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Behavioral Health 2 > Personality Disorders > Flashcards

Personality Disorders Flashcards

1
Q

4 areas in which personality disorders manifest

A
  • Cognition
  • Affectivity: range, intensity, lability, appropriateness of emotional response
  • Interpersonal functioning
  • Impulse control
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2
Q

4 General dx criteria for personality disorder (DSM5)

A
  • Enduring pattern of inner experience and behavior that deviates markedly from cultural expectations.
  • Pattern is inflexible and pervasive across broad range of personal and social situations
  • Pattern is stable, long duration, onset traced back to adolescence or early adulthood
  • Lead to clinically sig distress or impairment
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3
Q

3 reasons important for clinicians to understand personality disorders

A
  • Improves patient-provider relationship
  • Enhances compliance
  • Reduces pt stress
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4
Q

DSM-5 description of paranoid personality disorder

A

Pervasive mistrust/suspiciousness of others, think their motives are malevolent

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5
Q

DSM-5 Diagnostic criteria for paranoid personality disorder

A

Indicated by 4+ of:

  • Suspects, without basis, that others are exploiting, harming, deceiving
  • Preoccupied with unjustified doubts about loyalty or trustworthiness
  • Reluctant to confide in others – unwarranted fear the info will be used maliciously against pt
  • Reads hidden demeaning/threatening meaning into benign remarks/events
  • Persistently bears grudges
  • Perceives attacks on character or reputation that are not apparent to others, quick ot react angrily
  • Recurring suspicions regarding fidelity of spouse/sexual partner
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6
Q

DSM-5 description of Schizoid personality disorder

A

Pervasive pattern of detachment from social relationships, restricted range of expression of emotions in interpersonal settings

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7
Q

DSM-5 Diagnostic criteria for schizoid personality disorder

A

Indicated by 4+ of:

  • Doesn’t desire or enjoy close relationships
  • Chooses solitary activities
  • Little, if any, interest in sexual experiences
  • Takes pleasure in few activities
  • Lacks close friends or confidants outside of first-degree family
  • Indifferent to praise/criticism
  • Emotional coldness, detachment, flattened affect
  • Not exclusively during course of other psych disorder (schizophrenia, bipolar, etc.)
  • Can be considered “premorbid” to schizophrenia dx
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8
Q

DSM-5 Description of schizotypal personality disorder

A

Pervasive pattern of social/interpersonal deficits marked by acute discomfort with/reduced capacity for close relationships AND cognitive or perceptual distortions and eccentricities of behavior

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9
Q

DSM-5 Diagnostic criteria for schizotypal personality disorder

A

Indicated by 5+ of:

  • Ideas of reference
  • Odd beliefes or magical thinking
  • Unusual perceptual experiences
  • Odd thinking and speech (vague, circumstantial, etc.)
  • Suspiciousness or paranoid ideation
  • Inappropriate or constricted affect
  • Behavior/appearance is odd/eccentric/peculiar
  • Lacks close friends, confidants other than first-degree family
  • Excessive social anxiety does not diminish with familiarity, tends to be associated with paranoid fears vs. negative judgemetn about self
  • Not exclusively during course of other psych disorder (schizophrenia, bipolar, etc.)
  • Can be considered “premorbid” to schizophrenia dx
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10
Q

DSM 5 description of antisocial personality disorder

A
  • Pervasive pattern of disregard for/violation of the rights of others
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11
Q

DSM-5 Diagnostic criteria for antisocial personality disorder

A
  • Occurring since age 15 but must at time of dx be at least 18
  • Evidence of conduct disorder with onset before age 15
  • Indicated by 3+ of:
  • Failure to conform to social norms
  • Deceitfulness (lying, aliases, conning for profit or pleasure)
  • Impulsivity
  • Irritability/aggressiveness: fights/assaults
  • Reckless disregard for safety of self/others
  • Consistent irresponsibility: repeated failure to work consistently or honor financial obligations
  • Lack of remorse: indifferent to/rationalize having hurt, mistreated, stolen from another
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12
Q

