Personality Disorders Flashcards
Describe the key features of the epidemiology and clinical presentation of personality disorder Be aware of the different approaches used to classify personality disorder Understand the aetiology of personality disorder Understand the general principles that underlie the treatment of individuals with personality disorder
What is personality?
An enduring pattern of perceiving, relating to, and thinking about the environment and oneself - it makes an individual who they are
Define personality disorder
A set of personality traits that are pervasive, ingrained, maladaptive, and create significant functional impairment or subjective distress
Why is personality disorder not an illness?
It is not a change from the individual’s normal level of functioning
Define mental illness
An impairment of an individual’s normal cognitive, emotional, or behavioural functioning
State the ‘big five’ personality traits
Openness, conscientiousness, extraversion, agreeableness, neuroticism
Describe cluster A personality disorders, as defined by ICD-10
Characterised by oddness, eccenticity, preference of isolation and a limited number of close relationships. There is a tendency to introspection and fantasy and a suspiciousness of others
Name the 2 cluster A personality disorders, as defined by ICD-10
Paranoid and schizoid
Describe cluster B personality disorders, as defined by ICD-10
Characterised by flamboyance, dramatism, emotional instability, and aggressiveness towards self (sometimes others). There is a tendency to selfishness and irresponsibility
Name the 3 cluster B personality disorders, as defined by ICD-10
Emotionally unstable/ borderline, histrionic, dissocial/ antisocial
Describe cluster C personality disorders, as defined by ICD-10
Characterised by anxiety, prone, rigidity, and fear of new situations. There is a tendency to perfectionism and help-seeking
Name the 3 cluster C personality disorder, as defined by ICD-10
Anakistic/ obsessive-compulsive, anxious-avoidant, dependent
How did ICD-11 change the classification of personality disorder?
It removed all the categories and made it a single diagnosis, which could be mild, moderate, or severe
State the community prevalence of personality disorder
4% - with below 1% of cases severe
State the prevalence of personality disorder in the prison population
70-80%, with 50% of cases severe
Using the ICD-10 criteria, what was the difference in prevalence between cluster A and cluster B personality disorders?
Cluster B prevalence was higher in inner cities, whereas cluster A prevalence was higher in rural areas
Why might rates of personality disorder be more common in unstable countries? (Huang et al, 2009)
Difficulty in giving a child a consistent upbringing and childhood exposure to violence
What is the effect of personality disorder on life expectancy?
It reduces it by 18 years
What percentage of those who die by suicide have personality disorder?
40%
Name the four symptom domains of borderline personality disorder
Affective, cognitive, behavioural, interpersonal
State the 3 affective traits of borderline personality disorder
Inappropriate intense anger or difficulty controlling anger, chronic feelings of emptiness, affective instability
State the 2 cognitive traits of borderline personality disorder
Transient paranoid ideation or severe dissociative symptoms, identity disturbance
State the 2 behavioural traits of borderline personality disorder
Recurrent suicidal behaviour, threats, or self-mutilation; impulsively harmful acts other than suicidal behaviour
State the 2 interpersonal traits of borderline personality disorder
Frantic effort to avoid abandonment, unstable and intense interpersonal relationships
How did DSM-IV define antisocial personality disorder?
A pervasive pattern of disregard for and violation of the rights of others occurring since the age of 15
State some of the criteria for antisocial personality disorder in DSM-IV
Failure to conform to social norms of lawful behaviours, deception, impulsivity or failure to plan ahead, irritability and aggressiveness, reckless disregard for safety, consistent irresponsibility, lack of remorse
Why is it difficult to assess personality disorder?
Individuals tend to fluctuate and often show symptoms only for brief periods, some symptoms cause agitation or a lack of cooperation, there may be confounders e.g. comorbid mood disorders
Name a validated semi-structured interview for personality disorder
SCID, IPDE
What is the main predictor of criminal behaviour? (Bohman, 1996)
Alcohol abuse
Based on the Swedish adoption study, what is the risk of a child whose biological parents have a criminal record having a criminal record if their adoptive parents do not?
12%
Based on the Swedish adoption study, what is the risk of a child whose biological parents do not have a criminal record having a criminal record if their adoptive parents do?
7%
High levels of which big five personality trait are associated with criminal activity?
Openness - high levels of novelty seeking and low reward dependence
Are genetic or environmental factors thought to be more important in personality disorder?
Environmental
Name some environmental factors involved in personality disorder
Unstable family background, neglect, childhood physical or sexual abuse
What percentage of people with borderline personality disorder experienced childhood physical or sexual abuse? (Brodsky et al, 1995)
60%
Why might personality disorder be associated with attachment?
There is a great deal of overlap between the symptoms of personality disorder and insecure attachment
