Personality Disorders Flashcards
Stages of Personality Development : Which Age?
- take initiative
- Learns to plan their own activities
- Harsh scolding for poor initiatives → promotes feelings of being unworthy, guilty and/or resentful
3 to 6 years
- Often hostile, angry, and irritable
- Inability to relax, muscular tension, and a need to scan the environment for clues
- Manner is humorless and serious
- Speech is goal directed and logical in their arguments
Paranoid PD
Which personality factor?
- tendency for one to relate to other people in a friendly way
- Soft-hearted vs. ruthless
- Trusting vs. suspicious
- Helpful vs. uncooperative
Warmth (agreeableness)
Mnemonic for Paranoid PD
S – spouse is cheating suspected
U – unforgiving / bears grudges
S – suspicious of others
P – perceives attacks and reacts quickly
E – enemy in everyone → suspects associates, friends
C – confiding in others feared
T – threats seen in very benign events
Behavior pattern associated w/ a distorted world view
- One’s thoughts regarding one’s self
Intrapersonal relations
Which cluster? Which 3 types?
- Individuals may appear odd or eccentric
- Cluster A
- Paranoid
- Schizoid
- Schizotypal
- Culture group
- (personality traits valued in one culture may not be as highly valued in another)
- Parents/home environment directly impacts a child’s personality
- hate/anger
- happiness/politeness
Environment affecting a patient’s personality
Everyone in group is alike in some ways but also different
(which personality)
Group personality
Birth order:
- more affectionate/peacemakers
Middle born
- Of stable and long duration, onset traced back to at least adolescence or early adulthood
- Patter not explained as manifestation or consequence of another mental disorder
- Not due to physiological effects of substance (drug abuse, meds) or another medical condition (head trauma)
Personality Disorder
- Twin and adoption studies
- 50% of trait variation is due to genetic influences
Genetics as an influencing factor or personality
Stages of Personality Development : Which Age?
- Create and nurture
- Important for adults to stay productive and creative
40 to 65 years
How many disorders are divided into the 3 “clusters”?
10
Which personality factor?
- How much one likes being with other people
- Sociable vs. retiring
- Fun-loving vs. sober
- Affectionate vs. reserved
Extroversion
- Suspects others are exploiting/harming/deceiving him or her
- Doubts loyalty/trustworthiness of friends or associates
- Reluctant to confide in others, bc/ fear info will be used maliciously against him or her
- Reads hidden demeaning/threatening meanings into benign remarks
- Persistently bears grudges
4 or more indicates Paranoid PD
- Think of this as like a “skill”
- Each skill allows us to take on a different persona, assume a particular role, mask or face
- Important to have a set of skills to choose from
- At times we consciously transition from one to another → there are many instances in which these transitions occur subconsciously
Personality Style
•Expect belittling comments, accusations, and potentially litigious threats from these patients
Paranoid PD
What are the 3 influencing factors of personality?
- Genetic (hereditary)
- Environment
- Birth order
Of the personality disorders, which is rare and which is more prevalent in Normway compared to Germany, UK, and US?
- Internalization personality disorder
- Externalization personality disorder
Internalization = more prevalent
Externalization = rare
- This type of PD may result from early learning that people and the world is a dangerous place
- Comorbid disorders:
- MDD
- Substance abuse
- Agoraphobia
- OCD
- Borderline PD, Narcissistic PD
Paranoid PD
Which personality factor?
- how open-minded one is
- Imaginative vs. practical
- Preference for variety vs. preference for routine
- Independent vs. conforming
Openness
Stages of Personality Development : Which Age?
- development of trust
- Needs are met → learns to trust others
- Needs are not met → learns to mistrust and may become withdrawn
Birth to 18 months
Behavior pattern associated w/ a distorted world view
- One’s thoughts regarding one’s environment
Interpersonal relations
Stages of Personality Development : Which Age?
- search for identity
- Search for identity / sense of self
12 to 19 years
Which personality factor?
- Those who tend to be relaxed, secure, and calm even during difficult situations
- calm vs anxious
- secure vs insecure
- self satisfied vs self pitying
Emotional stability
An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.
Personality Disorder
Birth order:
achievement oriented
1st born
- Rarely present for treatment → early termination common
- Psychotherapy is the treatment of choice
- Individual client centered therapy focused on building rapport / counter negative thinking
Tx for Paranoid PD
Stages of Personality Development : Which Age?
- establish intimacy
- Establish close bonds with others
20 to 40 years
- Enduring patterns of perceiving, relating to, and thinking about the environment and oneself.
- Tendency to feel, perceive, behave, and think in relatively consistent ways across time and across situations in which the trait may manifest.
- levels can and do change over time
Ex: Anxious in circumstances in which most people would be calm and relaxed (high anxiety)
Personality traits
- unique and relatively stable behavior patterns
- Relatively enduring pattern of the thoughts, feelings and behaviors that distinguish one individual from another
- Emerges early in life and changes in meaningful ways throughout the lifespan
- Influenced by a multitude of personality traits
Individual personality
•We are all alike in some ways
(which personality)
Universal Personality
Stages of Personality Development : Which Age?
- development of independence
- Learns to do things on their own
- Failure to master promotes self-doubt
18 months to 3 years
Which personality factor?
- how responsible and self-disciplined one is
- Organized vs. disorganized
- Careful vs. careless
- Disciplined vs. impulsive
Conscientiousness
What are the 5 primary personality factors?
- Emotional stability
- Extroversion
- Openness
- Warmth (agreeableness)
- Conscientiousness
Individuals often appear anxious or fearful
•Avoidant, Dependent, Obsessive-Compulsive
Cluster C
Stages of Personality Development : Which Age?
- Look back on their lives
- Reflection and resultant acceptance or non-acceptance may influence changes
65 years +
- Fear that provider or others may harm them
- Misinterpretation of innocuous or even helpful behaviors
- Increased likelihood of argument or conflict with staff
Pt behavior of Paranoid PD
- Pharmacotherapy mainly used for agitation or anxiety
- Anti-anxiety agents for severe anxiety or agitation
•Buspirone (Buspar)
•Hydroxyzine (Vistaril)
•Clonazepam (Klonopin)
•Anti-psychotic medication such as haloperidol (Haldol) may be used if a patient decompensates into severe agitation or delusional thinking
Tx for Paranoid PD
- Defensive, argumentative, or angry response that “confirms” patient’s suspicions
- Ignoring the patient’s suspicious or angry stance
Provider behavior w/ Paranoid PD patient
Individuals often appear dramatic, emotional, or erratic
•Antisocial, Borderline, Histrionic, Narcissistic
Cluster B
Which 4 comorbid physical disorders are associated w/ personality disorders?
- Cardiovascular disease
- Arthritis
- Diabetes
- GI disorders
(all contribute to reduced life expectancy)
Stages of Personality Development : Which Age?
- skill development
- Strong skill development children feel competent → capable of achieving their goals
- Poor skill development children may feel like a failure
6 to 12 years
- Personality style: independent/vigilant
- Theme: distrust, suspicious of others
- Constantly on guard (believe society is hostile)
- Defensive
- Refuse responsibility for their own feelings, assign responsiblity to others
Paranoid PD
Birth order:
Risk taker/intellectual rebels
Last born
Individuals may appear odd or eccentric
•Paranoid, Schizoid, Schizotypal
Cluster A
- Cognition (i.e., ways of perceiving and interpreting self, other people, and events)
- Affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response)
- Interpersonal functioning
- Impulse control
Pt needs 2 or more of these to be dx w/ personality disorder accorindg to DMS 5
