Personality Disorders

Question 1

What are the prominent problems in cluster A personality disorders?

Answer 1

The perceived safety of interpersonal relationships

Question 2

Examples of cluster A personality disorders

Answer 2

Paranoid Personality Disorder
Schizoid personality disorder
Schizotypical personality disorder

Question 3

Definition of paranoid personality disorder

Answer 3

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

Question 4

Symptoms of paranoid personality disorder

Answer 4

Suspects, without sufficient basis, that others are exploiting, harmful or deceiving to them
Is preoccupied with unjustified doubts about the loyalty or untrustworthiness of friends or associates
Is reluctant to confide in others because of an unwarranted fear that the information will be used maliciously against them
Reads hidden demeaning or threatning means into benign remarks or events
Peristently bears grudges
Percieves attacks on their character or reputation that are not apparent to others
quick to react angrily or to counterattack
has recurrent suspicions, without justification, regarding fidelity of a spouse or sexual partner

Question 5

Presentation of schizoid personality disorder

Answer 5

neither desires or enjoys close relationships (inc family)
almost always choses solitary activites
has little, if any interest in having sexual activites with another person
takes pleasure in few, if any, activites
lacks close friendships or confidants other than first degree relatives
appears indifferent to the praise or critiscm of others
shows emotional coldness, detatchment or flattened affectivity

Question 6

Definition of schizoid personality disorder

Answer 6

A pervasive pattern of detatchment from social relationships and a restricted expression of emotions in interpersonal setting, beginning in early adulthood

Question 7

Definition of schizotypical personality disorder

Answer 7

Pervasive patterns of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as cognitive or perceptual distortion and eccentricities of behaviour, beginning by early adulthood

Question 8

Presentation of schizotypical personality disorder

Answer 8

Ideas of reference
Odd beleifs and magical thinking that influences behaviour
odd thinking and speech
Suspiciousness and paranoid ideation
innapropriate or constricted affect
odd, eccentric or peculiar appearance or behaviour
lack of close friends or confidants other than 1st degree relatives
excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears

Question 9

Summary and differences of cluster A PDs

Answer 9

Paranoid PD = persuasive distrust and suspiciousness of others
Schizoid PD = detatchments of social relationships and restricted emotions in IP settings
Schizotypical PD = Pervasive social and IP deficits, marked and acute discomfort at close relationships as well as cognitive or perceptual distortions and eccentricities of behaviour

Question 10

What is the most prominent problem with Cluster B PDs?

Answer 10

Keeping feels tolerable without acting

Question 11

Examples of cluster B personality disorders

Answer 11

Antisocial PD
Narcissistic PD
Borderline PD
Histrionic PD

Question 12

Definition of antisocial PD

Answer 12

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

Question 13

Symptoms of Antisocial PD

Answer 13

Failure to conform to social norms with respect to the law, repeatedly performing acts that are ground for arrest
Decitefullness, lying repeatedly, use of liases, or conning others for personal profit/pleasure
impulsivity or failure to plan ahead
irritability and aggressivefullness, as indicated by repeated physical fights or assaults
reckless disregard for the safety of others
consistent irresponsibility, with repeated failure to sustain consistent work behaviour or to honour financial obligations
lack of remorse showing by being indifferent or rationalising having hurt, mistreated or stolen from another

Question 14

What is a severe form of APD called?

Answer 14

Psychopathy

Question 15

Definition of borderline PD

Answer 15

A pervasive pattern of instability of interpersonal relationships, self image, and affects, with marked impulsivity, beginning in early adulthood

Question 16

Symptoms of borderline PD

Answer 16

Frantic efforts to avoid real or imagined abandonment
A pattern of unstable and intense interpersonal relationships characterised by altering extremes off devaluation and ideation
Identity disturbance
Persistently unstable self image or sense of self
Impulsivity in at least 2 of spending, sex, substance abuse, reckless driving, binge eating
Recurrent suicidal ideation or behaviour or self mutilating behaviour
affective instability due to marked reactivity of mood
chronic feelings of emptiness
innapropriate, intense anger or difficulty controlling it
transient stress related paranoid ideation or severe dissociative symptoms

