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Personality Disorders Flashcards

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1
Q

What is required to make the diagnosis of a personality disorder?

A
  • a pattern of behavior that affects cognition, affect, personal relations, or impulse control
  • this must be pervasive and inflexible and present since adolescence
  • it must cause significant distress or functional difficulties
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2
Q

What are the cluster A, B, and C personality disorders and what features do those in the same cluster share?

A
  • A includes schizoid, schizotypal, and paranoid and is characterized by eccentricity and peculiarity
  • B includes antisocial, border, histrionic, and narcissistic and patients are emotional, dramatic, and inconsistent
  • C includes avoidant, dependent, and obsessive-compulsive and patients are anxious or fearful
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3
Q

In general, what is the treatment for personality disorders?

A

most are unresponsive to pharmacotherapy; instead psychotherapy is the preferred treatment modality and meds are used to treat comorbid disorders

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4
Q

What diagnosis would be appropriate: A 30 year old says his wife has been cheating on him because he does not have a good enough job to provide for her needs. He also claims that on his previous job, his boss laid him off because he did a better job than his boss. Refuses couples therapy because he believes the treater will side with his wife. Believes his neighbors are critical of him.

A

paranoid personality disorder

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5
Q

What diagnosis would be appropriate: A 45 year old scientist works in the lab most of the day and has no friends, according to his coworkers. Has not been able to keep his job because of failure to collaborate with others. He expresses no desire to make friends and is content with his single life. He has no evidence of a thought disorder.

A

schizoid personality disorder

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6
Q

What diagnosis would be appropriate: A 35 year old man dresses in a space suit every Tuesday and Thursday. He has computers set up in his basement to detect the precise time of alien invasion. He has no evidence of auditory or visual hallucinations.

A

schizotypal personality disorder

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7
Q

Describe paranoid personality disorder.

A

someone with pervasive distrust and suspicion of others, often interpreting motives as malevolent and frequently characterized by others as pathologically jealous

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8
Q

How is paranoid personality disorder differentiated from paranoid schizophrenia?

A

unlike patients with schizophrenia, patients with paranoid personality disorder do not have fixed delusions and are not frankly psychotic

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9
Q

What is the preferred therapy for paranoid personality disorder?

A

psychotherapy

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10
Q

Describe schizoid personality disorder.

A

the key feature is a lifelong pattern of social withdrawal; these patients are quiet, unsociable, and have a constricted affect; importantly, they have no desire for close relationships

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11
Q

How does schizoid personality disorder differ from avoidant personality disorder?

A

most important is that those with SPD have no desire for close relationships whereas those with APD have that desire

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12
Q

What is the preferred therapy for schizoid personality disorder?

A

psychotherapy

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13
Q

Describe schizotypal personality disorder.

A

these are patients with eccentric behavior and peculiar thought patterns; they often have magical thinking including a belief in clairvoyance or telepathy or odd superstitions; they often become involved in cults or strange religious practices

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14
Q

How does schizotypal personality disorder differ from paranoid schizophrenia?

A

those with schizotypal personality disorder are not frankly psychotic and do not have fixed delusions

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15
Q

What is the preferred treatment for schizotypal personality disorder?

A

psychotherapy

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16
Q

What is the appropriate diagnosis: A 30 year old unemployed man has been accused of killing three senior citizens after robbing them. He is surprisingly charming in the interview. In his adolescence, he was arrested several times for stealing cars and assaulting other kids.

A

antisocial personality disorder

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17
Q

What is the appropriate diagnosis: A 23 year old student attempted to slit her wrists because things did not work out with a man she had been dating over the past 3 weeks. She states that guys are jerks and not worth her time. She often feels that she is alone in the world.

A

borderline personality disorder

18
Q

What is the appropriate diagnosis: A 33 year old scantily clad woman comes to your office complaining that her fever feels like she is burning in hell. She vividly describes how the fever has affected her work as a teacher.

A

histrionic personality disorder

19
Q

A 48 year old CEO comes in after an accident. He does not let the residents operate on him and requests the chief of trauma surgery because he is vital to the company. He makes several business phone calls in the ED to stay on top of his game.

A

narcissistic personality disorder

20
Q

Describe antisocial personality disorder.

A
  • they are exploitive of others and violate the rights of others to meet their own needs
  • they lack empathy and compassion and are unremorseful but may appear charming
  • they must be at least 18 to make the diagnosis with a history of conduct disorder as a child
21
Q

What is the preferred therapy for antisocial personality disorder?