DSM 5 description of conduct disorder

A

Repetitive and persistent pattern of behavior in which basic rights of others or major age-appropriate societal norms/rules are violated

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13
Q

DSM-5 Diagnostic criteria for conduct disorder

A
  • Must be < 18 yo
  • Manifested by 3+ of following in past 12 months:
    1. Aggression to people/animals
  • Bullies, threatens, intimidates
  • Initiates fights
  • Physically cruel to people
  • Physically cruel to animals
  • Stole while confronting a victim (mugging, extortion)
  • Raped
    2. Destruction of property
  • Fire setting to cause damage
  • Destruction of property other than fire
    3. Deceitfulness or theft
  • Broken into someone else’s house, car, building
  • Lies to obtain goods/favors or to avoid obligations
  • Has stolen items without confronting a victim (shoplifting, forgery)
    4. Serious violations of rules
  • Stays out past curfew starting < 13 yo
  • Ran away from home overnight min 2 times or once if left for long period of time
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14
Q

DSM 5 description of borderline personality disorder

A

Pervasive pattern of instability of interpersonal relationships, self-image, and affect and marked impulsivity

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15
Q

DSM-5 Diagnostic criteria for borderline personality disorder

A

Indicated by 5+ of:

  • Frantic efforts to avoid real/imagined abandonment
  • Unstable/intense interpersonal relationships, alternation between idealization and devaluation
  • Identity disturbance – unstable image or sense of self
  • Impulsivity in two areas that are potentially self damaging (spending, sex, substance abuse, etc.)
  • Recurrent suicidal behavior, gestures, threats, self-mutilation
  • Affective instability – marked reactivity of mood
  • Inappropriate, intense anger or difficulty controlling anger
  • Transient, stress-related paranoid ideation/severe dissociate sx
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16
Q

DSM 5 description of histrionic personality disorder

A

Pervasive pattern of excessive emotionality and attention seeking

17
Q

DSM-5 Diagnostic criteria for histrionic personality disorder

A

Indicated by 5+ of the following:

  • Uncomfortable if not center of attention
  • Interactions with others characterized by inappropriate sexually seductive or provocative behavior
  • Rapidly shifting/shallow expression of emotions
  • Consistently uses physical appearance to draw attn. to self
  • Speech is excessively impressionistic/lacking in detail
  • Self-dramatization, theatricality, exaggerated expression
  • Suggestible
  • Considers relationships to be more intimate than they are
18
Q

DSM 5 description of narcissistic personality disorder

A

Pervasive pattern of grandiosity (fantasy or behavior), need for admiration, lack of empathy

19
Q

DSM-5 Diagnostic criteria for narcissistic personality disorder

A

Indicated by 5+ of:

  • Grandiose senses of self-importance: exaggerates achievements/talents
  • Preoccupied with fantasies of unlimited success, power, brilliance, etc.
  • Believes is special and unique, can only be understood by/associate with other special, high-status people
  • Requires excessive admiration
  • Sense of entitlement
  • Interpersonally exploitative
  • Lacks empathy
  • Envious of others, believes others are envious of self
  • Arrogant, haughty behavior/attitudes
20
Q

DSM 5 description of avoidant personality disorder

A

Pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation

21
Q

DSM-5 Diagnostic criteria for avoidant personality disorder

A

Indicated by 4+ of:

  • Avoid occupational activities that involve sig interpersonal contact bc of fears of criticism, disapproval, rejection
  • Unwilling to interact w/ppl unless certain of being liked
  • Restraint in intimate relationships dt fear of being shamed/ridiculed
  • Preoccupied with being criticized or rejected in social situations
  • Inhibited in new interpersonal situations bc of feelings of inadequacy
  • Views self as socially inept, personally unappealing, inferior
  • Unusually reluctant to take personal risks, engage in new activities bc might be embarrassed
22
Q

DSM 5 description of dependent personality disorder

A

Pervasive and excessive need to be taken care of, leads to submissive and clinging behavior and fears of separation

23
Q

DSM-5 Diagnostic criteria for dependent personality disorder

A

Indicated by 5+ of:

  • Difficulty making everyday decisions without advice/reassurance from others
  • Needs others to assume responsibility for major life areas
  • Difficulty expressing disagreement dt fear of loss of support/approval
  • Difficulty initiating projects/doing things on own dt lack of self confidence (not lack of energy or motivation)
  • Excessive lengths to obtain nurturance and support from others, to point will volunteer to do unpleasant things
  • Uncomfortable/helpless when alone – exaggerated fears being unable to care for self
  • Urgently seeks relationship as source of care when close relationship ends
  • Unrealistically preoccupied with fears of being left to take care of self
24
Q

DSM 5 description of obsessive-compulsive personality disorder

A

Pervasive pattern of preoccupation with orderliness, perfectionism, mental/interpersonal control at the expense of flexibility, openness, efficiency

25
Q

DSM-5 Diagnostic criteria for obsessive-compulsive personality disorder

A

Indicated by 4+ of:

  • Preoccupied with details, rules, lists, order, organization to extent that major point of activity is lost
  • Perfectionism that interferes with task completion
  • Excessively devoted to work/productivity while excluding leisure and friendships
  • Over-conscientious, scrupulous, inflexible about matters of morality, ethics, values
  • Unable to discard worn-out or worthless objects even when have no sentimental value
  • Reluctant to delegate tasks or work with others unless do things exactly same way
  • Miserly spending style toward self and others – money should be hoarded
  • Rigid and stubborn
26
Q

Clinician behavioral approach to paranoid personality disorder

A
  • Admit mistakes
  • Forthcoming and honest
  • Professional but not overly warm (suspicious)
  • Don’t confront
  • Set limits
  • Clearly explain procedures, medications, results
27
Q

Clinician behavioral approach to schizoid personality disorder

A
  • understand need for isolation
  • min new contacts, intrusions
  • maintain quiet, reassuring, considerate interest
  • don’t insist on reciprocal responses
28
Q

Clinician behavioral approach to schizotypal personality disorder

A
  • Similar to Schizoid
  • Do not ridicule or judge
  • Respect need for privacy
  • Pt often have misinterpretations of physical sx and tx
29
Q

Clinician behavioral approach to antisocial personality disorder

A
  • Set firm limits
  • Try not to be manipulated
  • High level of skepticism
  • Don’t Rx excessive and/or unnecessary meds
30
Q

Clinician behavioral approach to borderline personality disorder

A
  • Be aware of and anticipate defenses
  • Be aware often regress through self-sabotage of tx plans
  • Open and continuous communication with other staff
  • Maintain stable and calm reactions
  • Gently comfort when needed
  • Set fair and consistent limits on acting out
31
Q

Clinician behavioral approach to histrionic personality disorder

A
  • Similar to borderline

- Mental illness threatens sense of attractiveness and self-image

32
Q

Clinician behavioral approach to narcissistic personality disorder

A
  • Pt will handle criticism poorly
  • Pt may be easily enraged
  • Med illness can be blow to self-esteem
  • Reinforce they are respected and appreciated
  • Set limits on demanding behavior
33
Q

Clinician behavioral approach to avoidant personality disorder

A
  • Patience and understanding
  • Med illnesses may be embarrassing
  • Min new and unfamiliar staff contacts
  • Respond with calm and reassuring demeanor
  • Do not criticize
34
Q

Clinician behavioral approach to dependent personality disorder

A
  • Respect feelings of attachment
  • Be careful when encouraging pt to change dynamics of abusive relationship
  • When ill might be frustrated not being helped
  • Be active in tx planning
35
Q

Clinician behavioral approach to obsessive-compulsive personality disorder

A
  • Allow pt to control care as much as possible
  • Provide pt with information
  • Avoid power struggles
  • Understand their need for order and control
36
Q

True/false: personality disorders are considered treatable

A

False -

generally considered not treatable

37
Q

One tx for borderline personality disorder

A

CBT with specially trained psychotherapist

38
Q

How to treat sx of generalized anxiety, depression, social anxiety, psychosis related to personality disorders?

A

pharmacotherapy as normal

Behavioral Health 2 (11 decks)

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