Question 17

Definition of narcissistic personality disorder

Answer 17

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration and lack of empathy, beginning in early adulthood

Question 18

Presentation of narcissistic personality disorder

Answer 18

Grandiose of self importance 
Preoccupied with fantasies of unlimited success, power, brilliance, beauty and ideal love 
Believes they are special and unique 
has a sense of entitlement 
requires excessive admiration 
interpersonally exploitive
lacks empathy 
often envious of others/believes others are envious of them

Question 19

Definition of Histrionic personality disorder

Answer 19

Pervasive pattern of excessive emotionality and attention seeking, beginning in early adulthood

Question 20

Symptoms of histrionic PD

Answer 20

Uncomfortable in situations when they are not the centre of attention
Interaction with others is often characterised by inappropriate sexually seductive or provocative behaviour
Rapid shifting and shallow expressions of emotions
consistently uses physical appearance to draw attention to self
speech is excessively impressionistic and lacking in detail
shows self dramatization, theatricality and exaggerated expression of emotion
is suggestive (easily influence by others)
Considers relationships to be more intimate than they actually are

Question 21

What are the prominent problems with cluster C Personality disorders?

Answer 21

Anxiety and how it is managed

Question 22

What PDs are cluster C?

Answer 22

Obsessive compulsive (anankastic) PD
Avoidant PD
Dependent PD

Question 23

Definition of Obsessive compulsive PD

Answer 23

A pervasive pattern of pre occupation of orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning in early childhood `

Question 24

Presentation of obsessive compulsive PD

Answer 24

Preoccupied pattern of orderliness, perfectionism, mental or interpersonal control
Preoccupied with details, rules, lists, organisation to the extent that the major point of the activity is lost
Perfectionism that interferes with task completion
Excessively devoted to work and productivity to the exclusion of leisure activities and friendships
Overconscious, scrupulous and inflexible about matters or mortality, ethics or values
Unable to discard worthless or worn out objects even when no sentimental value
reluctant to delegate tasks unless they do it exactly how the person wants
miserly spending style
rigidity and stubbornness

Question 25

Definition of Avoidant PD

Answer 25

A pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation, beginning in early adulthood

Question 26

Symptoms of avoidant PD

Answer 26

Avoids occupational activities that involve significant interpersonal contact because of fears of disapproval, criticiscm and rejection
Unwilling to get involved with people unless certain of being liked
Restraint in intimate relationships because of fear of being shamed or ridiculed
Inhibited new interpersonal situations because of feelings of inadequacy
preoccupied with being criticsed or rejected in social situations
views self as socially inept, personally unappealing or inferior to others
Reluctant to take personal risks or do any new activities as they may prove embaressing

Question 27

Definition of dependent PD

Answer 27

A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, starting in early adulthood

Question 28

Symptoms of dependent PD

Answer 28

has difficulty making everyday decisions without excessive amounts of advice and reassurance from others
needs others to assume responsibility for major parts in their life
doesn’t disagree with others because of fear of loss of support or approval
cant initiate projects or do things on their own
goes to excessive lengths to obtain nuturence and support from others, to the point of volunteering to do things that are unpleasant
feels uncomfortable/helpless when alone
urgently seeks another relationship when a close one ends
Is unrealistically preoccupied with fears of being left to take care of themselves

Question 29

What directly influences PDs?

Answer 29

Pharmacotherapy

Question 30

When giving pharmacotherapy for a PD, what are you often treating?

Answer 30

A co morbid mental disorder

Question 31

Pharmacotherapy used in PDs

Answer 31

Dialetic behavioural therapy
Mentalisation based treatment
Symptomatic prescribing
Co-occurring mental illness

Question 32

What is an effective treatment for borderline PD?

Answer 32

Dialectal behavioural therapy

Question 33

What is dialectal behavioural therapy?

Answer 33

Targeted therapy which is CBT based, but has been adapted to help people who experience emotions very intensely