Personality Disorders

Question 1

Define ‘personality disorders’:

Answer 1

Long lasting rigid patterns of thought, affect and behaviours which are not attributed to an organic, cultural or religious source.

Question 2

According to the ICD-10 definition, what are the criteria to be diagnosed with a personality disorder?

Answer 2

• Characteristic and enduring
• Inflexible, maladaptive, dysfunctional behaviours
• Stay consistent through mood changes
• can be traced back to childhood
• social disadvantaging or personally distressing
• Not due to organic source or a pre-existing mental health problem

Question 3

According to the DSM-IV criteria, what personality types come under Class A?

Answer 3

(Mad)
Schizoid
Paranoid

Question 4

According the DSM-IV criteria, what personality types come under class B?

Answer 4

(Bad)
Dissocial
Histrionic
emotional –> impulsive or borderline

Question 5

According to the DSM-IV criteria what personality types fall under cluster C?

Answer 5

(Sad)
Anxious/avoidant
Dependent
Anankastic (obsessive)

Question 6

List some of the criteria for diagnosing a dissocial personality disorder:

Answer 6

(must have at least 3)
Callous lack of concern for others
Cant maintain relationships
Irresponsible - no regard for social norms
Lack of guilt / failure to modify behaviours
Low frustration tolerance / violent
Blames others or rationalises their behaviour

Question 7

What reflex is used to diagnose dissocial PD?

Answer 7

Defensive startle reflex / blink response

Showing the patient positive and negative image stimuli - patient will have reflex inhibition (ie will not react)

Question 8

Patients with dissocial PD may also be referred to as _________?

Answer 8

Psychopaths
More extreme version of dissocial behaviour
Will have deficits in the aversive motivational system

Question 9

What following features are used to diagnose the impulsive emotionally unstable PD:

Answer 9

Must have at least 3:

• unpredictable
• quarrelsome
• explosive
• desultory
• capricious

Question 10

Define capricious:

Answer 10

Sudden changes in mood or behaviour for no reason

Question 11

Define desultory:

Answer 11

Lacking emotion or motivation

Question 12

List the criteria for diagnosing a borderline emotionally unstable PD:

Answer 12

Must have at least 3 from impulsive and then 2 from the following:

• Poor self image
• relationship crisis
• Fear of abandonment
• Self harm
• Feelings of emptiness

Question 13

What is a major risk factor for developing borderline personality disorder:

Answer 13

Physical or sexual abuse from a young age

especially if associated with a family member/loved one

Question 14

List the features of Anankastic/obsessive personality disorder which are essential for diagnosis:

Answer 14

Four of the following to diagnose:

• Cautious
• Orderliness
• Conscientiousness
• Productivity
• Pedantic
• Rigid
• Martinet

Question 15

Define martinet:

Answer 15

This is a person who demands strict obedience / discipline

Question 16

List some of the features used for diagnosing narcissistic personality disorder:

Answer 16

At least 5 of the following:

• Grandiose
• High ideals
• Self opinionated
• Needs admiration
• Expects privileges
• Exploits others
• lacks empathy
• Envy
• Arrogant

Question 17

What are the options for pharmaceutical treatments of personality disorders?

Answer 17

Short term antipsychotics

• useful for symptoms more so than a specific PD
• can be useful in borderline

Mood stabilisers:

• lithium
• carbamazepine

Antidepressants:
- SSRI’s

Question 18

What anti-depressants are thought to worsen borderline personality disorder?

Answer 18

Tricyclic Antidepressants