A

dialectical behavior therapy

22
Q

Describe borderline personality disorder.

A
  • they have unstable moods, behaviors, and interpersonal relationships
  • they fear abandonment and have a poorly formed identity
  • they often have a history of self-harm or suicide attempts
  • they often utilize splitting in which they view others as all good or all bad
23
Q

How does borderline personality disorder differ from bipolar II?

A

with borderline personality disorder, mood swings are moment-to-moment and in response to perceived environmental triggers, furthermore these patients don’t have the same tendency toward excessive spending or sexual activity

24
Q

What is the preferred therapy for antisocial personality disorder?

A

dialectical behavior therapy

25
Q

Describe histrionic personality disorder.

A
  • these individuals are attention-seeking and very emotional
  • they are dramatic, flamboyant, extroverted, and often sexually inappropriate
  • they are uncomfortable when not the center of attention
26
Q

What is the preferred treatment for histrionic personality disorder?

A

psychotherapy

27
Q

Describe narcissistic personality disorder.

A
  • these people have a pattern of grandiosity, need for admiration, and lack of empathy
  • they often have a fragile self-esteem despite their grandiosity
28
Q

How does narcissistic personality disorder differ from antisocial?

A

while both exploit others, narcissists want status and recognition while those who are antisocial want material gain or the subjugation of others

29
Q

What is the preferred treatment for narcissistic personality disorder?

A

psychotherapy with group therapy to help patients learn empathy

30
Q

What is the appropriate diagnosis: A 30 year old postal worker rarely goes out with her coworkers and often makes excuses when they ask her to join them because she is afraid they will not like her. She wishes to go out and meet new people but, according to her, she is too shy.

A

avoidant personality disorder

31
Q

What is the appropriate diagnosis: A 40 year old man lives with his parents and is having trouble deciding on how to go about having his car fixed. He calls his father at work several times to ask very trivial things. He has been unemployed over the past 3 years.

A

dependent personality disorder

32
Q

What is the appropriate diagnosis: A 40 year old secretary has been recently fired because of her inability to prepare some work projects in time. According to her, they were not in the right format and she had to revise them six times, which led to the delay. This has happened before but she feels that she is not given enough time.

A

OCPD

33
Q

Describe avoidant personality disorder.

A

these patients have a pervasive pattern of social inhibition and fear of rejection and avoid situations in which they may be rejected; they desire companionship but are extremely shy and have feelings of inadequacy

34
Q

How does avoidant personality differ from social phobia?

A
  • if the symptoms are integral to the patient’s personality and have been evident since before adulthood, personality disorder is more likely
  • social phobia involves a fear of embarrassment whereas those with avoidant personality disorder are fearful of rejection and have a sense of inadequacy
  • patients can have both
35
Q

What is the preferred treatment for avoidant personality disorder?

A
  • psychotherapy, including assertiveness training

- beta blockers can be used to control autonomic symptoms of anxiety

36
Q

Describe dependent personality disorder.

A
  • these patients have poor self-confidence and fear separation
  • they have an excessive need to be taken care of and need others to make decisions for them
  • they will urgently seek another relationship when one ends
37
Q

What is the preferred treatment for dependent personality disorder?

A

psychotherapy, particularly group and social skills training

38
Q

What is the preferred treatment for each:

  • paranoid personality disorder
  • schizoid personality disorder
  • schizotypal personality disorder
  • antisocial personality disorder
  • borderline personality disorder
  • histrionic personality disorder
  • narcissistic personality disorder
  • avoidant personality disorder
  • dependent personality disorder
  • obsessive-compulsive personality disorder
A
  • paranoid: psychotherapy
  • schizoid: psychotherapy
  • schizotypal: psychotherapy
  • antisocial: DBT
  • borderline: DBT
  • histrionic: psychotherapy
  • narcissistic: psychotherapy and group therapy
  • avoidant: psychotherapy and assertiveness training
  • dependent: psychotherapy with group and social skills training
  • obsessive-compulsive: psychotherapy
39
Q

How does narcissistic personality disorder and OCPD differ from one another?

A

narcissists are driven by status and recognition while OCPD patients are motivated by the work itself

40
Q

What is the preferred treatment for OCPD?

A

psychotherapy

Psych (17 decks)

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