Personality Disorders Flashcards
What is a personality disorder?
An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas:
- Cognition
- Affectivity
- Interpersonal functioning
- Impulse control
Describe the pattern of a personality disorder.
- The pattern is inflexible and pervasive.
- It leads to clinically significant distress or impairment in a range of important areas of functioning.
- The pattern is stable and can be traced back at least to early adulthood.
- It is not better explained by another diagnosis.
- It is not attributable to a physiological change.
What are the prominent problems of cluster A personality disorders?
The prominent problems are with the perceived safety of interpersonal relationships
What are the cluster A personality disorders?
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
What is paranoid personality disorder?
- A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts.
- Requires 4 or more criteria
What is the criteria for a paranoid personality disorder?
- Suspects, that others are exploiting, harming or deceiving them
- Preoccupied with unjustified doubts about loyalty and trust
- Reluctant to confide in others
- Reads hidden demeaning or threatening meanings into benign events
- Persistently bears grudges
- Perceives attacks on their character that are not apparent to others
- Recurrent suspicions regarding partners fidelity
What is Schizoid personality disorder?
- A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts
- Requires 4 or more criteria
What are the criteria for Schizoid personality disorder?
- Neither desire nor enjoys close relationships
- Chooses solitary activities
- Little, if any interest in sexual experiences
- Takes pleasure in very few activities
- Lacks close friends
- Appears indifferent to praise or criticism
- Shows emotional coldness, detachment or flattened affectivity
What is Schizotypal personality disorder?
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capcity for close relationships ass well as by cognitive or perceptual distortions and eccentricities of behaviour, beginning by early adulthood and present in a variety of contexts
-Requires 5 or more criteria
What is the criteria for Schizotypal personality disorder?
- Ideas of reference
- Odd beliefs or magical thinking
- Unusual perceptual experiences
- Odd thinking and speech
- Suspiciousness or paranoid ideation
- Inappropriate or constricted affect
- Behaviour or appearance that is odd
- Lack of close friends
- Excessive social anxiety
What is the problem with cluster B personality disorders?
The prominent problems are with keeping feelings tolerable without acting
What are the cluster B personality disorders?
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Borderline Personality Disorder
- Histrionic Personality Disorder
What is antisocial personality disorder?
A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years
- Requires 3 or more criteria
- > 18 years
What is the criteria for antisocial personality disorder?
- Failure to conform to social norms with respect to lawful behaviours
- Deceitfulness, repeated lies, conning others, use of aliases
- Impulsivity
- Irritability and aggressiveness
- Reckless disregard for safety of others
- Consistent irresponsibility
- Lack of remorse
What is the sphere of antisocial behaviour?
- Antisocial behaviour
- Antisocial personality disorder
- Severe ASPD
- Psychopathy
What is borderline personality disorder?
A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts
-Requires 5 or more criteria
What is the criteria for borderline personality disorder?
- Frantic efforts to avoid real or imagined abandonment
- Pattern of unstable and intense interpersonal relationships
- Identity disturbance
- Impulsivity in at least 2 areas
- Recurrren suicidal behaviour
- Chronic feelings of emptiness
- Inappropriate intense anger
- Transient stress related paranoid ideation
What is narcissistic personality disorder?
A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration and lack of empathy, beginning by early adulthood and present in a variety of contexts
-Requires 5 or more criteria
What is the criteria for narcissistic personality disorder?
- Grandiose sense of self-importance
- Preoccupied with fantasies of unlimited success
- Believes they are special
- Requires excessive admiration
- Sense of entitlement
- Interpersonally exploitative
- Lack empathy
- Envious of others or believes other are envious of them
- Shows arrogant, haughty behaviours
What is histrionic personality disorder?
- A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts
- Requires 5 or more criteria
What is the criteria for histrionic personality disorder?
- Uncomfortable when they aren’t centre of attention
- Inappropriate sexual or provocative behaviour.
- Rapidly shifting and shallow expression of emotion
- Uses physical appearance to draw attention
- Excessive style of speech
- Self-dramatization
- Is suggestible
- Considers relationships to be more intimate than they are
What is the problem with cluster C personality disorders?
The prominent problems relate to anxiety and how it is managed (in relationships)
What are the cluster C personality disorders?
- Obsessive-Compulsive (Anankastic) Personality Disorder
- Avoidant Personality Disorder
- Dependent Personality Disorder
What is dependent personality disorder?
- A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears separation, beginning by early adulthood and present in a variety of contexts
- Requires 5 or more criteria
What is the criteria for dependent personality disorder?
- Has difficulty making everyday decisions without advice or reassurance
- Needs other to assume responsibility for most areas in their life
- Difficulty expressing disagreement
- Difficulty initiating projects
- Goes to excessive lengths to get support from others
- Feels uncomfortable when alone
- Urgently seeks relationship when one ends
- Unrealistically preoccupied with fears of being left to take care of themselves
What is obsessive compulsive disorder?
- A pervasive pattern of preoccupation with orderliness, perfectionism and mental and interpersonal control at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts
- Requires 4 or more criteria
What is the criteria for obsessive compulsive disorder?
- Preoccupied with details and organisation
- Shows perfectionism
- Excessively devoted to work and productivity
- Over conscientious and scrupulous
- Unable to discard worn-out or worthless objects
- Reluctant to delegate
- Money is hoarded
- Rigid and stubborn
What is avoidant personality disorder?
- A pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of context
- Requires 4 or more criteria
What is the criteria for avoidant personality disorder?
- Avoids occupational activities that involve interpersonal contact for fear of criticism
- Unwilling to get involved with people
- Shows restraint within intimate relationships
- Preoccupied with being criticised in social situations
- Inhibited in new interpersonal situations
- Views self as socially inept
- Unusually reluctant to take personal risks
What is psychopathy?
- Severe form of antisocial pd.
- Characterised by a antisocial behaviour, callous disregard and lack of empathy.
How is psychopathy diagnosed?
Using the PCL-R (psychopathy checklist revised)
What is the rationale for pharmacotherapy?
- Pharmacotherapy directly influences PDs
- Pharmacotherapy exerts an effect over core or nuclear symptom clusters
- Pharmacotherapy exerts its therapeutic effect by treating comorbid Axis I disorders
Metalizing
Process by which we make sense of each other and ourselves, implicitly and explicitly in terms of subjective states and intentional varied mental processes
What is the prevalence of personality disorders?
- Community 10 %
- General practice 20 %
- Psychiatric outpatients 30%
- Psychiatric inpatients 40%
- Prison up to 80 %
What are the general principles of psychodynamic psychotherapy?
- Stability of framework
- Therapists active contribution
- Tolerance of hostility and negative transference.
- Discouraging self destructive behaviours
- Using interpretation to establish bridges between actions and feelings
- Setting limits
- Focussing on here and now
- Careful monitoring of countertransference
What are the effective ingredients for psychotherapy treatment?
- Well structured
- Devote considerable effort to enhancing compliance
- Have clear focus
- Theoretically highly coherent to both therapist and patient
- Relatively long term
- Encourage a powerful attachment relationship between therapist and patient
- Well integrates with other services available to the patient
