consequences
What is psychoticism?
Exhibiting a wide range of culturally incongruent odd, eccentric, or unusual behaviors or cognitions
What is the definition of a personality disorder?
An enduring pattern of inner experience and behavior that is markedly different from the expectations of the individuals cultures
What are the areas that are affected with personality disorders? How many must be affected to diagnose someone with personality disorder?
- Cognition (“think”)
- Affectivity (“feel”)
- Interpersonal functioning
- Impulse control
2/4
True or false: Personality disorders needs to be persistent across a range of situations and is inflexible
True
True or false: Personality disorders need to be cause clinically significant distress or impairment
True
True or false: personality disorders need to be stable over time
True
When do personality disorders present? What happens as you grow older?
Onset of adolescence or early adulthood
Generally become more normal as they age
What does it mean for a personality pattern to be inflexible?
Needs to apply to all situations, regardless of variables of the situation
What is the prevalence of personality disorders in:
- the general population
- Primary care population
- Psychiatric outpatients
- 10-15% of general populations
- 20-30% of primary care
- 50% of psychiatric outpatients
What is the only age at which a personality disorder can be diagnosed?
18+
True or false: Those with personality disorders often misperceive the clinician’s intents
True
True or false: if the pt and clinician are having difficulty comprehending the other’s perspective, this is suggestive of a personality disorder
True
Do personality disorders need to be consistent across time?
Yes
What is ego-dystonic?
When past personality is incongruent with current self
What is ego-syntonic?
Self now is congruent with past self
Are personality disorders generally ego-syntonic or ego-dystonic?
syntonic
True or false: maladaptive interpersonal patterns increase under stress
True
What percent of individuals who meet full criteria for one personality disorder will meet full criteria for another?
60%
What are cluster A disorders? What are the three types?
odd, eccentric
- Paranoid
- Schizoid
- Schizotypal
What are cluster B disorders? What are the four types?
Dramatic, emotional
- Antisocial
- Borderline
- Histrionic
- Narcissistic
What are cluster C disorders? What are the three types?
Anxious, fearful
- Avoidant
- Dependent
- Obsessive-compulsive PD
What is paranoid PD?
Pattern of excessive distrust and suspicion of others, and belief that others have malevolent intent
What is the treatment approach for paranoid PD?
- Be very open about what you are doing and why
- Acknowledge patient’s feelings and concerns
True or false: Paranoid PD pts may take a slightly more friendly tone
False–overtones of friendliness may be met with suspicion
What is schizoid personality disorder?
Neither desires or enjoy close relationships
How are Social anxiety disorders different from schizoid personality disorders?
Schizoids Neither desire or enjoy close relationships, but social anxiety want relationships
True or false: schizoid personality disorders have little interest in sexual activities with another person
True
What is the treatment approach for schizoid personalities?
- Maintain a professional style, and interest in their well being.
- Respect privacy
Why must you explain why schizoid pts need to follow your your advice?
Do not care to please you–need a good reason to f/u
What is the schizotypal PD?
- Discomfort with close relationships
- Odd beliefs or magical thinking
- Odd perceptual experiences (“psychosis-light”)
What is the approach to pts with schizotypal PD? (2)
- Avoid confronting odd beliefs or behaviors
- Screen for more florid forms of psychosis
What is an antisocial PD?
- Persistent disregard for the right of others without remorse
- Consistent deceitfulness
- Irritability
What is the approach to antisocial PD?
- Set clear patient-clinician relationship boundaries
- Be mindful of drug-seeking or malingering
What is the key defining quality of antisocial PD?
Lack of remorse
What is borderline PD?
- Desperation to avoid abandonment
- Intense, All good or all bad relationships
What is the approach toward pts with borderline PD? (3)
- Avoid rescuing or abandoning
- Be predictable and stable
- Establish realistic expectations and boundaries
What is the classic defining feature of borderline PD?
All good or all bad relationships
True or false: pts with borderline PDs often have intense, poorly controlled anger
True
True or false: pts with borderline PDs do not have suicidality
False–diagnostic criteria that they do
What is histrionic PD?
- Desire to be center of attention at all times
- Often seductive or sexually provocative
What does it mean to say that histrionic PDs are suggestible?
Your suggestions influence their responses
What is the approach to a histrionic PD?
Maintain clear boundaries
What is narcissistic PD?
- Sees self as superior and expects others to do the same
- Lacks empathy
True or false: narcissistic PDs tend to lack empathy
True
What is the approach to narcissistic PD?
Avoid confronting the entitlement–frame suggestions with a statement about the patient deserving the best care possible
What is an avoidant PD?
Very strong fears of criticism and rejection that leads to avoidance of activities of personal contact
What is the approach to avoidant PD?
Be calm, transparent, and reassuring.
What is depended PD?
- Requires excessive advice and reassurance to make small decisions
- Feels uncomfortable or helpless when alone
What is the approach to dependent PD?
Avoid making decisions for patient–offer options and support them
What is obsessive-compulsive PD?
- Preoccupied with details and order more than the main point of the task
- Perfectionist to a level that impairs functioning
What is the approach to obsessive-compulsive PD?
Assume a consultant role
What are the comorbidities with cluster C PDs?
Depression
substance abuse
What are the comorbidities with cluster B PDs?
Elevated risk of suicide
What is the treatment for PDs?
- Management is the goal
- psychotherapy
How can you manage your feelings of a PD pt?
-Consult with colleagues
What is the major issue with obtaining a history with a schizoid personality disorder?
Unlikely to volunteer information
